Cranial Cruciate Ligament Disease (CCLD) is a common orthopedic condition in dogs, with certain breeds being predisposed (including Labradors, Rottweilers, Boxersand West Highland White Terriers.) The cruciate ligaments are responsible for stabilizing the knee joint, and when they are damaged, it can lead to pain, lameness, and joint instability. The pathology of CCLD involves a tear or rupture of the ligament, often as a result of degenerative changes. 

Symptoms

Hindlimb lameness is the most common sign of a CrCL injury. Stifle swelling, pain and instability of the joint can also be found. Some owners may notice that dogs will sit with the affected leg held out to the side and thigh muscle atrophy (weakness) may occur. The diagnosis of CCLD is typically made through a combination of physical examination, radiographs, and possibly additional diagnostic imaging.

Treatment Options

Treatment options for CCLD in dogs include conservative management, surgical repair, or a combination of both. Conservative management involves rest, weight loss, and physiotherapy, which may help to alleviate some of the symptoms associated with CCLD. However, conservative management is typically reserved for small dogs or those with mild to moderate CCLD.

Surgical repair of CCLD is the most common treatment option for dogs with moderate to severe CCLD, and there are several surgical techniques available. One of the most common surgical techniques used for CCLD is Tibial Plateau Leveling Osteotomy (TPLO). TPLO involves cutting the tibia and rotating the plateau to change the angle of the joint, which helps to stabilize the knee. TPLO has a high success rate and can provide long-term relief for dogs with CCLD.

Another surgical option is the lateral suture technique, which involves placing a suture around the outside of the joint to provide support. However, this technique is less commonly used in larger dogs or those with more severe CCLD, as it may not provide adequate stabilization.

In conclusion, CCLD is a common orthopedic condition in dogs, particularly in larger breeds and overweight dogs. Treatment options for CCLD include conservative management, surgical repair, or a combination of both. TPLO is a common surgical technique used for CCLD and can provide long-term relief for dogs with moderate to severe CCLD. If you suspect your dog may have CCLD, it is important to seek veterinary advice promptly to ensure appropriate diagnosis and treatment.

Aftercare

The patient is normally discharged on the same day of surgery, although sometimes a longer hospitalisation period may be required in order to allow full recovery from the anaesthetic and for drug administration (especially pain killers).

The wound is on the inner side of the knee and it is covered by a wound dressing; stitches are all buried under the skin. Gently applying an ice pack is allowed for the first 48h, if the dog tolerates it. Medication is dispensed at the time of discharge and normally includes an anti-inflammatory and an adjunctive pain killer.

We normally recommend a post operative check at your local vets 5 days after the surgery.

Post surgery the dog must be strictly rested for the first week and go out only for toileting purposes. Once the dog has been checked he/she may be able to start very short and gentle lead walks and this should continue for the next 7-8 weeks.

Trotting, running, jumping and playing with other dogs must be avoided, as well as slippery surfaces and stairs. Sometimes cage or room confinement is recommended when unsupervised for the full recovery period.

If the dog bothers with the wound and wants to lick it, we recommend keeping a buster collar on until the wound is healed (normally around 10-14 days after surgery).

We advise taking follow up radiographs at 8-9 weeks post operatively, to assess bone healing; this can be done either with your local vet or with ourselves. Once bone healing has been confirmed, lead walking can be gradually increased over a period of 4 weeks when the dog can return to normal unrestricted exercise.

If you have any concerns, please do not hesitate to give us or your vet a call.