Cruciate ligament disease is one of the most common causes of hind leg lameness in dogs. At Yarra Ranges Animal Hospital, we regularly see dogs with cruciate ligament injuries ranging from partial ligament damage and intermittent lameness through to complete tears where dogs may suddenly struggle to put weight on the affected leg.
For many dogs with cruciate ligament disease, surgery provides the best opportunity to restore stability to the knee, reduce pain and allow them to return to an active life. One of the most widely used surgical techniques is the Tibial Plateau Levelling Osteotomy (TPLO). At Yarra Ranges Animal Hospital, we offer a range of small animal surgical procedures, including advanced orthopaedic surgery.
What is the cruciate ligament in dogs?
The cranial cruciate ligament (CCL) is an important ligament within the dog’s knee, or stifle joint. It performs a similar role to the anterior cruciate ligament (ACL) in humans, helping to stabilise the knee during movement.
Unlike many ACL injuries in people, which commonly occur following a sudden sporting injury, cruciate ligament disease in dogs is often a progressive degenerative process. The ligament gradually weakens over time and may partially or completely rupture.
Once the ligament is damaged, the knee becomes unstable. This instability causes inflammation and pain and contributes to the development and progression of osteoarthritis within the joint.
How common is cruciate ligament disease in dogs?
Cruciate ligament disease is extremely common and is one of the most frequent orthopaedic conditions we diagnose in dogs.
Medium and large-breed dogs are commonly affected, with breeds including Rottweilers, Staffordshire Bull Terriers, Boxers, Great Danes and Labradors often represented.
However, cruciate disease isn’t limited to large dogs. Dogs of any breed, size or age can be affected, and we also regularly diagnose the condition in smaller breeds such as Jack Russell Terriers and Maltese.
Dogs that develop cruciate disease in one knee can also be at increased risk of subsequently developing the condition in the opposite knee.
What are the signs of a cruciate ligament injury?
The signs can vary depending on whether the ligament is partially damaged or completely ruptured.
Common signs include:
- Sudden or persistent lameness in a back leg
- Difficulty or reluctance to rise
- Difficulty jumping into the car or onto furniture
- Reluctance to exercise
- Sitting with the affected leg positioned out to the side
- Pain or stiffness after exercise or rest
- Muscle wasting over the thigh
- Swelling or thickening around the knee
Some dogs with a complete rupture become suddenly very lame, while dogs with a partial tear may initially have much more subtle or intermittent symptoms.
How is cruciate ligament disease diagnosed?
Diagnosis begins with an orthopaedic examination. Your veterinarian will assess your dog’s gait and examine the knee for pain, swelling and abnormal movement.
A cruciate-deficient knee may demonstrate characteristic instability known as cranial drawer movement or tibial thrust.
Some dogs, particularly those that are painful or tense during examination, may require sedation to properly assess the joint.
X-rays are also important. Although the cruciate ligament itself cannot normally be seen on a standard X-ray, radiographs can identify changes associated with cruciate disease, including joint swelling and arthritis, while also helping us assess the structure of the knee and plan surgery.
What is TPLO surgery?
TPLO stands for Tibial Plateau Levelling Osteotomy and is an advanced orthopaedic procedure used to treat cruciate ligament disease in dogs.
Interestingly, TPLO does not replace the damaged cruciate ligament.
Instead, the surgery changes the biomechanics of the knee so that it remains stable when the dog bears weight despite the damaged ligament.
During a TPLO, a precise curved cut is made in the upper portion of the tibia. This section of bone is carefully rotated to change the angle of the tibial plateau and is then stabilised in its new position using a specialised orthopaedic plate and screws.
The bone subsequently heals in its new position.
Post-operative X-ray following TPLO surgery performed by Dr Ben Fell at Yarra Ranges Animal Hospital on a 65 kg Bernese Mountain Dog.
Why is TPLO commonly recommended?
TPLO can provide excellent functional outcomes for dogs with cruciate ligament disease. While traditionally associated with medium and large dogs, TPLO can be performed successfully in dogs of many different sizes and is particularly beneficial for active dogs where strong, reliable stability of the knee is important.
The aim of TPLO surgery is to:
- Restore functional stability to the knee
- Reduce pain and lameness
- Allow the dog to return to comfortable activity
- Reduce the ongoing effects of abnormal joint instability
- Provide good long-term function
No surgical procedure can completely prevent arthritis once cruciate disease has occurred, but stabilising the joint is an important part of managing the condition and protecting long-term function.
Experience matters with TPLO surgery
TPLO is an advanced orthopaedic procedure requiring specialised equipment, careful surgical planning and considerable surgical experience.
At Yarra Ranges Animal Hospital, Dr Ben Fell has been performing TPLO surgery for more than 15 years and has performed over 2,000 TPLO procedures.
In addition to performing TPLO surgery at our Lilydale hospital, Ben travels to other veterinary clinics to perform this procedure for their patients.
We use synthes orthopaedic implants for our TPLO procedures and carefully plan each surgery using pre-operative radiographs and measurements specific to the individual patient.
If your dog requires TPLO surgery, it is reasonable to ask your veterinarian or surgeon about their training and experience performing the procedure, as well as the implants used, surgical planning, anaesthetic monitoring and post-operative care provided.
What happens after TPLO surgery?
Recovery doesn’t finish when your dog leaves hospital. Controlled rehabilitation is an important part of achieving a successful outcome.
Initially, activity needs to be carefully restricted while the osteotomy heals. Dogs are generally limited to controlled lead walking, with running, jumping and uncontrolled activity avoided.
Exercise is then gradually increased according to the dog’s progress and bone healing.
Follow-up examinations and X-rays may be recommended to assess healing before returning to unrestricted activity.
While recovery varies between individual dogs, many dogs begin using the operated leg relatively quickly following TPLO surgery, with strength and mobility progressively improving during rehabilitation.
Does every dog with cruciate disease need TPLO surgery?
Not necessarily.
The best treatment depends on several factors, including your dog’s size, age, activity level, degree of instability, other health conditions and the nature of the cruciate injury.
TPLO is our preferred surgical technique for most dogs with cruciate ligament disease and can be performed successfully in dogs of all sizes. However, treatment is tailored to each individual patient, and alternative surgical techniques, such as extracapsular stabilisation, or conservative management may be appropriate in selected cases.
An orthopaedic assessment allows us to determine the most appropriate treatment for the individual dog.
Concerned your dog may have a cruciate ligament injury?
If your dog has developed a persistent limp, suddenly stopped bearing weight on a back leg, is having difficulty getting up or jumping, or you have noticed changes in the way they sit or exercise, we recommend having their knee assessed.
Early diagnosis allows us to identify the cause of the lameness and discuss the most appropriate treatment options before ongoing instability causes further discomfort and joint changes.
Yarra Ranges Animal Hospital provides small animal and orthopaedic surgery, including TPLO surgery for dogs, at our veterinary hospital in Lilydale, caring for patients from throughout the Yarra Ranges and Yarra Valley.
Contact our team to arrange an orthopaedic assessment for your dog.