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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.

Duke the BulldogIt 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.

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12 Responses to What Happens if a CCL Rupture is Not Repaired?

  1. January 31, 2010 at 6:30 pm #

    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.

  2. February 2, 2010 at 7:15 am #

    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.

  3. November 28, 2010 at 4:28 pm #

    I am looking for anyone that has chosen conservative (non-surgical) therapy. I have a 7 yo female golden. She has a partial tear that occurred about 8 weeks ago. I have taken her off all pain medications and she is doing well. She is bearing about 65-80% weight on injured leg. I’ve kept her restricted (against her will) and seems to be doing well. I have another appointment next week, but would like to hear from anyone that has tried the non-surgical approach.

    Thanks

  4. December 15, 2010 at 12:11 am #

    READ THIS BEFORE YOU HAVE THE SURGERY DONE!

    I have a small (42 lbs) APBT female named Emma. 2 years ago, as of this Christmas, she just stopped using one of her rear legs. As soon as we got back into town I took her to my Vet. She was put under and it was found that she had the drawer symptom. The vet gave us some pain killers, explained the treatment choices and sent us on our way.
    I exhausted myself reading all I could and just tried to make the best decision for her. Well, two weeks later I came home from work and my baby could not walk. She just hopped not moving EITHER OF HER REAR LEGS! I freaked out and started bawling my head off! Thank god for a husband that keeps a level head! I took a deep breath and called my vet. A day later and we had a confirmation that she had blown the other CCL! At this point I knew I could not afford both legs. I had a hard time convincing my husband to agree to one! I decided to try conservative methods and if she was not better in 8 weeks, then I would get one leg done.
    I totally restricted her. I mean totally. NO walks, NO jumping and pretty much no activity. I got a doggie litter box and a lot of toys and crossed my fingers.

    Well, now here we are two years later and Emma RUNS EVERYWHERE! No one would ever guess she ever had any issues. Will she have arthritis? Yeah probably, but so will the dogs that had Tightrope, Ex-cap, TTI, and TPLO. Her scar-tissue does the same thing as the tightrope and ex-cap.

    And people if your vet is telling you that your little 20 pounder needs surgery, get a second opinion! I am just saying what do you have to loose? If you restrict the activity level, no considerable damage will occur so do not think that. And if you are thinking “geeze I could never manage to keep my dog that constricted” just forget about treatment right now as the recovery period after a surgical fix is about the same as conservative therapy.

    Just my and Emma’s 2 cents.

  5. December 21, 2010 at 3:55 am #

    Hi my 33 lb rotty had a tear in his ACL and had the Extracapsular Repair surgery after months of trying to rest the limb but didnt mend so vet decided to operate. He was doing brilliant and after four months he has started to limp again on the same limp. I called my vet who told me it was probably arthritis pain and to rest him. So I did and three days later he limped bad and walked strange again. So I took him to the vet and she said he would nbeed to come in to have to checked again..so operation was ment to be preformed yesterday (2.12.2010) I was told to pick him up at 6pm. I went down at 6pm and was told they didnt operatate (ARRGGHHH) he is showing sign of the drawer method again but he has swelling around the knee. He says he wants to see him in 3 weeks and assess him again ( I aint happy ) so has the Extracapsular Repair failed or do they still have slight drawer movement in the joint for a while? could u plz email me and let me know thankyou

  6. February 13, 2014 at 8:42 am #

    hi I got a chow 58 pound she got an acl right now the vet told me to make her loose weight and put her on diet some day she walk and jump around like she got nothing and some days she limp but she dosent look like shes is in pain at all she bring me toy and wait for me to throw them I don’t cause am scare to make her worst should I operate her put her in all the pain of that operation and how long they will keep her at the vet after that operation can someone answer please

