When to Consider Conservative Management with Rehab After a CCL Tear
A diagnosis of a cranial cruciate ligament (CCL) tear can be devastating for an owner to receive. Studies have shown surgery is the most effective option for treating CCL tears; however, not all dogs are good candidates for surgery. What if the dog is in poor health and anesthesia is too risky? Surgery can be expensive, what if there are financial constraints? These dogs need options to restore function and mobility too.
The CCL is a ligament in the canine stifle. It’s analogous to the human ACL in the knee, and is one of the main stabilizing ligaments of the stifle. CCL tears can happen due to a single traumatic incident, such as stepping in a hole while chasing a squirrel, or from mild repetitive trauma from daily wear and tear. Genetics, poor conformation, some large breeds, age, obesity and being spayed/neutered can play a role in the incidence of CCL tears.
What happens with no treatment? The body will try to re-stabilize the stifle by creating inflammation, osteophytes and accelerating the development of osteoarthritis. This leads to compensation patterns which increase the risk of injury to the meniscus, the other CCL and other parts of the body as they work to reduce the strain on the injured stifle. This can happen within weeks of the injury. Early intervention is important regardless of whether you choose surgery or conservative management. Dogs with osteoarthritic stifles typically show signs of pain and difficulty with walking, sitting, and getting up. Don’t wait to see your veterinarian if you notice a sudden change in these signs!
Human ACL studies have shown surgery does a better job at restoring normal knee muscle activation and function compared to conservative management. Cases that do particularly well with surgery vs conservative management are ones in which the meniscus is also torn, and when the dog is looking to return to high energy performance sports. Rehabilitation therapy after surgery has been shown to further improve outcomes compared to surgery alone.
However, you and your veterinarian might decide surgery is not appropriate for your dog. If that’s the case, rehabilitation therapy can be a great tool for improving your dog’s function and make it easier for them to perform their everyday activities. Rehab can help slow the development of osteoarthritis by decreasing pain, normalizing joint mobility, correcting gait mechanics and strengthening muscle. Your rehabilitation therapist can also guide you on appropriate supplements, weight management and exercise prescription for your dog.
As you can see, there are many factors to consider when deciding how to treat your dog’s CCL tear. Early intervention is key to restore stability in the stifle, slow the development of osteoarthritis and reduce compensatory issues. Hopefully you and your pup won’t have to ever deal with a CCL tear, but if you do, know we’re here to help. Feel free to call us if you would like to discuss your specific situation!