Cranial Cruciate Ligament (CCL) Surgery in Dogs

Cranial cruciate ligament (CCL) tears are a frequent type of orthopedic injury found in dogs. Our veterinarians at Seattle will describe this injury and provide an overview of the surgical procedure required to treat your dog. 

What is a CCL?

The CCL is a tissue in a dog's knee that connects and stabilizes the upper and lower leg. When this tissue gets torn, it causes pain, immobility, and instability in the joint. CCL ruptures in dogs happen when the cranial cruciate ligament (CCL), similar to the ACL in humans, gets torn in the knee.

How to Identify a CCL Injury

When it comes to CCL tears in dogs, 80% of cases are chronic onset ruptures caused by degeneration, mainly occurring due to aging in dogs aged five to seven. Acute onset ruptures are more commonly observed in pups four years or younger and are caused by injuries sustained during their everyday activities.

Symptoms of a CCL rupture may include:

  • Crepitus (crackling noise of bones rubbing against each other)
  • Decreased range of motion
  • Hind leg extension while sitting
  • Pain when the joint is touched
  • Lack of motivation to exercise
  • Irritability
  • Restricted mobility
  • Stiffness after exercising
  • Swelling/Inflammation
  • Thick/firm feel of the joint
  • Weight shifted to one side of the body while standing
  • "Pop" sound when walking

If you notice any of the listed symptoms above, contact your vet and schedule an examination for your dog. 

Non-Surgical Treatment

For small dogs weighing less than 30 pounds, there's a chance of recovery without surgery. It involves providing enough rest, administering anti-inflammatory medication, and engaging in physical rehabilitation. However, the possibility of recovery depends on your pet's size, overall health, and the seriousness of the CCL injury. Your veterinarian will guide you on the most suitable steps to take for your dog's well-being.

Treatment Via Surgery

CCL surgery is extremely common in dogs, accounting for approximately 85% of all orthopedic surgeries performed annually. Due to its prevalence, various procedures have been developed to treat this ligament injury. Each technique has advantages and disadvantages, so it's crucial to consult your veterinarian to identify the most suitable procedure for your dog. Here are the primary methods used to repair this injury.


Arthroscopy is a minimally invasive technique used to see the structures of the stifle joint, including the cranial and caudal cruciate ligaments. It provides improved visibility and magnification of the joint. The technology used in this procedure allows for small incisions when treating partial tears of the cruciate ligaments and meniscus. However, it may not be suitable for completely torn ligaments.

Lateral Suture or Extracapsular

Ideal for small to medium-sized dogs, this surgery uses sutures on the outside of the knee joint to stabilize it. It's a commonly performed procedure for this type of injury and is typically done on dogs weighing less than 50 pounds.

TTA (Tibial Tuberosity Advancement)

TTA is a method of surgery that corrects the need for the CCL by cutting the top of the tibia, moving it forward, and stabilizing it in its new position using a plate. Therefore, the goal with TTA is to replace the ligament entirely, rather than repair it.

TPLO (Tibial Plateau Leveling Osteotomy)

TPLO surgery is becoming increasingly popular and is the best option for larger dog breeds. The procedure entails cutting and leveling the tibial plateau. From there, the surgeon stabilizes the tibial plateau using a plate and screws. This surgery also eliminates the need for the ligament.

Post-Op Recovery

No matter what operation is done to fix the ligament, the care your dog gets after surgery determines how successful it is. The first 12 weeks after surgery are crucial for recovery. Limiting exercise and encouraging your dog to use their leg are important for a successful recovery. After two weeks, you can gradually increase the length of your dog's leashed walks. 

By the eighth week, your dog should be able to take two 20-minute walks each day and do some basic daily activities. After ten weeks, your vet will take x-rays to check how the bone is healing. Your dog can gradually go back to normal activities. We recommend a rehabilitation program for your dog's recovery. 

Make sure the rehabilitation facility you choose has experience with post-op recovery for orthopedic injuries like TPLO.  Acupuncture treatments and laser therapy for dogs have shown positive results for some dogs

Is your dog showing signs of a CCL tear? Contact our Madison Park Veterinary Hospital vets and book a consultation today