Canine cranial cruciate ligament rupture (CCLR) remains the most common orthopaedic problem seen in veterinary practice around the world. It is one of the most common reasons for hind limb lameness, pain, and subsequent knee arthritis.
The cranial cruciate ligament is an essential ligament involved in stabilising the canine stifle joint (knee). The ligament attaches from the femur (thigh bone) to the tibia (shin bone) and prevents excessive motion in the joint. The illustration depicts a CCL rupture - note how there is forward movement of the shin bone in relation to the femur. The meniscus, which is a ‘cartilage-like’ structure that sits in between the femur and tibia bones can also become damaged when the CCL is torn or ruptured
The development of this problem in dogs is much more complex than in human ACL tears (which are the result of sudden excessive trauma) and they experience different degrees of rupture ranging from partial tears to complete rupture. The canine condition is therefore referred to as ‘cranial cruciate ligament disease'
Cruciate disease is caused by a combination of many factors, including
Aging of the ligament (degeneration),
Poor physical condition,
Conformation (skeletal shape and configuration)
With cruciate disease, ligament rupture is a result of slow degeneration / microtrauma that has been taking place over several months or even years rather than the result of acute (sudden) trauma to an otherwise healthy ligament (which is very rare).
About 50% of dogs that have CrCLD in one knee will, at some future time, develop a similar problem in the other knee.
Partial tearing of the CrCL is common in dogs and progresses to a full tear over time.
Cranial cruciate ligament disease can affect dogs of all sizes, breeds, and ages.
Certain dog breeds are known to have a higher incidence of CrCLD (Rottweiler, Newfoundland, Staffordshire Bull Terrier, Mastiff, Akita, Saint Bernard, and Labradors) .
A genetic mode of inheritance has been shown for Newfoundlands and Labrador Retrievers.
Poor physical body condition and excessive body weight are risk factors for the development of CrCLD. Keeping your dog at a healthy weight and body condition can significantly reduce the risks of develping CCLR.
What can be done?
Full rupture of the CCL: surgical stabilisation is required. There are several techniques which your veterinary surgeon will discuss with you. The choice of technique is usually made based on the dog's weight.
Partial tears: It is increasingly being realised that a conservative approach leads to inevtiable rupture of the CCL and arthritis, therefore prompt surgical stabilisation of the joint is recommended
How can physiotherapy help?
lifestyle modification, exercise advice and weight management are key for your pet to achieve optimum comfort, function and a good quality of life for the future.
Treatment will include:
• Joint range of motion/stretches
• Joint mobilisation techniques
• Active strengthening exercises
• Balance/proprioceptive exercise
• Pain relief where necessary
• Prescription of home exercises
• Advice on controlled exercise