The dog's cranial cruciate ligament (CCL) is frequently referred to as the dog's ACL or 'cruciate'. This connective tissue joins the upper and lower leg bones at the dog's knee and may become injured. Today, our Ruckersville vets explain the three main ACL surgeries for dogs.  

ACL, CCL, or Cruciate - What is it?

The anterior cruciate ligament (ACL) is a thin piece of connective tissue in the human knee. It connects the lower leg bone (tibia) to the upper leg bone (femur) and plays a crucial role in the knee's functionality. In dogs, the cranial cruciate ligament (CCL) is the connective tissue that joins their tibia and femur. 

Pet owners and veterinarians often use different terms to refer to the cranial cruciate ligament in dogs, which is equivalent to the ACL in humans. These terms include ACL, CCL, or simply 'cruciate'.

How did my dog hurt their ACL?

Dogs typically experience a gradual development of ACL injuries, which tend to worsen with increased activity. Your dog's ACL injury may not have a clear moment of occurrence, but as they continue to exercise, they will experience an increase in the severity and pain of their symptoms.

What are the signs that my dog has injured their ACL?

Dogs suffering from ACL injuries experience difficulty walking and endure discomfort. You may observe your dog limping in its hind legs, experiencing stiffness after exercise, and struggling to rise off the floor or jump if they have injured their ACL.

How are ACL injuries in dogs treated?

It is crucial to take your dog to a vet for a proper diagnosis and treatment if you suspect an injured ACL.

If your dog's ACL is torn or injured, the tibia (lower leg bone) will slide forward in relation to the femur (thigh bone). The 'positive drawer sign' movement causes knee instability, which can result in cartilage and bone damage, as well as osteoarthritis.

There are several surgical treatments available for ACL injuries in dogs:

Extracapsular Lateral Suture Stabilization - ELSS / ECLS

The surgery for a torn ACL in dogs addresses the issue of 'tibial thrust' by utilizing a strategically placed suture to prevent the sliding forward of the dog's tibia.

When a dog's ACL is torn or injured, the tibia, which is the lower leg bone, slides forward in relation to the femur, which is the thigh bone. Referred to as a 'positive drawer sign,' this condition results in knee instability, potentially causing damage to cartilage, bone, and even leading to osteoarthritis.

The Extracapsular Lateral Suture Stabilization procedure addresses tibia thrust by securely connecting the tibia to the femur using a carefully placed suture during surgery. The suture tightens the joint and provides stability to the knee, preventing the femur and tibia from sliding front to back. This allows the ACL to heal and the muscles around the knee to strengthen.

The ACL injury will heal only if the suture remains intact for 8-12 weeks. The suture may start to loosen or even break.

The surgery for smaller dogs has a high success rate and is known for being quick and uncomplicated. Repairing a torn ACL in dogs can also be more cost-effective compared to other methods. Dogs of different sizes and activity levels experience varying degrees of long-term success.

Tibial Plateau Leveling Osteotomy - TPLO

Consider the tibial plateau leveling osteotomy (TPLO) as an alternative surgical option for your dog's injured ACL. This surgery is more complex compared to the ELSS and focuses on minimizing forward movement in the dog's stride without relying on the ACL (CCL). 

A full cut is made through the top of the tibia, known as the tibial plateau. Following that, the tibial plateau undergoes rotation to alter its angle, and a metal plate is inserted to provide stability to the fractured bone during the healing process. The tibia heals and strengthens over several months.

It will take several months to fully recover from TPLO surgery, but you may start seeing some improvement within just days of the procedure. Following your vet's instructions after your dog's TPLO surgery is crucial for proper healing of the bone. It's important to restrict your dog's activities during this time.

Dogs treated with TPLO have a positive long-term outlook, and the chances of re-injury are low. You don't have to remove the stabilization plate from your dog's leg unless it starts causing any issues.

Tibial Tuberosity Advancement - TTA

Tibial Tuberosity Advancement surgery is comparable to TPLO, but it may be considered a slightly less invasive option. Many dogs seem to recover more quickly from TTA compared to TPLO.

During TTA surgery, the surgeon cuts and separates the front part of the tibia from the rest of the bone. A special orthopedic spacer is used to screw the front section of the tibia forward and up, creating a gap between the two sections of the tibia. Moving along the front of the knee, the patellar ligament aligns better, preventing abnormal sliding movement. Once we finish the procedure, we will attach a bone plate to ensure the front section of the tibia stays in place.

Dogs with a steep tibial plateau often undergo TTA surgery. The vet will assess your dog's knee structure to determine the most suitable surgery for your dog's ACL treatment.

How long does it take for dogs to recover from ACL surgery?

All dogs are different and some dogs will recover more quickly than others following ACL surgery. Nonetheless, recovery from ACL surgery is always a long process!

Your dog may be able to walk as soon as 24 hours following surgery, however full recovery and a return to normal activities will take 12 - 16 weeks or maybe longer. 

It is essential to follow your vet's instructions and to pay attention to your dog's healing progress. Never force your dog to do exercises if they resist as this can lead to re-injuring the leg.

If your dog has been diagnosed with a torn or injured ACL and you'd like to learn more about ACL surgeries, contact your Ruckersville vet to book an appointment.