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Cranial Cruciate Ligament (CCL) Surgery in Dogs

Ruptures of the cranial cruciate ligament (CCL) are common orthopedic injuries in dogs. Our veterinarians in Somerset explain the injury and the CCL surgery process that is likely necessary for your dog.

What is a CCL?

The CCL is a connective tissue of the knee that connects and stabilizes the lower leg to the upper leg. It connects the dog's tibia to the femur above and, when torn, results in partial or total joint instability, pain, and immobility. CCL ruptures result from a tear in the cranial cruciate ligament (CCL) in the dog's stifle (knee), equivalent to the ACL in humans.

How to Identify a CCL Injury

Regarding CCL tears in dogs, 80% of cases are chronic onset ruptures caused by degeneration and usually occur due to aging. This is most commonly seen in dogs aged five to seven.

Acute onset ruptures are most commonly seen in dogs four years old or younger. These tears are caused by injuries that a dog sustains while running around living their daily lives.

Symptoms of a CCL rupture may include:

  • Crepitus (crackling noise of bones rubbing against each other)
  • Decreased range of motion
  • Hind leg extension while sitting
  • Pain when the joint is touched
  • Lack of motivation to exercise
  • Irritability
  • Restricted mobility
  • Stiffness after exercising
  • Swelling/Inflammation
  • Thick/firm feel of the joint
  • Weight shifted to one side of the body while standing
  • "Pop" sound when walking

If you notice any of the listed symptoms above, contact your vet and schedule an examination for your dog. 

Non-Surgical Treatment

If your dog is under 30 pounds and has a CCL injury, there is a chance that they can recover without the need for surgery. This can be achieved through adequate rest, anti-inflammatory medication, and physical rehabilitation. However, the success of this approach depends on your pet's size, overall health, and the severity of their injury. Your veterinary surgeon is the best person to advise you on the most suitable course of action for your dog.

Treatment Via Surgery

Canine cruciate ligament (CCL) surgery is the most frequently performed orthopedic surgery on dogs, accounting for approximately 85% of all such surgeries carried out every year. Given the high incidence of this type of injury, numerous surgical techniques have been developed over the years to repair the ligament.

Each technique has its own advantages and disadvantages, so it is essential to discuss the options with your veterinarian to determine which procedure would be most suitable for your dog's specific condition. Below are some of the most common methods used to repair a CCL injury.


Arthroscopy is the least invasive way of visualizing the structures of the stifle, the cranial and caudal cruciate ligaments. This technique enables better visualization and enlargement of joint structures. The technology developed for this procedure allows for minimal surgical incisions for partial tears of the CCL and meniscus. This method is not always feasible for completely torn ligaments.

Lateral Suture or Extracapsular

Often recommended for small and medium-sized dogs, this surgery stabilizes the stifle (knee) with sutures placed on the outside of the joint. It is one of the most frequent surgical procedures for this type of injury and is generally performed on dogs weighing less than 50 pounds.

TTA (Tibial Tuberosity Advancement)

TTA is a method of surgery that corrects the need for the CCL by cutting the top of the tibia, moving it forward, and stabilizing it in its new position using a plate. Therefore, the goal with TTA is to replace the ligament entirely rather than repair it.

TPLO (Tibial Plateau Leveling Osteotomy)

TPLO surgery is becoming increasingly popular and is the best option for larger dog breeds. The procedure entails cutting and leveling the tibial plateau. From there, the surgeon stabilizes the tibial plateau using a plate and screws. This surgery also eliminates the need for the ligament.

Post-Op Recovery

Whichever operation is used to repair the ligament, the care your dog receives after the operation will determine its success. The first 12 weeks after surgery are a crucial period for recovery and rehabilitation. Limiting exercise and encouraging your dog to start using his paw are the keys to a successful recovery.

Two weeks after the operation, you can gradually increase the duration of your dog's walks on a leash.

By the eight-week mark, your dog should be able to take two 20-minute daily walks and perform some of his basic daily activities.

Ten weeks after the operation, your veterinarian will take X-rays to assess bone healing. Your dog will gradually be able to resume normal activities. At Midway Veterinary Hospital, we recommend a rehabilitation program to optimize your dog's recovery.

Whichever rehab center you visit should have experience in post-operative rehabilitation of orthopedic injuries such as TPLO.

Some dogs have also achieved positive results with acupuncture and laser therapy.

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.

Is your dog showing signs of a CCL tear? Contact our Midway Veterinary Hospital vets and book a consultation today

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Are you looking for a new vet in the Somerset area? Midway Veterinary Hospital is accepting new patients! Get in touch today to book your pet's first appointment.

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