Often referred to as a dog’s ACL or ‘cruciate’, your dog’s cranial cruciate ligament (CCL) is a connective tissue that joins the shin bone to the thigh bone. This can be painfully torn or injured. In this post, our Baltimore vets discuss three options for ACL surgery in dogs.
What is the ACL, CCL or Cruciate?
In a human’s knee lies a thin piece of connective tissue called the anterior cruciate ligament (ACL) connecting our lower leg bone (tibia) to our upper leg bone (femur). This helps our knee to function efficiently. A dog also has tissue connecting their tibia and femur, but in dogs this tissue is known as the cranial cruciate ligament or CCL.
While a dog’s CCL and a person’s ACL function somewhat differently, veterinarians and pet owners will often refer to a canine’s cranial cruciate ligament as an ACL, CCL or ‘cruciate’ interchangeably.
How did my dog’s ACL get injured?
In dogs, ACL injuries typically occur gradually rather than suddenly and grow progressively worse with activity. There is no defining moment when an ACL is suddenly injured for many dogs. Instead, it is more likely that symptoms that began as mild gradually become more pronounced and painful as your dog continues to exercise.
What are the signs of ACL injuries in dogs?
If your dog is suffering from a torn ACL, they will experience significant pain and be unable to walk normally. You may also notice they are having difficulties rising or jumping from the floor, a limp in their hind legs, or symptoms of stiffness after exercise.
What happens when a dog’s ACL is injured or torn?
If a dog’s ACL is injured, the tibia will slide forward in relation to the femur. This forward sliding movement is called ‘positive drawer sign’ and leads to instability in the knee. This can cause damage to the surrounding bones and cartilage or osteoarthritis.
Which treatments are available for a torn ACL in dogs?
If your dog is displaying signs of an ACL injury, it’s imperative to book an appointment with your vet right away to have the condition officially diagnosed. Surgical treatment is required before symptoms become more severe. You should beware that many dogs with one ACL injury will often go on to injure the other leg soon after.
Surgery Options for Treating ACL Injuries in Dogs
Extracapsular Lateral Suture Stabilization - ELSS / ECLS
This surgical treatment works by counteracting the sliding forward of the dog's shinbone ('tibial thrust') with a specifically placed suture.
The sliding motion of tibial thrust is caused by the transmission of weight up the dog's tibia and across the knee, causing the tibia to “thrust” forward in relation to the dog's femur (thigh bone). This forward thrust movement occurs because the top of the tibia is sloped, and the dog's injured ACL which would normally able to oppose the forward force, is no longer able to prevent the unwanted movement from occurring.
Extracapsular Lateral Suture Stabilization corrects tibia thrust by “anchoring” the tibia to the femur with suture placed by your dog's surgeon. The suture stabilizes the dog's knee by pulling the joint tight and preventing the front-to-back sliding of the tibia so that the ACL has an opportunity to heal itself, and the muscles surrounding the knee have a chance to regain their strength.
ELSS surgery is fairly quick and uncomplicated with a good success rate in small to medium sized dogs. ELSS surgery can also be less expensive than other ACL surgical treatment options. Long-term success of ELSS surgery varies in dogs of different sizes and activity levels. Speak to your vet to find out if ELSS surgery is an option for your injured dog.
Tibial Plateau Leveling Osteotomy - TPLO
The next surgical option we'll look at for treating your dog's injured ACL is the tibial plateau levelling osteotomy (TPLO). This surgery is more complicated than ELSS surgery and aims to reduce tibial thrust without relying on the dog's ACL (CCL).
This surgery involves making a complete cut through the top of the tibia (tibial plateau), then rotating the tibial plateau in order to change its angle. Finally a metal plate is added to stabilize the cut bone as it heals. Over the course of several months, your dog's leg will gradually heal and strengthen.
Full recovery from TPLO surgery in dogs takes several months however some improvement can be seen within just days of the procedure. Following your vet's post-surgery instructions and restricting your dog's activities, are essential for successful healing. TPLO surgery in dogs has a good long-term prognosis, and re-injury is uncommon.
How long will it take for my dog to recover from ACL surgery?
Some dogs recover more quickly than others following ACL surgery however, recovery from a torn ACL is always a long process!
Many dogs are able to walk as soon as 24 hours after surgery, but a full recovery and a return to normal activities will take 12 - 16 weeks or possibly longer.
It is essential to follow your vet's instructions and pay attention to your dog's healing progress. It's important not to rush exercise following ACL surgery. Never force your dog to do exercises if they resist as this can lead to re-injuring the leg.
Note: The advice provided in this post is intended for informational purposes and does not constitute medical advice regarding pets. For an accurate diagnosis of your pet's condition, please make an appointment with your vet.