Rupture of the cranial cruciate ligament (CrCL) is one of the most common orthopedic problems seen in veterinary medicine, and between medication, rehab, surgery and other items, billions of dollars are spent annually on CCL disease and associated arthritis treatment. The cranial cruciate ligament is one of the most important stabilizers of a dog’s knee. In humans, this same ligament is called the anterior cruciate ligament (ACL).
Unlike humans, in which an ACL tear is always a traumatic injury, research suggests that for many of our patients, CrCL is a disease that involves progressive weakening of the ligament. Most dogs that have CrCL disease of one leg will develop disease of the other CrCL as well. Dogs with excessive weight may be more prone to these issues.
How can you tell if your pet has CrCL disease? If your dog has difficulty rising or jumping or shows pain and resistance to exercise, a trip to the veterinarian or orthopedic specialist is in order. Other symptoms include limping or loss of muscle of the hindlimb, decreased range of motion or a popping noise in the knee.
An orthopedic specialist can confirm a CrCL rupture through an examination and x-rays, which also can spot increased fluid in the joint or signs of arthritis. Doctors also may use advanced diagnostics such as ultrasounds or MRIs, but those are rarely needed to achieve a diagnosis.
Surgery is usually the best treatment for CrCL disease because it’s the only way to permanently control the instability present in the knee joint. The goal of surgery isn’t to repair or replace the CrCL, but to eliminate that instability and the pain that accompanies it.
Surgical options include suture techniques, which are effective for dogs less than 40-50 pounds and cats. Larger dogs tend to show better results with bone cut (osteotomy) techniques.
For some dogs, surgery isn’t the best option. If your pet has a bleeding disorder, terminal disease, or is a high anesthetic risk because of cardiac, respiratory or other conditions, you might want to choose conservative therapy. This treatment often includes pain management, weight management and physical therapy, along with supplements such as glucosamine. Non-surgical therapies, which usually take 4-6 weeks, can be effective for dogs less than ten pounds and cats.
For clients who choose surgery, careful post-operative care and follow-up is critical for success. Studies have shown that physical rehabilitation can speed recovery and improve final outcomes regardless of the surgical technique. The rehabilitation, which usually takes 8-12 weeks, can start within a couple days of surgery. Your CARE surgeon will provide you a detailed guide for at-home therapy.
The good news: The long-term prognosis for animals undergoing surgical stabilization is encouraging, with patients often regaining 90 to 95 percent of knee function. That’s more than enough to make those early morning walks something both you and your pet can look forward to again.