Rupture of Cranial Cruciate Ligament

Rupture of the cranial cruciate ligament is one of the most common orthopedic injuries affecting our pets. The cranial cruciate ligament (CCL) is an important structure stabilizing the knee in dogs, it is equivalent to the anterior cruciate ligament (ACL) in people. This ligament is in the knee, or stifle of the dog, which is in the hindlimb. When these pets tear their CCL they are most frequently toe touching or non weight bearing in the affected hind limb.  People most frequently tear their ACL in a traumatic injury, pets can tear their CCL traumatically but most commonly it is a degenerative condition based on confirmation and genetics. Pets that are overweight are at a higher risk of this injury.  30-50% of Dogs that tear one cruciate ligament will tear the second one within one to two years due to the degenerative nature of the disease. Additionally due to the degenerative component partial tears are very common as well. These pets have more mild lameness and intermittently use the limb normally. At Dogwood Veterinary Clinic, we may recommend trying to manage a partial tear medically with regenerative medicine or other medical treatment. In the event of a complete tear, surgical treatment is the only option for full recovery.

Surgical Treatment Options

For pets greater than 35 lbs at Dogwood Veterinary Clinic Dr. Chris Franklin performs the modified maquet procedure or the MMP. The MMP uses a wedge shaped implant of titanium foam to reduce tibial thrust by making a 90 degree angle between the tibial plateau slope and the patellar tendon. Another surgical technique, The Tibial Plateau Levelling Osteotomy, TPLO, and the MMP achieve the same outcome through adjusting the pet’s anatomy in a different way. The anatomical angle created by these surgeries removes the forces typically applied to the cruciate ligament, relieving the pain for the patient. The MMP procedure is a modification of the  tibial tuberosity advancement or TTA. There are positives and negatives to all three of these procedures and no clear indication of which surgery is considered the best. We are happy to discuss surgical options with you during a presurgical consultation and discuss if your pet is a good candidate for the MMP. 

A lateral suture is a procedure which utilizes a strong suture material passed through the front of the tibia and around the fabella of the femur to reduce tibial thrust. Like the procedures described above, elimination of tibial thrust alleviates forces on the damaged cruciate ligament. This is a very successful procedure in smaller patients, but in larger size dogs there is high risk of failure, meaning the suture stretches or tears and is no longer accomplishing the goal of reducing the tibial thrust. At Dogwood Veterinary Clinic this procedure is not recommended in patients over 35-40 lbs. 

Dr. Chris Franklin at Dogwood Veterinary Clinic very comfortable and experienced in surgical treatment of cranial cruciate ruptures. Please contact us at Dogwood Veterinary Clinic, Louisville veterinary clinic to discuss treatment options from your Louisville dog surgeon.