CRUCIATE LIGAMENT SURGERY AT VSS

The cruciate ligament is the most commonly injured part of a dog’s stifle (knee) that requires surgery in veterinary medicine.

The cruciate ligament is one of the primary stabilisers of the stifle and is also known as the anterior cruciate ligament or ACL. Similar to humans who injure their ACL playing sports, dogs commonly injure their cruciate ligament as well. In dogs, however, dissimilarly to humans, the ligament can degenerate slowly prior to a partial or complete rupture and trauma/acute injury is not always involved. 

In the below video, Dr Daren Roa (DVM, DACVS), Specialist Small Animal Surgeon at Veterinary Specialist Services Carrara, talks about cranial cruciate ligament disease in dogs.

If you have been referred to a veterinary specialist for your dog’s injured stifle/knee or a cruciate ligament condition, this video will help to explain:

  • the diagnosis
  • the surgical process and options
  • the recovery time and success

CRUCIATE LIGAMENT SURGERY FAQs

The usual outcome for cruciate ligament surgery in dogs is excellent, with many dogs returning to full athletic ability. High levels of comfort in everyday life are generally accomplished. On occasions, dogs may require anti-inflammatory medications to help control lameness flare-ups, which are generally a result of underlying osteoarthritis.

 

The best way to reduce the degree of osteoarthritis is with surgery. 

Broadly speaking, the options for surgical treatment are either an osteotomy technique, an extracapsular technique or an intracapsular technique (not currently recommended). 

 

Variations of these procedures have been available for over 50 years, however the scientific evidence has advanced and the newer literature favours osteotomy procedures over other techniques. The technique of choice, is based on discussion with owners about the pros and cons and any particular patient characteristics. There is no ‘one size fits all’ procedure and we assess each patient individually. Several procedures can be successful depending on a surgeon's experience, and the overall outcome from these surgeries is usually very positive.

Extracapsular techniques require sutures to be passed from the outside, or lateral aspect of the knee joint to the front of the tibia. The suture is a temporary stabiliser and therefore the technique relies on fibrous tissue stabilisation for any permanent stability. This is one of the reasons why this procedure may not achieve as favourable outcomes when compared to the osteotomy techniques. 

 

Osteotomy works differently in that it involves a bone cut (osteotomy) in the tibia. This then changes the position of the stifle joint, such that the joint is stable in the absence of a cruciate ligament. This superior stability is what allows dogs to return to athletic function and reduces the development of osteoarthritis, compared to other techniques. Common osteotomy techniques are called TPLO, which stands for tibial plateau levelling osteotomy and TTO which stands for triple tibial osteotomy. TTA, or tibial tuberosity advancement, is another osteotomy technique. Although our surgeons can perform this technique, it is not our technique of choice as the scientific evidence currently favours other techniques.

When making the decision between the extracapsular technique and osteotomy, a surgeon will discuss with the owner what is the best fit for the dog. This decision may depend on a dog’s size, breed, lifestyle, and age. 

 

Smaller dogs can have positive results with extracapsular techniques, however, generally do better with osteotomy techniques. For larger breeds, an osteotomy technique is highly recommended. 

POST-OPERATIVE CARE FOR CRUCIATE LIGAMENT SURGERY IN DOGS

After surgery:

Following surgery, patients stay in the hospital overnight, where they are closely monitored by our nursing staff. With special attention, post-operative pain is managed, and dogs are encouraged to get up and move around as soon as possible and begin eating and drinking again.

Most patients are discharged the day after surgery, and at that time, the surgeon will provide discharge instructions to help with the recovery process.

We see patients back at 2 and 6 weeks following surgery. At the 2-week check, we will remove any sutures. At the latter appointment, we will re-X-ray the limb to assess bone healing.  This requires a short anaesthetic and is a day procedure. 

The following instructions as given as part of our discharge notes:

Exercise: 

It is imperative that your pet is kept rested and confined and exercise is limited to the recommended amounts for the next 6-12 weeks. Failure to do so may lead to an increased risk of an unsuccessful repair or damage to the implants which may require a second surgery. A light sling can be helpful for support in the postoperative period, especially if you need to navigate a small step.

Please keep your pet confined to a small room, pen or cage with non-slip flooring where they cannot freely run, jump or fall.

  • DO NOT allow free exercise in a yard or park.

  • DO NOT allow a pet to run between rooms in the house or up and down hallways/stairs etc.

  • AVOID playing with other animals in the household.

  • ALL EXERCISE should be on a leash.

All exercises should consist of short leash walks only. This should consist of:

  • 5-minute leash walks, 2-3 times per day, in weeks 1 and 2 after surgery

  • 5-10 minute leash walks, 2-3 times per day, in weeks 3 and 4 after surgery

  • 10-15 minute leash walks, 2-3 times per day, in weeks 5 and 6 after surgery

  • Advice on exercise after 6 weeks will be given based on a review of a pet and repeat radiographs (x-rays)

Wound care:  

Please check the surgical wound daily for evidence of swelling, discharge, self-trauma, etc and alert the hospital immediately with any concerns.  

If your pet licks or chews the stitches then an Elizabethan collar is required to help protect the surgery site. This can be purchased from us or your local veterinary clinic.

Diet:  

No dietary changes are necessary for the short term. A good quality commercial dog food is recommended. If a pet is gaining significant weight in the postoperative period due to exercise restriction then a reduction in the amount of food offered is recommended.

Physiotherapy:

Physiotherapy has been shown to improve outcomes after TPLO and is highly recommended in the recovery period. Please make an appointment with reception.

VSS
Veterinary
Hospital

Refferring A Patient?

Referring a Patient?

Find Out More
Have You been Referred?

Have You been Referred?

Find Out More