CCL Tear (TPLO Surgery)
The Cranial cruciate ligament connects the femur to the tibia. Abnormal degeneration of the cruciate ligament can cause laxity of the knee joint. In people, this disease is known as an ACL tear. In dogs and cats the most common cause for CCL tear is degeneration and arthritis of the ligament. This fibrous band (cranial cruciate ligament) which is one of main stabilizers of the knee joint can rupture causing destabilization, lameness and pain in our pet friends.
How is cranial cruciate injury diagnosed?
You, your family veterinarian, and our veterinary surgeons use multiple layers of diagnostic tools to confirm a CCL injury in your pet friend. You may notice lameness in your dog which is the most common sign of a CCL injury. Your primary care veterinarian will detect pain on the physical exam along with laxity. We complete the diagnostic process by performing a thorough orthopedic and neurological examination, follow up x rays under sedation or general anesthesia. An experienced surgeon can palpate the knee joint and generally be able to tell if the CCL is partially or completely torn and recommend proper treatment.
How is CCL injury treated?
Medical management and rehabilitation is rarely recommended as this is a mechanical disruption of the joint and needs surgical stabilization. We do provide K laser, steroid injections, and injection of PRP (platelet rich plasma) in small pets and cats and anesthetically non suitable dogs as a medical management for this disease.
TPLO surgery: This is one of the most common surgeries done in our patients with CCL injury. It involves removing the excessive slope on the tibia to reduce the “free slide” of the femur and hence stabilizing the joint.
Since this is an osteotomy (making a 1/4 circular cut in the bone) it is stabilized with a locking bone plate. Dogs generally go home the next day. We provide instruction to do at home physical therapy which yields speedy recovery of your pets to normal activity.
Healing time is about 8 weeks and 95% of our patients return to normal activity. A normal activity means you as an owner would not be able to detect lameness at home, and working dogs can easily go back to helping our community (police dogs, seeing eye dogs, and therapy work dogs).
Prosthetic ligament surgery: In small dogs this can be performed although the healing time is unpredictable which may take up to 6 months. This repair is not as robust as TPLO. At AMSC, Dr Jha and his team offer lateral suture (a TightRope like technique) procedure.
Potential Complications of These Surgeries
Although very rare, the main complications are implant failure and infection. We treat infection using antibiotics and implant failure is dealt with removal of implants once the TPLO osteotomy has healed. These complications can occur with too much activity before the bone has healed or pets licking/chewing at the incision line.