Cruciate Ligament Rupture Repairs

What is a Cruciate Ligament Tear?

The cranial cruciate ligament (CCL) helps stabilize your dog’s knee. When it tears or ruptures, the knee becomes unstable, painful, and prone to arthritis if left untreated.

In humans, ACL tears are usually acute, traumatic injuries, whereas dogs rarely tear this ligament from a single injury. In most cases, it’s a progressive condition caused by wear, genetics, and body mechanics.

 Signs pet owners may notice:

• Limping or sudden lameness, ranging from a slight limp to not bearing weight at all

• Difficulty standing up or sitting down, hesitation with stairs or jumping

• “Toe-Touching” 

• Stiffness, especially after rest

• A "popping" or "clicking" sound from the knee

• Muscle atrophy (wasting) in the affected limb due to lack of use

• Decreased activity or playfulness

"Some dogs show subtle signs at first, which can make early diagnosis tricky. If any of these signs sound familiar, you’re not alone, and you don’t have to guess."

How we evaluate a suspected CCL injury

Because the signs of a cranial cruciate ligament (CCL) injury can be subtle and sometimes mimic other orthopedic issues, diagnosis is more than just watching how a dog walks.

Here’s what a veterinary evaluation typically includes:

Physical examination

Your pet will be placed on his/her side, and the veterinarian will feel the knee for a “cranial drawer motion”. Which will assess your dog’s knee stability, muscle tone, and range of motion. Cranial drawer motion refers to an abnormal forward sliding of the tibia (shin bone) relative to the femur (thigh bone) in a dog's knee, resembling a drawer opening. Any instability or excessive movement signifies a positive test, pointing to ligament damage. 

“Diagnosis isn’t based on just one test. We look at the whole picture: the exam, imaging, and how the dog is using the leg before making recommendations.” — Dr. Johnson

X-rays

While X-rays don’t show the ligament itself, they are an important tool. They help rule out other causes of lameness, assess joint changes, and look for signs of arthritis or inflammation associated with CCL disease.

The full picture

Diagnosis isn’t based on just one finding. Age, breed, activity level, body condition, and how long symptoms have been present all factor into determining the best next steps.

Because CCL injuries are often progressive, early and accurate diagnosis is key to protecting the joint and preventing further damage. Once a CCL injury is confirmed, treatment options are discussed based on your dog’s size, lifestyle, and long-term joint health.

“From the first exam to imaging, we are focused on your pet’s comfort and safety before, during, and after surgery.” — Amber, Surgery Nurse

What are my treatment options?

TPLO (Tibial Plateau Leveling Osteotomy):  A surgical procedure that stabilizes the leg joint by changing the biodynamics of the knee with a plate and screws. This is the best recommended treatment for larger, active dogs.

Lateral suture (Extracapsular stabilizing suture):  A surgical procedure where a strong, non-biodegradable suture is placed outside the joint capsule to stabilize the knee. This procedure is best for dogs under 30 lbs that have a more inactive lifestyle.

Medical management: No surgical procedure. 4-6 months of activity restriction, where the knee builds up scar tissue to help stabilize the knee. Not the optimal treatment.

“Once a CCL injury is confirmed, our job is to help families understand all their options, what each one involves, what recovery looks like, and how it may affect their dog long-term. There’s no one-size-fits-all answer, and that conversation matters.”— PAH Surgery Team