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SURGERY > Surgery Topics > TPLO
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What is a Cranial Cruciate Ligament (CCL) rupture?
Cranial Cruciate Ligament (CCL) rupture is one of the most common orthopedic injuries in dogs. Although it is equivalent to an ACL injury in humans, the cause is very different. Unlike humans, canine ACL tears aren't typically related to trauma. A CCL rupture may affect any breed of dog at any age. When injured, the CCL can either be partially or completely ruptured. Acute ruptures are often complete and can occur while jumping, stepping in a hole (causing the leg to twist or hyper-extend) or due to excessive exercise over time. Clinical signs vary but include stiffness in the affected leg, intermittent lameness, or non-weight bearing lameness. To obtain a diagnosis of a CCL rupture, a thorough orthopedic exam is required. In addition, x-rays should be taken to rule-out other concurrent orthopedic disease.
The CCL is the primary stabilizer in the dog's stifle (knee) when walking. It prevents the lower leg bone (tibia) from moving forward relative to the upper leg bone (femur). This movement toward the dog's head is called cranial-tibial thrust. Elimination of the cranial-tibial thrust is the primary goal when repairing a CCL rupture.
How is a CCL rupture treated?
Depending on the size and age of the pet, there a several different treatment options. The surgical options that we most often perform are the Tibial Plateau Leveling Osteotomy (TPLO) and the Tibial Tuberosity Advancement (TTA). Both procedures alter the biomechanics of the joint so that forces are transferred through the knee to the ankle. These procedures also help to minimize the progression of degenerative joint disease (arthritis). Based on our findings during physical examination, orthopedic examination, and x-rays, our surgeons will recommend the best procedure for your pet.
What results can be expected?
Approximately 90% of patients that undergo TPLO return to normal function. In cases that do not perform as well, there are usually compounding factors (such as hip problems or severe arthritis) that hinder progress. The recovery period varies from 10-16 weeks with the first six weeks being the most critical. During this period your pet is strictly confined to a crate (or small room, i.e. 3’ by 5’) with leash walks to urinate and defecate. This recovery period is essential to allow the bone to heal and reduce the stress placed on the plate. It is important to note that roughly 40% of dogs will rupture the CCL in the opposite limb within 1 year, while others have a bilateral CCL ruptures at the time of initial diagnosis.
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Dr. Maxwell
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