The dog's cranial cruciate ligament (CCL) is frequently called 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 New York vets explain the three primary dog ACL surgeries.
What is ACL in Dogs?
ACL stands for anterior cruciate ligament, a crucial part of a dog's knee joint. This ligament is called the cranial cruciate ligament (CCL) in dogs. The ACL (or CCL) plays a vital role in stabilizing the knee joint by preventing the tibia (shin bone) from moving too far forward relative to the femur (thigh bone). When a dog suffers an ACL injury, it often leads to significant pain, lameness, and difficulty in movement.
Causes of ACL Injuries in Dogs
ACL injuries in dogs typically result from a combination of factors, including:
- Degeneration: Over time, the ligament may weaken due to age, genetics, or repeated stress.
- Trauma: A sudden twist or hyperextension of the knee, often during vigorous activity, can lead to a tear.
- Obesity: Excess weight strains the knee joint, increasing the risk of injury.
- Breed Predisposition: Certain breeds, such as Labrador Retrievers, Rottweilers, and Newfoundlands, are more prone to ACL injuries.
Symptoms of ACL Injuries in Dogs
Identifying an ACL injury in a dog involves observing several vital symptoms, including:
- Sudden limping or lameness in one hind leg
- Difficulty standing up or sitting down
- Reluctance to bear weight on the injured leg
- Swelling around the knee joint
- A "clicking" sound when the dog moves the leg
Can a dog live with a torn ACL?
While a dog can live with a torn ACL, it significantly affects their quality of life. An untreated ACL injury can lead to chronic pain, arthritis, and severe mobility issues. Therefore, seeking prompt veterinary care is essential to manage the condition effectively and improve the dog's overall well-being.
How are ACL injuries in dogs treated?
If you suspect your dog has an injured ACL, it is important to see a vet to diagnose and treat the condition.
If your dog's ACL is torn or injured, the tibia (lower leg bone) slides forward concerning the femur (thigh bone). This movement, known as a 'positive drawer sign, ' results in knee instability, which could damage the cartilage and surrounding bones or lead to osteoarthritis.
Surgical treatments for ACL injuries in dogs include:
Extracapsular Lateral Suture Stabilization - ELSS / ECLS
This surgical treatment for a torn ACL in dogs works by counteracting 'tibial thrust' (the sliding forward of the dog's tibia) with a specifically placed suture.
Tibial thrust is caused by the transmission of weight up the tibia and across the knee, causing the tibia to “thrust” forward relative to the femur. The forward thrust movement occurs because the top of the tibia is sloped, and the dog's injured ACL, which can usually oppose the forward force, can no longer prevent this unwanted movement.
Extracapsular Lateral Suture Stabilization corrects tibia thrust by “anchoring” the tibia to the femur with a surgically placed suture. The suture pulls the joint tight and helps to stabilize the knee, preventing the front-to-back sliding of the femur and tibia while the ACL heals and the muscles surrounding the knee strengthen.
The suture must stay intact for 8-12 weeks for the ACL injury to heal. After that, it will begin to loosen or even break.
This surgery is relatively quick and uncomplicated and has a success rate in smaller dogs. It can also be less expensive than other methods for repairing a torn ACL in dogs. Long-term success varies in dogs of different sizes and activity levels.
Tibial Plateau Leveling Osteotomy - TPLO
Another surgical option for treating your dog's injured ACL is the tibial plateau leveling osteotomy (TPLO). This surgery is more complex than the ELSS and aims to reduce the amount of forward movement during the dog's stride without the help of the ACL (CCL).
This procedure makes a complete cut through the top of the tibia (tibial plateau). The tibial plateau is then rotated to change its angle, and a metal plate is added to stabilize the cut bone as it heals. The tibia will gradually heal and strengthen over several months.
Full recovery from TPLO surgery will take several months. However, some improvement can be seen within days of surgery. Following your vet's instructions after your dog's TPLO surgery is essential, as is restricting your dog's activities to allow the bone to heal properly.
The long-term prognosis for TPLO treatment in dogs is good, and re-injury is uncommon. The stabilization plate does not need to be removed from your dog's leg unless it begins to cause problems.
Tibial Tuberosity Advancement - TTA
Tibial Tuberosity Advancement surgery is similar to TPLO but may be slightly less invasive than TPLO. Recovery from TTA appears to be quicker than recovery from TPLO in many dogs.
When TTA surgery is performed, the front part of the tibia is cut and separated from the rest of the bone. Next, a special orthopedic spacer is screwed into the space between the two sections of the tibia to move the front section forward and up. By doing this, the patellar ligament, which runs along the front of the knee, is forced into better alignment and helps to prevent much of the abnormal sliding movement. Once this process has been completed, a bone plate will be attached to hold the front section of the tibia in its proper position.
TTA surgery is typically performed in dogs with a steep tibial plateau (angle of the top section of the tibia). Your vet will evaluate your dog's knee geometry to determine which ACL treatment surgery is best.
How long does it take for dogs to recover from ACL surgery?
All dogs are different; some will recover more quickly following ACL surgery. Nonetheless, recovery from an ACL surgery is always a lengthy 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 to 16 weeks, or maybe even longer.
Following your vet's instructions and paying attention to your dog's healing progress is essential. Never force your dog to do exercises if it resists, as this can lead to re-injuring the leg.
Note: The advice provided in this post is intended for informational purposes and does not constitute medical advice regarding pets. For an accurate diagnosis of your pet's condition, please make an appointment with your vet.