If your dog is limping on a hind limb, it may have a torn cranial cruciate ligament. This is synonymous to an ACL tear in humans. However, in dogs this is usually due to the degeneration of the cruciate ligament overtime, rather than one traumatic injury like in humans. While conservative treatment (anti-inflammatory medications, strict rest, and/or physical therapy) may help, surgery is indicated in most dogs, especially if they are larger than 30 lbs, young, and active. Another major reason to pursue surgical management is because research has shown that 50% of these dogs will also tear the cruciate ligament on the other knee. Therefore, it is important to address the first injury as soon as possible.
Since the knee has become unstable due to this ligament tear, the goal of surgery is to stabilize the joint. There are multiple surgical techniques used in veterinary medicine to achieve this goal, but here at Animal Ark, we practice two techniques.
The first technique is called an Extracapsular Repair and is a surgery that Dr. Spindel and Dr. Burtnett perform. This involves the placement of a very strong wire anchoring from the fabella (small bone in the back of the knee) to the tibial tuberosity (front of the knee). This is the least invasive of the techniques and most appropriate for small dogs, less than 40 lbs.
The second procedure is called a Tibial Tuberosity Advancement (TTA). This procedure is done at our hospital by Dr. Aderhold, who travels all over the state to do this surgery. This method involves an osteotomy (cutting into the bone) at the tibial crest (front of the tibia), advancing this forward to extend the tibial plateau, inserting a cage into the gap along with a bone graft, and placing a plate to hold it in place. While this procedure is more invasive, it is recommended for larger dogs (>40 lbs) because when healed properly, it will be much more stable.
After your pet has had one of these procedures they will be sent home with a compression bandage for 24 hours. After 24 hours, you will be instructed to do range-of-motion exercises for 10 repetitions, 2-3 times daily (see video for demonstration). Applying ice for 10 minutes, 2-3 times daily can also help with any swelling. It is extremely important that these pets are on strict rest for at least 2 weeks post-op. This means no running, jumping, or rough housing for at least two weeks. They should only be walking when they are going out to the bathroom, which should always be on a short leash. They should also wear a cone to prevent them from licking the incision, because it is extremely important to not introduce bacteria to the surgical site since we had to go into the joint capsule.
When you return in 14 days for the incision to be checked, your doctor can assess how much activity your pet can go back to doing. We are lucky enough to have Clemmons Animal Rehab and Therapy next door which has many resources to get your pet back in shape! See our rehab blog post for more info and follow Kona’s journey in her TTA vlogs!
Megan Burtnett, DVM