Cranial Cruciate Ligament Rupture in Your Pet
Cranial cruciate ligament rupture is the most common orthopedic injury in dogs, especially large and giant breeds such as labs, rottweilers, golden retrievers etc. This type of injury can be chronic in nature from day-to-day wear and tear, or acute, from intense physical activity.
How can I prevent cruciate rupture in my dog?
Keeping your dog fit and the appropriate weight is a great way to prevent cranial cruciate rupture. Veterinarians are still not 100% sure what causes cruciate rupture, but they have identified being overweight as a significant risk factor. Other contributing factors are: breed, inactivity with occasional strenuous activity, and straight conformation in the hind limbs. These factors cause degeneration or weakening of the ligament fibres and eventually result in rupture of the ligament. In dogs who have had a cranial cruciate ligament rupture, it is very common for the other cranial cruciate (other leg), to rupture within 1-2 years.
If your dog has ruptured a cruciate, you will know immediately because the joint will become very swollen, and the dog will be unable to bear weight on that limb. It is important to contact your veterinarian immediately for an appointment to properly diagnose the problem and determine a plan of management. Partial tears are often difficult to diagnose and present as occasional lameness that comes and goes. When a tear is partial, surgery is not typically indicated and will respond well to anti-inflammatory medications and physical therapy or chiropractic.
If your veterinarian has diagnosed your dog with a complete tear of the cranial cruciate ligament it is likely that surgery will be recommended. It is important to discuss the different surgical options with your veterinarian. Extracapsular surgical repair (ESR) also known as “Tightening” procedures (ECR) involve using heavy nylon sutures to mimic the function of the cranial cruciate ligament and will likely return your pet to approximately 80% function. This is often used in cats or toy breed dogs. Other surgical options include the Tibial Plateau Leveling Osteotomy (TPLO), Tibial Tuberosity Advancement (TTA), and the Modified Maquet Procedure (MMP). The TPLO surgery involves shaving off the top surface of the lower leg bone (tibia) in order to stabilize the joint and prevent too much extension of the stifle. The TTA involves shifting the tibial tuberosity with the goal of changing the angle of the stifle joint. This altered angle neutralizes the forces on the stifle joint and leaves the tibia intact so that your pet can bear weight on the affected leg shortly after surgery. The MMP is a variation of the TTA procedure, with smaller incisions and faster return to function for your pet.
So what does the research say about the best option for cranial cruciate repair in your pet? If you have a large or giant breed dog, veterinarians suggest that the TPLO surgery is the best option and this is supported by the research. For small pets such as cats or toy breed dogs the “tightening” procedures are considered the most successful and appropriate.
Chiropractic care and physical therapy are also important aspects of the healing process. Once your pet has undergone surgery to repair the stifle, it is crucial that they have the injury properly rehabilitated in order to return to optimal function. Often times, these injuries can result in compensatory changes of the other hind limb and altered movement patterns in the spine. Chiropractic care helps to balance tight muscles and correct for biomechanical changes.
When dealing with a pet who has had a cranial cruciate ligament rupture, it is important to
discuss all of your treatment options with your veterinarian and come up with a plan that is most appropriate for your animal. A combination of surgical intervention and conservative care such as chiropractic or physical therapy, will help improve your pet’s quality of life and restore function.