Cranial Cruciate Ligament Rupture

• Sudden lameness: In one of the hind legs. The lameness may be intermittent initially, but it can progress to a consistent limp over time.
• Reluctance to bear weight on the affected leg: Dogs may avoid using the leg altogether or may only partially bear weight on it.
• Swelling around the knee joint: Also known as the stifle joint, can occur due to inflammation and joint effusion. The affected area may feel warm to the touch.
• Pain: Dogs with a CCL rupture may exhibit signs of pain, such as vocalization, reluctance to be touched around the affected leg, and a noticeable behavior change.
• Decreased range of motion: Dogs may have difficulty fully extending or flexing the affected knee joint. They may keep the leg in a partially bent position, known as a "stifle sit," to relieve pressure on the injured ligament.
• Muscle atrophy: Over time, muscle wasting (atrophy) may occur in the affected leg due to decreased use and instability of the joints.

Keep in mind that the above symptoms of CCL rupture can vary depending on the severity of the injury.

The veterinarian will start with a physical examination to assess your dog’s gait, lameness, and range of motion in the affected limb. The veterinarian may ask about any known incidents or trauma that could have caused the injury. They will also inquire about any previous episodes of lameness or joint problems in your dog. X-rays are commonly used in the initial evaluation of a suspected CCL rupture. While they do not directly visualize the ligament, they help rule out other potential causes of lameness and assess the condition of the knee joint. X-rays can reveal signs of joint effusion (swelling), changes in the alignment of the bones, osteoarthritis, or any bone fractures that may be associated with the CCL rupture. The vet will also perform a cranial drawer test – a specific physical manipulation to assess the stability of the knee joint. It involves applying controlled forward and backward movement to the tibia (lower leg bone) while stabilizing the femur (thigh bone). If the CCL is ruptured, there will be increased forward movement of the tibia compared to a healthy knee joint.

The treatment options can vary depending on the severity of the injury, the size and age of the dog, and other factors. Here are some common treatment options:

1. Conservative Management: This approach involves rest, restricted activity, and the use of anti-inflammatory medications to manage pain and reduce inflammation. It is typically used for small dogs or those with partial tears, but it may not be suitable for all cases.
2. Surgery: Surgical intervention is often recommended for more severe cases or larger dogs. There are different surgical techniques available:

• • • Extracapsular Repair: This procedure involves placing a strong suture or synthetic material around the outside of the joint to stabilize it. It is typically recommended for smaller dogs or those with less active lifestyles.
    • Tibial Plateau Leveling Osteotomy (TPLO): TPLO surgery involves altering the angle of the tibia to stabilize the joint and eliminate the need for the cranial cruciate ligament. It is commonly recommended for medium to large dogs.
    • Tibial Tuberosity Advancement (TTA): TTA surgery involves changing the position of the tibial tuberosity to alter the forces on the joint and stabilize it. It is also suitable for medium to large dogs.

• 3. Physical Rehabilitation: Regardless of the chosen treatment, physical rehabilitation plays a crucial role in the recovery process. It typically includes exercises, controlled activities, and modalities such as therapeutic ultrasound or laser therapy to aid in healing, improve strength, and regain range of motion.