What is the cranial cruciate ligament?
The cranial cruciate ligament (CrCL) in dogs functions similarly to the anterior cruciate ligament (ACL) in humans. It is a strong band of fibrous tissue that connects the femur (thigh bone) to the tibia (shin bone), preventing the tibia from moving forward relative to the femur and also helping to stabilize the stifle (knee) joint by limiting its over-extension and rotation.
While ACL injuries in humans are often caused by sudden trauma during sports activities like football, rugby, or golf, CrCL disease in dogs develops differently. Instead of a sudden rupture due to acute trauma, the ligament in dogs tends to degenerate gradually over time, resembling a fraying rope. This distinction in the nature of the injury is why treatment approaches for CrCL damage in dogs differ significantly from those used for ACL injuries in humans.
What is the cause of cruciate ligament injury in dogs?
In most dogs, the cranial cruciate ligament (CrCL) ruptures due to gradual degeneration, where the ligament’s fibers weaken over time. The exact cause of this degeneration is not fully understood, but genetic factors are likely the primary influence, with certain breeds—such as Labradors, Rottweilers, Boxers, West Highland White Terriers, and Newfoundlands—being more prone to the condition. Evidence supporting a genetic cause comes from examining family lines and noting that many dogs experience CrCL ruptures in both knees, often at a young age. Additionally, factors like obesity, individual body structure, hormonal imbalances, and specific joint inflammatory conditions may also contribute to the risk.
How can I tell if my dog has cruciate ligament disease?
Limping is the most common indication of a CrCL injury in dogs. It can occur suddenly during or after exercise in some cases, or develop gradually and intermittently in others. Dogs with CrCL injuries may be affected in both knees simultaneously, which can make it hard for them to get up from a lying position and result in a very unsteady, “pottery” gait. In severe cases, the dogs may be unable to stand at all, potentially leading to a mistaken diagnosis of a neurological issue.
What is happening inside an affected joint?
How is cranial cruciate ligament injury diagnosed?
How is cruciate ligament injury treated?
Non-surgical management:
Non-surgical treatment is usually only recommended when anesthesia or surgery poses too much risk, such as in dogs with severe heart, hormonal, or immune issues. It involves managing bodyweight, physiotherapy, exercise changes, and anti-inflammatory medications. While these measures are also important for post-surgical care, surgery aims to minimize the need for long-term restrictions and medications. Non-surgical treatment has a poor success rate in dogs over 15 kg, but dogs under 15 kg and cats may see some improvement, though it often takes several months and is rarely complete.
Surgical management:
Surgical treatments fall into two main categories: those that replace the damaged ligament and those that make the ligament redundant by cutting the tibia and realigning the forces on the stifle joint.
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