My dog needs knee surgery; now what?
Picture your beloved dog running in the yard with its favorite toy and suddenly, it takes a turn and gives out a yelp. Alternatively, picture your four-legged friend taking a jump off the couch when the doorbell rings and giving out a yelp. After either of those events, your dog is now limping on its back leg and is putting only partial weight on that affected leg. After a couple days of rest the limp is no better, and you bring your friend to the local veterinary practice, where it is diagnosed with an anterior cruciate ligament (ACL) tear. In animals the proper terminology is a cranial cruciate ligament tear (CCL).
Based on its anatomy, the knee joint is a hinge joint. The joint is relatively unstable because there are not locking bones in the joint; instead, it is held together by several ligaments. The cruciate ligament in particular is one that allows the joint to move back and forth like a hinge, but restrict side-to-side motion.
There are several ways to address a CCL tear in a dog. One of the ways is rest, pain control, laser therapy, acupuncture, physical therapy and supplements to help slow down arthritis formation. The second option is surgery.
There are several surgical techniques available to address the torn ligament and pain. One of them is referred to as an extracapsular repair or swivel lock (modified version). This technique involves a plastic implant that connects the femur (upper thigh bone) to the tibia (lower leg bone). This is the least expensive procedure and less invasive, but the one with the highest failure rate. The failure rate is even higher for a very active or high-energy dog.
The other corrective techniques include cutting of the bone and placing titanium implants to support the bone to heal. When cutting and repositioning the bone we are altering the physics associated with the moving mechanics of the knee. Some of the other techniques are referred to as tibial plateau-leveling osteotomy (TPLO), CORA-based leveling osteotomy (CBLO), and tibial tuberosity advancement (TTA). Depending on the size of the dog and stage of arthritis in the joint, the surgery can cost $2,000 to $6,000. The techniques all have different success rates, so it is very important to review them with a veterinarian specializing in surgery.
When a dog has a torn CCL, it can be a very difficult condition to manage the pain, and often patients will not want to eat or drink or will be otherwise disinterested in their usual activities. The best course of action is to talk to your family veterinarian and review all the options, as surgery is not the best course of action for everyone.