Owners should try rest first for a dog with a cruciate ligament injury because restricted activity often reduces pain and inflammation naturally. It allows the joint to stabilise through scar tissue formation, helping some mild or partial tears heal without surgery and providing a clearer picture of long-term treatment needs.
Treatment of Cruciate Ligament Injury in Dogs
A cruciate ligament injury in a dog is a common orthopaedic issue that can significantly impact their mobility and quality of life. The cruciate ligament stabilises the knee joint, and when torn, causes pain, swelling and lameness. Without proper treatment, this condition can lead to arthritis and long-term joint damage. Early diagnosis and consultation with a vet are essential to develop an effective treatment plan that’s tailored to the dog’s needs and that’s aimed at securing a return to a comfortable, active life.
Treatment of cruciate ligament injuries are often associated with a surgical technique called TPLO. At Elizavet, we welcome TPLO referrals from first opinion practices and pet owners looking for better value. Our collaborative approach deploys seamless communication, detailed case updates and shared care protocols to deliver good outcomes for every TPLO referral. You can read more about what we have to offer below.
Common questions about torn cruciate ligaments
Can a dog live comfortably with a torn cruciate ligament?
A dog with a torn cruciate ligament can live a long life, but their quality of life largely depends on the care they receive for their injury. Such an injury causes pain, joint instability, and difficulty moving, which can worsen without proper treatment. Consulting a vet is crucial to determine the most appropriate course of action.
Only an expert can assess the severity of the injury and recommend tailored solutions to relieve pain and improve mobility. Ignoring the issue or attempting unqualified treatments may exacerbate the condition.
How can you tell if a dog’s cruciate ligament is damaged?
There are several signs that indicate pain and instability in a dog’s knee joint. Here are some common symptoms.
- Difficulty rising or sitting: they might have trouble standing or sitting , often with an abnormal posture, to compensate for discomfort.
- Limping or lameness: the dog may favour one leg, especially after exercise. They may avoid putting weight on the affected limb.
- “Toe touching” behaviour: your dog might stand with the affected leg slightly off the ground or just touch it lightly for balance.
- Clicking sounds: you may hear a clicking noise from the knee joint during movement, indicating instability.
- Reduced activity: a reluctance to run, jump, or play can signal that something is wrong.
- A swollen knee: the joint may appear swollen or feel warm to the touch.
If any of these signs are observed, it’s essential to consult a vet promptly. They can perform a physical examination, assess the joint’s stability or recommend imaging, such as X-rays, to confirm the diagnosis. Early intervention is key to preventing further damage and ensuring good outcomes.
What is the most appropriate treatment for a dog’s cruciate ligament injury?
Once it has been confirmed that there is an issue there are four options for treating cruciate ligament injury in dogs…
1. Rest
2. Weight management
If rest doesn’t resolve a cruciate ligament injury, weight management is the next crucial step. Excess body weight increases stress on the damaged joint, delaying healing and worsening pain. Helping a dog reach a healthy weight reduces pressure on the knee, improves mobility and enhances the effectiveness of further treatments.
3. Physical therapy & medical treatment
After rest and weight management, physical therapy or medical treatment can be the next step for managing a dog’s cruciate ligament injury, before considering surgery. This approach may suit older, inactive, or higher-risk dogs under 15 kg. It combines anti-inflammatory medication, a strict diet, and controlled exercise to reduce pain and support healing. Physiotherapy and hydrotherapy can help restore mobility and strengthen surrounding muscles, promoting better function and comfort. However, maintaining joint stability is essential to avoid further damage or the progression of osteoarthritis. This non-surgical route is generally unsuitable for younger, more active dogs who typically place greater strain on joints.
4. Surgical treatment
If rest, weight management, medication and physiotherapy have not had the desired outcomes you can consider various surgical techniques to stabilise the stifle joint. Common procedures involve modifying joint biomechanics by cutting the top of the tibia.The three main TPLO procedures we may recommend are…
Tibial plateau level osteotomy (TPLO)
The aim of this surgery is to stabilise the stifle joint by modifying its biomechanics. A flattening of the tibial plateau is achieved by making a circular incision on the top of the tibia (an osteotomy). The top bony fragment is then rotated and fixed with plates and screws. The amount of rotation is measured using high-quality radiographic images taken prior to the surgery. We always use a high-quality locking plate system, which helps reduce post-operative complications.
Once the slope is no longer present, the knee will no longer require the cranial cruciate ligament to stabilise the leg as it bears weight. A meniscus inspection is always performed as a routine procedure before executing a bone cut. Meniscus treatment is undertaken in case of additional injury.
Closing wedge osteotomy (CWO)
The aim and the mechanics of this procedure are exactly the same as the TPLO. The main difference is that a wedge of bone is removed from the tibia to achieve a flat tibial plateau. This will lead to a shortening of the leg.
Tibial tuberosity advancement (TTA)
The aim of this surgery is to modify the biomechanics of the joint by making a vertical straight cut on the top and front of the tibia. The tibial front fragment is pulled forward and secured with a metallic cage, plate, and screws. The goal of the advancement of the tibial crest is to modify the angle between the patellar tendon and tibial plateau (top of the tibia). The stability of the joint is achieved when the tibial plateau has an angle of 90 degrees with the patellar tendon.
What areas do you accept TPLO referrals from?
We commonly receive surgical TPLO referrals from vets and pet owners in Camden, Kilburn and Hampstead as well as surrounding areas such as; West Hampstead, Belsize Park, St John’s Wood, Maida Vale, Queens Park, Primrose Hill and Marylebone. We’re happy to accept referrals from vets and pet owners across Greater London and beyond who are looking for good value surgical treatment of cruciate ligament injury in dogs.
More information about cruciate ligament injuries
The cranial cruciate ligament in dogs
In dogs the cranial cruciate ligament is the same as the “anterior” cruciate ligament (ACL) in humans. The canine CCL, situated within the stifle (knee joint), connects the tibia (shin bone) to the femur (thigh bone) and serves a mechanical function. It stabilises the joint during flexion and extension, preventing forward movement of the tibia (cranial drawer movement) and limiting rotation and hyperextension.
When bodyweight compresses the femur and tibia, the absence of a healthy cranial cruciate ligament results in rolling between the bones, causing forward tibia movement and backward femur rolling.
The menisci
The menisci, two fibro-cartilage discs within the stifle joint, act as shock absorbers. They are positioned on the inside and outside of the knee, between the femur and tibia.
Rupture of the cranial cruciate ligament
Often caused by slow ligament degeneration, a ruptured cranial cruciate ligament leads to joint instability, lameness, pain, and potential meniscal injuries. The loss of the ligament’s mechanical function results in a cranial drawer movement during exercise. This causes pain and increases the risk of meniscal injury. The absence of mechanical function also leads to the tibia pushing forward as it bears weight, which can contribute to the occurrence of osteoarthritis.
Complications and why we prefer TPLO
The complication rate is generally low for all procedures. Infections are common but manageable with antibiotics. Deep infections following TPLO may require plate removal, whereas Lateral Fabella Suture and TTA may involve more complex procedures. Late meniscal injuries are possible, with varying rates for each surgery type. TPLO, despite its complexity, exhibits a lower complication rate and easier infection management. With TPLO, osteoarthritis progression is minimal compared to untreated joints
TPLO surgery limits osteoarthritis progression
While the goal is joint stability and a lameness-free patient, all surgical methods result in minimal osteoarthritis progression. That said, surgical treatment significantly reduces osteoarthritis compared to untreated joints.