Cruciate

Cranial Cruciate Ligament Rupture

General Information

Extra-Articular 4-in-one Transplant Fibular Head Transposition

A ligament consists of tough, fibrous tissue connecting 2 bones. In the knee, rupture of the cranial cruciate ligament allows the femur (thigh bone) to slide back and forth over the tibia (shin bone).

The rupture first causes pain, then abnormal wear and tear lead to arthritis. This sequence of events occurs most frequently in overweight, middle-aged to old dogs.

Depending on the severity of the rupture, treatment may consist of limited exercise and rest, or surgical repair of the torn ligament. There are many opinions about what to do about torn cranial cruciate ligaments in small dogs and cats. As a general rule Dr. McKee was taught (and beleives) that all torn cranial cruciate ligaments should be stabilized. If this is not done there will be improvement but more arthritic change will occur and this will be a perminate problem.

Question and Answer

Understanding Your Pet's Medical Diagnosis

What is cranial cruciate ligament disease?

Cranial cruciate ligament disease is an acute or chronic degenerative injury of the cranial cruciate ligament (CrCL) that results in partial or complete instability of the knee joint. The equivalent injury in people is damage to the anterior cruciate ligament.

What causes cranial cruciate ligament disease?

CrCL injury has many causes. Trauma to the knee joint may result in injury, but that is not a common cause in dogs. Age-related changes, poor conformation, obesity, and immune-mediated diseases are some of the more common causes. An immune-mediated disease is a condition where the body's defense mechanism turns against itself and starts attacking the body, instead of protecting it.

What are signs of cranial cruciate ligament disease?

Athletic or traumatic events generally cause the kind of acute CrCL injuries that result in a nonweight bearing lameness with the affected limb held up off the ground. Degenerative types of CrCL injuries are noted by subtle to marked intermittent lameness that goes on for weeks to months. Bilateral disease, where both knee joints are affected, is common.

How is cranial cruciate ligament disease diagnosed?

Your veterinarian may suspect CrCL injury after an examination. Often sedation and/or general anesthesia is required to adequately evaluate and examine by feeling (palpate) the animal's knee joint. Radiographs (X-rays) assist in identifying arthritic changes within and around the knee joint.

How is cranial cruciate ligament disease treated?

Surgery is the treatment of choice, especially in dogs weighing more than 30 pounds. In certain dogs weighing less than 30 lbs. (13.5 kg.), surgery may not be required. Many surgical options are available. Your veterinarian will discuss these with you. Medications are often prescribed, with or without surgery, as a means to lessen pain and inflammation within the joint, and to improve the health of the cartilage.

What is the prognosis for animals with cranial cruciate ligament disease?

Regardless of the surgical technique, the success rate is approximately 80 to 85%. Clinical signs related to arthritis are common following CrCL injury, even when treated with surgery. If the animal has this kind of injury, he or she has a 30-50% chance that the opposite knee joint may have a similar type injury in the future.

Important Points in Treatment

1. Exercise: Restrict your pet's activity for ____ weeks. Slick floors can be very dangerous since you pet may slip and injure the surgical site. Exercise restriction following the surgery for this injury may be almost as important as the type of surgery done. Do not let your pet run unrestrained. On-leash walking is the only activity permitted outside the home. Prevent jumping whenever possible. Begin increasing exercise gradually after ____ days/weeks.

2. Diet: Ordinarily no special diet is required for healing. If your pet is overweight, weight reduction can speed recovery and possibly prevent further injury. The doctor will discuss weight control with you if necessary.

3. Care of the splint/bandage: We do NOT usually place a splint or bandage on the leg following repair. Certain surgical corrections require use of a splint or bandage for 1-6 weeks after surgery. If your pet has a splint or bandage, extra care is needed to protect it. Do not let the apparatus become wet. In damp weather, place a plastic bag over it when you walk your pet. Do not allow unrestrained exercise.

4. Incision: Check the incision daily and report abnormalities to the doctor. Your pet will be evaluated for suture removal in ____________________ days.

Notify the Doctor if Any of the Following Occur:

* Your pet seems to be in pain or is uncomfortable.

* Your pet chews or damages the splint/bandage or stitches.

* There is a change in your pet's general health