Unfortunately, what I’ve been worrying about for years has happened. Haley recently ruptured her CCL. If you don’t know what the CCL is, it’s the cranial cruciate ligament, equivalent to the ACL in our human knees. Her knee problems started about three years ago when she stretched the ligament. Even though it tightened up after a few weeks of limited activity, it’s given her trouble on and off since then and arthritis added insult to injury, so to speak.
All of the things I’ve done to try to protect Haley’s knee, like starting her on Adequan injections, were outmatched by a few meandering deer passing through our backyard. She set off to protect her territory on four legs but returned from the chase hobbling on just three. After giving her several days to see if her condition improved, she would only put a little weight on the leg while walking and she would hop along on three legs when she wanted to move faster. I had a bad feeling about her condition and our vet confirmed my suspicion; she had ruptured her CCL and needed surgery. Ugh!
The first part of this video shows how Haley was getting around before her surgery.
Why Are CCL Knee Injuries So Common?CCL injuries are one of the most common orthopedic injuries in dogs. I’ve known several family members and friends whose dogs required CCL surgery and one of Haley’s littermates has the exact same knee injury.
Some dogs injure the ligament while running when they quickly change directions. The shift in their body direction at high speed puts a great deal of weight and stress on the knee, especially if a dog is overweight or obese. Other dogs may have chronic degenerative ligament disease where the ligaments become weak with age and eventually stretch, tear or rupture.
Dogs at a higher risk of ligament problems are spayed females and larger breed dogs. A few studies have found a link between early spaying and neutering and an increased risk of CCL injuries related to the role that sex hormones play in bone growth and development. Another reason CCL injuries might be so common is the increased number of overweight and obese dogs these days.
Do Ruptured CCLs Always Require Surgery?I’ve read a lot of articles about successful, non-surgical treatments for ruptured CCLs but most of those remedies work best for small dogs under 25 pounds with most treatments being coupled with a period of restricted physical activity. Some dog owners have had success with stifle braces or custom-made casts. Even though there’s a variety of therapeutic and holistic types of treatment, surgery is often the best option for larger dogs and it was the course of action recommended by Haley’s vet.
Types of CCL Surgical RepairsThere are several types of surgical repairs for CCL knee injuries. Some require cutting the bone and using plates to stabilize the joint such as the Tibial Plateau Leveling Osteotomy (TPLO) or Tibial Tuberosity Advancement (TTA). Other surgeries are suture based where a heavy suture or wire is used to stabilize the joint which takes over the function of the ligament until scar tissue can form to help stabilize the knee. For more details on surgery options, check out this article by the American College of Veterinary Surgeons. It’s good to keep in mind, one of the most important factors affecting the outcome of the surgery is the experience level of the surgeon.
Haley had the extra-capsular suture stabilization type of surgery a little over a week ago. The first 48 hours after surgery were a little rough, especially when it came time for her to do her business outside and none of us got much sleep around here. I saw a big improvement on the third and fourth day after surgery but then she had a side effect to Rimadyl (one of her pain medications) that forced us to discontinue its use, so she’s been in a little more pain while finishing out this first week. She’s such a trouper and an exceptionally tolerant patient, especially when I have to do her rehab flexion and extension exercises.
Here are some tips I’ve discovered over the past week while helping Haley recover from her surgery.
10 Tips for Helping Your Dog After CCL Surgery
I hope the information and tips are helpful if your dog might be facing CCL surgery in the future. If you’ve already been through this, share your experience and any tips you might have. I’d love to hear them!