  7. February 28, 2014 at 1:37 pm #

    Have a Great Pyrenees that I am waiting for the extender to come for his new ctrac braces.
    Bilateral ccl tears for an 80 lb baby is tough. I “carry” his backside to the yard and back inside. He will not just stop and take care of business.He does stay quiet in the house, and pretty much in the same place day and night. Started Yucca, glucosamine and duramax. Hope to back off duramax with Yucca. Trying to lose weight with diet of vegis low fat high
    protein (body building) chow. Anyone use Darwin? or other natural foods?
    Does the fear for your pal subside? The heartache of watching them limp, wobble after
    being active is huge. Anymore UPstories of CM care? would love to see more.
    thanks

  8. February 28, 2014 at 3:55 pm #

    Nancy
    I have a female golden who tore her knee four years ago. After having two dogs go through the surgery, I decided to treat it without surgery. I did all the same bed rest and therapy, as if she had the surgery and the results were better than the two that had surgery. Less limp and no intense pain. My orthopedic doctor used her as a case study. I was thrilled with the results.
    However, each case should be evaluated on its own merits but I knew I could always do the surgery if necessary.
    During her recovery we used the sand dunes to maintain strength without impact. The heal time takes months and should be done on the advice of your doctor.

    She is now 11yo and has no issues with that leg.

    Good luck

    • March 2, 2014 at 11:53 am #

      Donna thank you for responding and positive words.
      Was this complete a complete tear, to the bone? I am so very afraid
      of hurting Norman more. He has never had anything wrong with him. A little bump removed from his lip, not a problem. He will have an ok day then crushingly lousy. Eats, but not that interested in going out. It is not comfortable to sit or get into the “usual position” to tinkle.His favorite thing to do besides ride in the car is be out with me. What kind of ramp did you find to be the best? Norman does not like his rumpus lifted all that much. Any suggestions for a hoist? Tried the sheet, towel, and I am not much bigger than him. And disabled. We are a pair. However he does the usual, gets excited after toitty breaks and wants to run.Glad he is still “in there”.
      So, what a crazy 2 weeks this has been. From a small tear to 2 full ones in a week.
      Just want whats best for Norman. Hard, its just us.
      Glad your kids are doing well! Patience It is a long commitment no matter what, right?
      Nancy

      • March 2, 2014 at 3:11 pm #

        Hi Nancy,’

        I am so sorry to hear about Norman’s knees. The bright side is that the legs will heal at the same time. I know that’s not much comfort right now. It is a long journey back to him being independent and then the run will be somewhat restricted.

        I have had the best luck with the ramps from dogramp.com. I drive a tahoe so it’s pretty high off the ground. They are light and easy to manipulate.

        Josie tore the other knee, (both partial tears) last September. She was on bed rest for 6 straight weeks and then the long journey back to a full walk. She is doing great. I swim her (inside all winter) at a local dog training place and I have her in the hot tub on the weekends.
        The combined water therapy and light walks are helping a lot. She was recently put on thyroid medicine to help with the weight loss. I also have her on Arnica Montana and Dasuquin with MSM everyday.
        I’ve been keeping her off the blacktop as much as possible. We’ve always hiked the trails and I feel that the blacktop is not as forgiving. Trail hiking helps her to use different muscles, in the knee, to assist in strengthening. She is tough old bird. 🙂
        She was miserable the first couple months, after her latest tear, but is back to a snotty golden.
        I did buy a fleece lined sling when my first golden tore her knee. I used that for Josie. She didn’t like it but needed the assistance.

        I hope some of this helps. Let me know if you have any other questions.

        Hang in there,

        Donna

        • March 2, 2014 at 6:33 pm #

          Thanks a bunch Donna! I will try the Arnica. I assume I will find it at a good health store. It seems that we will have ups and downs for a bit. Hard by myself. Big guy scary stuff. One would think mid life would make us tougher. Not at all. Norman has been a God send so I am really partial.
          I will keep checking in and if you think of anything else please post. Nice to hear kind words of encouragement.
          Nancy

Trackbacks/Pingbacks

  1. Brewster - Ruptured CCL Misdiagnosis? - Dog Knee Injury - July 27, 2018

    […] I most certainly do not want Brewster having surgery unless it’s absolutely necessary. I am scared to death I’m making the wrong decision, but I am sold on conservative management. Only worries are keeping a 1 year old puppy on […]

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