What Happens if a CCL Rupture is Not Repaired?
Surgical intervention for cranial cruciate ligament repair can be a costly and time-intensive process. The procedure can range anywhere from $800 to $2500 plus, depending on which surgical technique is used. Your dog will also need to be on a number of medications including sedatives, antibiotics, and anti inflammatories. Owners must place their pets under strict supervision for a few months to follow the procedure, to ensure that the stability of the procedure is maintained. All of these factors need to be taken into consideration when developing the best treatment plan for your dog.
Surgery is not always an option for some animals. There are risks from anesthesia, and allergies to which some dogs are particularly sensitive. The financial burden of a surgical procedure can be great, and is not always an option for even the most caring owner.
What happens if my dog’s cranial cruciate tear is not repaired? Will my dog’s knee heal on its own?
A ruptured or torn CCL will decrease stability within the stifle (knee) joint. Your dog will begin to produce wear between the bones and meniscal cartilage, becoming abnormal, the joint will begin to develop degenerative changes. Eventually bone spurs known as osteophytes develop and chronic pain and loss of joint motion result. The osteophytes are evident as soon as 1 to 3 weeks after the rupture in some patients, with others showing no osteophyte development after years of living with the condition. The development of osteophytes, and degenerative changes in general, typically is related to the size of the dog, i.e. it is more difficult for a large breed dog to bear extra weight on an injured joint, whereas a lighter dog has an easier time with weight displacement.
It is normal for dogs, of all sized, to show signs of improvement within several weeks of the time of the acute injury. During this time the dog may appear to get better, but it is unlikely that your pet will become permanently normal. There was a study done on a group of dogs for 6 monts after cruciate rupture. At the end of 6 months, 85% of the dogs under 30 pounds had regained near normal or improved function, whereas only about 20% of dogs over 30 lbs had regained near normal funciton. Both groups of dogs required at least 4 months of exercise restriction and anti-inflammatory medication use, also known as conservative management, before maximum improvement was shown.
Remember, any degenerative changes, such as osteophyte development and arthritis, that have taken place after your dog’s CCL injury will not be healed by surgery. These changes are permanent, and while they can be arrested by surgery, they can not be reversed.
i live in australia and have just been to the clinc to see a vet about ccl injury for my 6yr old labrador her name is Holly, she went lame about september last year. she weigh’s about 36kg an she is a lazy dog. Holly is quite happy to laze about the backyard an sleep all day, she does go for walks but not for long.Holly loves swimming in her paddle pool an our large pool. Other than that she sleeps an she is happy, the vet is recommending TPLO but i prefer extra capsular repair as it is less invasive an she is not an active dog the cost is not important. I have read everything possible on your site but still unsure, I am wondering if you could give me some advice on which one to do. I have another lab an she is very active with no ccl injury to speak of yet and i would not hesitate to do tplo on her but Holly i am not sure of. thanking you melanie from australia.
Melanie, My first opinion for my dog was TPLO. She is 170 lb Mastiff who had torn both hind CCL’s. I did some research and yes, TPLO is more expensive, and I would have done it for her, but opted to get a second opinion at a teaching hospital (they perform Encapsulation, TTA, TPLO…not into tight rope yet, but I was certain I didn’t want that). I wanted a true evaluation for all three options. Going in, I was leaning toward TTA or Encapsulation. Because of her size and the fact that she needed both legs done, they recommended TTA. They had done 5 or 6 bilaterals in the past months and all dogs walked out in 4-5 days, assisted with a sling, of course. At 170 lbs, we knew this was our best option. Kendra had her surgery this past Friday and she was walking on Saturday evening. We had two legs done at the same price as one TPLO. Now I would also tell you that our friends had a 195 lb Mastiff who had his first encapsulation at 3 yrs old, the second one needed to be done a couple of years later….he lived to be 13 1/2 and was walking up to the end. So I was very interested in doing encapsulation. There were a few reasons I decided not to do encapsulation – she would not have enough stability to put pressure on both legs at the same time, TTA implants a small plate for that stability. the encapsulation specialist we would have gone to, not available for two more weeks and the fact that the teaching hospital could do any of these procedures, and they would still recommend TTA due to her size and the fact that we could not carry her or lift her. It was an overall approach that would work best for her and for us. Do some more research and get a second opinion, preferably somewhere where they do all of the procedures. We have always had our best results at a Vet teaching hospital…don’t know if you have access to one. Our Vet is very good about referring us to specialists and to the teaching hospital for further opinion. It sounds to me like encapsulation would work for your dog. Make sure they would use at least 2 wires, in case one breaks. The healing process is a bit longer because it relies on the body’s ability to develop scar tissue, which in fact, is what ends up being the stabilizer longer term. This is again why we couldn’t do it. By the way, the plate and bone cutting in a TPLO was more significant…in my mind, than the TTA. And we were told that it would be 4-5 weeks between leg surgeries due to the healing process of the first TPLO. Not a viable option for Kendra.