Cranial Cruciate Ligament (CCL) injuries are a common orthopedic issue in dogs, often leading to significant pain and mobility problems. Dog owners must understand what a CCL rupture is, how to recognize it, and what treatment options include surgery and recovery.

What is a cranial cruciate ligament (CCL) rupture?

The Cranial Cruciate Ligament (CCL) in dogs is analogous to the Anterior Cruciate Ligament (ACL) in humans. It is a critical ligament within the knee joint, providing stability during movement. A CCL rupture occurs when this ligament is torn or damaged, leading to instability, pain, and impaired mobility. This injury can happen suddenly due to trauma or develop gradually due to degenerative changes in the ligament.

How to Identify Symptoms of CCL Injuries in Dogs

Regarding CCL tears in dogs, 80% of cases are chronic-onset ruptures caused by degeneration, usually due to aging. This is most commonly seen in dogs senior dogs.

Acute onset ruptures are most commonly seen in pups four years or younger. These tears are caused by injuries sustained while the dog is running or living its daily life.

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

Dogs weighing under 30 pounds can recover from a CCL injury without needing surgery. This can be achieved through ample rest, anti-inflammatories, and physical rehabilitation, such as cold laser therapy. Whether this approach is suitable for your pet will depend on their size, overall health, and the severity of the injury. Your veterinary surgeon will guide your dog's most appropriate course of action.

Treatment Via Surgery

Canine cruciate ligament (CCL) surgery is the most frequent orthopedic surgery performed on dogs, accounting for about 85% of all such surgeries annually. Due to the prevalence of this injury, various procedures have been developed to address the ligament damage.

Each technique has advantages and disadvantages, so it's essential to consult your veterinarian to determine the most suitable procedure for your dog's specific condition. Below are the most commonly used methods for repairing this injury.


Arthroscopy is a minimally invasive procedure for visualizing the knee joint structures, including the cranial and caudal cruciate ligaments. This technique provides improved visibility and magnification of the joint structures. It involves minimal surgical incisions and can be used for partial CCL and meniscus tears but may not be suitable for completely torn ligaments.

Lateral Suture or Extracapsular

Often recommended for small to medium-sized dogs, this surgery stabilizes the stifle (knee) using sutures placed outside the joint. It is one of the most frequently performed surgeries for this type of injury and is usually performed on dogs that weigh under 50 pounds.

TTA (Tibial Tuberosity Advancement)

TTA is a surgical method 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.

CCL Surgery in Dogs Post-Op Recovery

No matter which operation is performed to repair the ligament, your dog's care after surgery will determine how successful the operation is. The first 12 weeks following surgery are crucial for recovery and rehabilitation. Limited exercise and encouraging your pup to use their leg are keys to a successful recovery.

You can gradually increase the length of your dog’s leashed walks at two weeks post-operatively.

By the eighth week, your dog should be able to take two 20-minute walks each day and perform some of their basic daily living activities.

After ten weeks post-operatively, your vet will take x-rays to assess how the bone is healing. Your dog will be able to be able to resume normal activities gradually. We at White House Animal Hospital recommend a rehabilitation program to optimize your dog’s recovery.

Whatever rehabilitation facility you attend should have experience in post-op recovery from orthopedic injuries such as the TPLO.

Some dogs have also experienced positive results via acupuncture treatments and laser therapy.

Note: The advice provided in this post is intended for informational purposes and does not constitute medical advice regarding pets. For an accurate diagnosis of your pet's condition, please make an appointment with your vet.

Is your dog showing signs of a CCL tear? Contact our White House Animal Hospital vets and book a consultation today