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Cranial Cruciate Ligament (CCL) Surgery in Dogs

Cranial cruciate ligament (CCL) ruptures are a common orthopedic injury in dogs. Our Tigard vets explain the injury as well as the CCL surgery process that is likely necessary for your dog. 

What is a CCL?

The CCL is a connective tissue that connects and stabilizes the lower and upper legs at the knee. When a dog's tibia tears, it connects to the femur above, causing partial or complete joint instability, pain, and immobility. CCL ruptures result from a torn cranial cruciate ligament (CCL) in a dog's stifle (knee), which is similar to the ACL in humans.

How to Identify a CCL Injury in Dogs

When it comes to CCL tears in dogs, 80% are chronic-onset ruptures caused by degeneration and usually occur as a result of aging. This is most common in dogs between the ages of five and seven.

Acute-onset ruptures are most commonly seen in pups four years of age or younger. These tears are caused by injuries a dog will sustain just running around and living their daily lives.

Symptoms of a CCL rupture may include:

  • Crepitus (crackling noise of bones rubbing against each other)
  • Decreased range of motion
  • Hind leg extension while sitting
  • Pain when the joint is touched
  • Lack of motivation to exercise
  • Irritability
  • Restricted mobility
  • Stiffness after exercising
  • Swelling/Inflammation
  • Thick/firm feel of the joint
  • Weight shifted to one side of the body while standing
  • "Pop" sound when walking

If you notice any of the listed symptoms above, contact your vet and schedule an examination for your dog.

Non-Surgical Treatment

Dogs weighing less than 30 pounds may be able to recover without surgery if they receive adequate rest, anti-inflammatory medications, and physical therapy. This is determined by your dog's size, overall health, and the severity of the CCL injury.

Your veterinarian will advise you on the best course of treatment for your dog.

Treatment Via Surgery

CCL surgery is the most common surgery performed in dogs and is estimated to make up about 85% of all orthopedic surgeries performed every year on dogs. Given that this is such a common injury, several procedures have been developed over the years to repair the ligament. Each technique has its pros and cons, so it is important to discuss the options with your veterinarian to determine which procedure would be best for your dog's situation. Below are the most common methods of repairing the injury.


Arthroscopy is the least invasive way to visualize the stifle, cranial, and caudal cruciate ligament structures. The technique enhances joint structure visualization and magnification. This procedure's technology allows for small surgical incisions for partial CCL and meniscus tears. This method may not be suitable for ligaments that are completely torn.

Lateral Suture or Extracapsular

This surgery, which is commonly recommended for small to medium-sized dogs, stabilizes the stifle (knee) with sutures placed on the outside of the joint. This is one of the most common surgeries for this type of injury, and it is typically done on dogs weighing less than 50 pounds.

TTA (Tibial Tuberosity Advancement)

TTA is a surgical procedure that corrects the need for the CCL by cutting the top of the tibia, moving it forward, and stabilizing it in its new position with a plate. As a result, the goal of TTA is to completely replace the ligament rather than simply repair it.

TPLO (Tibial Plateau Leveling Osteotomy)

TPLO surgery is increasingly popular and the best option for large dog breeds. The procedure involves cutting and leveling the tibial plateau. The surgeon then uses a plate and screws to secure the tibial plateau. The ligament is also no longer needed as a result of this surgery.

Post-Op Recovery of CCL Surgery in Dogs

Regardless of which procedure is used to repair the ligament, the care your dog receives following surgery will determine the success of the operation. The initial 12 weeks following surgery are critical for recovery and rehabilitation. The keys to a successful recovery are limiting exercise and encouraging your dog to begin using his legs.

At two weeks post-operative, gradually increase the length of your dog's walks.

By the eighth week, your dog should be able to go for two 20-minute walks a day and perform some basic daily activities.

Your veterinarian will take x-rays ten weeks after surgery to assess the bone's healing progress. Your dog will eventually be able to resume normal activities. We at Cascade Veterinary Referral Center recommend a rehabilitation program to help your dog recover.

The rehabilitation facility you choose should have experience with post-op recovery from orthopedic injuries like the TPLO.

Some dogs have also benefited from acupuncture and laser therapy.

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.

Is your dog showing signs of a CCL tear? Contact our Cascade Veterinary Referral Center vets and book a consultation today

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Cascade Veterinary Referral Center is accepting new patients! Get in touch with us today for information on how to book a specialty appointment for your pet. 

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