Cruciate ligament

If a dog goes suddenly lame or is limping in one of the hind legs, he might have torn or ruptured a cruciate ligament. Common tears involve the anterior (also known as cranial) cruciate ligament. Much like in humans, such as athletes and sports players who often sustain cruciate tears.

The cruciate ligaments are two bands of fibrous tissue located in the knee joint. They join the bones above and below the knee together so that the knee works as a hinged joint. Like in dysplasia, environmental influences play a huge role in ligament injury. Over exercise, inappropriate or overly excited activity, obesity, jumping up and down from objects (especially cars and furniture), improper nutrition, disruption of hormones (such as spaying a dog too early before fully sexually mature), are the major external influences.

Signs of cruciate ligament injury

Cruciate ligament disease tends to occur in two forms.

1. The first, chronic form, occurs in dogs with mild ongoing lameness, which may initially resolve with rest and pain relief. Eventually the lameness worsens and does not respond to pain relief.
2. The second, acute form, occurs in dogs with sudden onset lameness. These injuries are often more obviously painful.

Signs of cruciate ligament rupture in dogs include:

• Lameness (limping) in the hind limbs.
• ‘Toe touching’ at rest – the dog is not properly weight bearing but just touching the toe to the ground.
• Reluctance to walk or exercise.
• Noticeable reduction of muscle mass (muscle atrophy) around the knee.
• Whimpering or yelping when bearing weight on the affected leg.

Treatments

A tear may be full or partial. There are several treatments options. Surgery is not always necessary for partial tears and conservative management is first advised. A full tear usually requires surgery at some stage but conservative management might be trialled initially.

Surgical

The procedure with the best outcome is TPLO surgery – Tibial Plateau Levelling Osteotomy. This a surgical procedure used to treat cranial (or anterior) cruciate ligament rupture in the knee joints of dogs. It involves changing the angle of the top of the shin bone (the tibial plateau) by cutting the bone, rotating it, and stabilising it in a new position with a plate and screws.

Non-surgical

Depending on the severity of the tear, you can heal a cruciate tear with physical therapy.

Dogs who are intermittently lame with a partial tear of the cruciate ligament are ideal physical therapy patients. In addition to providing weekly or twice-a-week ultrasound, laser, and electrical stimulation treatments, and a home strengthening program with range-of-motion and stretching exercises. “Every program is different depending on the dog’s condition.

Prolotherapy for Dogs

Prolotherapy, also known as proliferative or sclerosing therapy, has been used for over 30 years to treat musculoskeletal pain in humans, including arthritis, sports injuries, and damaged or partially torn ligaments, tendons, and cartilage.

The term “prolo” is short for proliferation, as this treatment is said to cause the proliferation (growth or formation) of new tissue in weakened areas. Ligaments have a limited blood supply, which slows healing, but in prolotherapy, injections of dextrose (sugar water) or other benign substances cause localised inflammation that increases the supply of blood and nutrients, stimulating tissue repair.

What to do if you suspect a cruciate ligament injury

If you suspect your labrador to have a cruciate ligament injury, please contact us and let us know first. Making an informed decision on treatment options for cruciate injury is very important and in our experience clients are often only given a surgical option by a lot of veterinarians, when in fact there are well-documented conservative treatment options that should definitely be considered as first.