Full Title: Cruciate Ligament Injury In Dogs
Author: Shawney Geisinger
Date of Publication: January 30, 2013
Research Paper Text:
The cruciate ligament tear, also known as an ACL or CCL, is one of the most common injuries in a dog. The cruciate ligament is a major part of a canine knee. Although this injury is not life threatening it is very important that it be addressed by a veterinarian, since this injury is very painful and will almost always require repair.
A canine’s knee, or stifle, is an intricate joint comprised of the patella, cartilage called the menisci and a series of ligaments connecting the femur to the tibia. Because the stifle is such an intricate joint it can be easily injured by a canine with the simple movement of running, or twisting and slipping on a floor is often the cause of this injury. Labradors and Rottweilers are the most common breeds for acquiring a cruciate tear, although it is an injury that can happen to any breed. Any canine that is overweight or obese is more susceptible to a cruciate tear.
Symptoms of a canine ACL tear are decreased range of motion, hind leg extended straight when sitting down, exercise intolerance. Other symptoms may include stiffness and limping, knee joint is swollen and there is heat radiating from the joint. Also, when standing a dog might only distribute weight on the toes instead of using the entire foot.
The function of the cruciate ligament in dogs is to stop the femur and the tibia from rubbing against one another. When the cruciate ligament is torn or ruptured the leg losses stability because the bones are now free to move back and forth on top of each other. This will cause inflammation due to the friction caused by the rubbing. This can also lead to arthritis.
There are acute and chronic cruciate ligament injuries. A chronic cruciate ligament injury can be associated with age and age related degenerative issues. When a canine is overweight its chances of acquiring a cruciate tear are greatly increased. Also the conformation of the knee can lead to chronic cruciate injury. Some large breed dogs are more prone to these types of injuries simply because of the way the back legs are formed. Acute cruciate injury is due to a sudden trauma of the joint, such as jumping, slipping or any type of jerking motion.
There are several types of surgery for dogs with an ACL tear. For small dogs, weighing 20 pounds or less, a ‘Lateral Suture’ or ‘Extracapsular Repair’ may be recommended because with this procedure a small dog may regain normal use of their leg in 8-14 weeks without too much risk of complications. This procedure is also the most traditional repair. A figure eight pattern is used to suture a strong lead line around the knee to provide stability and to help keep the knee in position.
For larger dogs a procedure called ‘Tibial Tuberosity Advancement’ (TTA) is often recommended. With this surgery the all the focus is on changing the angles of the bones within the knee joint. With this surgery the tibia is cut and moved forward to create more stability in the joint. A bone plate is used to hold the joint in this position. The bone plate can be removed after the joint has healed.
Another procedure used is the ‘Tibial Plateau Leveling Osteotomy’ (TPL). With this surgery the slope of the tibial plateau is adjusted by cutting and rotating the top of the tibia, this position is also kept in place with a bone plate.
A procedure called ‘Triple Tibial Osteotomy’ (TTO) is a combination of the TPLO and TTA techniques. It moves the tibial crest forward and also adjusts the tibial plateau to 90 degrees.
The ‘Tightrope Surgery’ is technique that uses lateral suture stabilization procedure in conjunction with a material called Fiber Tape to provide bone to bone stabilization.
With the ‘Fibular Head Transposition’ the fibular head utilizes another ligament in the knee, the lateral collateral ligament, to take the place of the CCL. The fibula is rotated so that the lateral collateral ligament can perform the function of the CCL.
After any cruciate tear ligament surgery the main concern is for the dog to have minimal use of the limb. The dog should be limited to a crate or small room when the owner is not with the dog. All outdoor time and potty time should be supervised and on a lead only. A cone collar is also useful during this healing process. A regular checkup at the vet will most likely be scheduled for 2 weeks, 4 week, 6 weeks and 8 weeks. The healing time for any ACL surgery will be 6 -14 weeks. It is also very important during the 3 months of healing that the home be post-surgery proofed, such as decreasing the chances of the dog slipping or jumping. Stairs can be especially dangerous for a dog healing from ACL surgery, and should be used with extreme caution or blocked off all together.
During the recovery time massage is an excellent idea. Massage would not be performed to the surgical area, but instead to all other areas of the dog’s body. Keeping good circulation during the healing process is important because the dog will be limited to the amount of activity it is able to perform.
In conclusion a crutiate tear can occur to any dog at almost any time. It is an injury that needs medical attention, but also an injury that can be very successfully treated, bringing the body back to a state of homeostasis.
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