A degenerating or torn cranial cruciate ligament is a common, congenital orthopedic condition found in canines. The cranial cruciate ligament in the dog prevents the shearing forces of cranial(forward) tibial thrust and helps with rotational stability of the knee. Left untreated, cruciate disease leads to crippling, irreversible osteoarthritis(OA) and degenerative joint disease(DJD).
Most veterinary orthopedists recommend surgical correction for torn or degenerating CCLs. The procedure of choice for active dogs over 50 lbs is either a TPLO or TTA. Both procedures achieve a biomechanical stabilization of the knee by altering vectors of force through cutting the tibial crest and fixing it in a different orientation with a bone plate. These procedures offer a faster recovery time and less progression of DJD in the stifle. Complications are uncommon but can include infection, bone fracture, implant failure, and bone cancer. At RAH, we have been doing TTAs since 2006 and have a high rate of success.
We also offer an older surgical repair known as the extra-capsular technique. With this procedure the knee is stabilized via a strong nylon suture on the outside of the joint capsule that is anchored to the tibial crest and lateral femoral fabella (small sesmoid bone behind the knee). This suture mimics the angle of the CCL. This suture will loosen over time but the knee is ultimately stabilized by a scaring down of the tissue around the knee. This procedure is suitable for small dogs (<50 lbs.) and older dogs that are not very active. In both surgical procedures, the knee joint is opened up and carefully inspected. Remnants of the degenerative CCL are removed and any torn meniscus is repaired.
Non surgical treatment for CCL disease involves weight loss when needed, chondroprotective agents like Glucosamine products, Omega 3 fatty acids as found in fish oil, and moderate exercise. This regimen is combined with either Laser Therapy or pain medications such as Rimadyl and Tramadol. The long term use of NSAIDs such as Rimadyl, Metacam, Deramaxx and Previcox requires close monitoring with bloodwork as these drugs can be harmful to the kidney, liver and GI system. For this reason, we recommend Laser Therapy as a safe and effective non-surgical treatment of CCL Disease. LT is an excellent modality for pain and inflammation control and has the unique ability to stimulate healing of diseased ligaments and other tissue making up the knee joint. LT allows the joint to stabilize via scaring down while keeping the development of DJD to a minimum. The procedure is painless and non invasive and ultimately requires a booster treatment every 1-3 months. In some cases of partial tears, the ligament can repair itself with LT. Combined with the aforementioned nutriceuticals, weight loss and moderate exercise, LT offers an affordable and healthier alternative to traditional management of CCL disease.