Cranial (Anterior) Cruciate Ligament Rupture – an overview of what we do at Victory Animal Hospital

The knee is intrinsically supported by multiple ligaments, the main being the cruciate ligaments. There are 2 of these ligaments and they stabilize the femur and tibia relative to flexion and extension of the knee.

The cranial cruciate ligament is the most susceptible to injury and thus rupturing. When ruptured the vet will note a positive “drawer sign” or a “tibial thrust” on a compression test. This occurs most commonly in athletic large breed dogs but can occur in any size dog or cat.

When examining patients with suspect CCL rupture the patients are often painful and guard the knee by tensing their muscles, thus sedation is often required. While sedated, radiographs can be taken and tests performed to confirm the diagnosis of CCL rupture.

Severe inflammation of the stifle joint secondary to CCL rupture – note the joint distension, obliteration of the fat pad, enthesophyte formation and soft tissue swelling with fascial plane collapse
Radiograph of the opposite knee for comparison – see if you can spot the changes

Once confirmed, treatments can be considered based on the degree of injury, Partial tears can be cage rested and platelet-rich plasma considered BUT Full ruptures will require surgery, unless the patient cannot tolerate the general anaesthesia due to underlying medical condition. Surgery is recommended due to the high rate of osteo-arthritic changes that occur in an unstable knee. The arthritis causes pain which reduces use of the limb, causing muscle wasting which further exacerbates the instability and progression of arthritis, creating a circle of pathology and deterioration

There are 3 techniques used at Victory Animal Hospital:

  • Extracapsular fixation with Liga-Fiba
  • TTA or Tibial Tuberosity Advancement
  • Cora-based Levelling Osteotomy or CBLO

Although all techniques used are based on age, weight, size and activity of the animal, the most commonly used technique, the CBLO, is the preferred procedure for cruciate repair in young athletic animals. The procedure allows for a better centre of gravity over the limb and return to function that is at the least equivalent if not better than other procedures.

The patient is often toe-touching within 7-10 days, although full recovery usually takes 8-12 weeks. Detailed post operative instructions will be discussed and printed for further assessment during the recovery.

Regular physiotherapy sessions, including TENZ/ Laser and mobility sessions will be planned and discussed as part of the rehabilitation period.

Although traumatic and stressful for you and your dog, Victory will support you through every moment of the procedure and recovery.

If you have any further queries, please feel free to contact us via e-mail or simply give the friendly staff a call.

We look forward to being of assistance.


Front Bioeng Biotechnol. 2019 Aug 6;7:180.Surgical Treatments for Canine Anterior Cruciate Ligament Rupture: Assessing Functional Recovery Through Multibody Comparative Analysis

Giovanni Putame 1Mara Terzini 1Cristina Bignardi 1Brian Beale 2Don Hulse 3Elisabetta Zanetti 4Alberto Audenino 1

Vet Surg. 2016 May;45(4):507-14. Owner Evaluation of a CORA-Based Leveling Osteotomy for Treatment of Cranial Cruciate Ligament Injury in Dogs

Erin N Kishi 1Don Hulse 2

Vet Surg. 2018 Feb;47(2):261-266..Second-look arthroscopic findings after CORA-based leveling osteotomyBarbara Vasquez 1Don Hulse 2Brian Beale 3Sharon Kerwin 2Chad Andrews 1Brian W Saunders 2


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