Cranial Cruciate Ligament Injuries in Dogs: What You Need to Know


What we want to do for dogs with CCL injuries is to relieve pain, improve function and put the brakes on the advancement of osteoarthritis. How CCL disease is treated depends on several factors. Smaller dogs may get by with rest, physical rehab sessions, and medication for pain. Larger dogs or performance dogs, such as field trial champions or agility stars, are more likely to need surgery, especially if the goal is for them to return to their former activities.

Other factors to consider include the dog’s age and activity level, not to mention your budget. The cost of surgery can go as high as $6,000, so that’s certainly an important component of your decision. Your veterinarian may also have a preference based on experience and training in orthopedic surgery. There’s no single right answer, so don’t hesitate to discuss all the options.

And we have a lot of options when it comes to surgical repair. They include the TightRope (TR) stabilizing procedure; a lateral suture (LS) procedure; a tibial plateau leveling osteotomy (TPLO); and a tibial tuberosity advancement (TTA) procedure. The TPLO and the TTA involve cutting the bone to rebuild the knee, while the TR and LS are less invasive implants that use synthetic materials to bind the femur and tibia. Each procedure has pros and cons. Ask about their complication rates and long-term success rates.

In the future, we may be able to use regenerative therapies to repair CCL injuries. Researchers are looking at whether platelets from a dog’s own blood, which contain growth factors, can heal the injuries. Another area of research is the use of stem cells to rebuild the tissue.


In the meantime, take the following steps to help prevent CCL disease in your dog:

  • Keep him lean. I can’t stress this enough. Fat dogs are at increased risk for developing CCL injuries.
  • Keep him active. Dogs need daily exercise for good muscle tone and joint health.
  • Keep him safe. Provide a ramp to help your dog get in and out of the car, and don't let him jump or run on slick surfaces.

Reconsider the age at which you spay or neuter your dog. It may be better to wait until the dog reaches full skeletal maturity or — for males — to use the Zeutering procedure, which sterilizes the dog but maintains a higher level of testosterone, which can have a protective effect on joints.

More on


Join the Conversation

Like this article? Have a point of view to share? Let us know!