Conservative Treatment Options for Partial and Complete CCL Tears in Dogs

Regenerative Medicine

Conservative Treatment Options for Partial and Complete CCL Tears in Dogs

August 30 2024
Companion

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Author(s): "Sherman O. Canapp Jr., DVM, MS, CCRT, DACVS, DACVSMR"
Published: Veterinary Practice News, November 2018

Dr. Canapp discusses options for the conservative treatment of partial CCL tears and complete CCL tears for which patients are unable to undergo surgical intervention. Options include photobiomodulation, regenerative medicine (including platelet-rich plasma and stem cell therapy), ice, NSAIDs, TENS, and more.

Cranial cruciate ligament (CCL) insufficiency is the most common cause of hind limb lameness in dogs. In 2003 alone, dog owners in the U.S. spent $1.32 billion for the treatment of CCL injuries in their pets. As an important stabilizer of the stifle joint, the CCL’s three main functions are to prevent hyperextension of the stifle, internal rotation of the tibia, and most importantly to prevent tibial
thrust in relation to the femur. Once torn, the damaged CCL leaves the stifle unstable and results in chronic, progressive lameness, predisposition to meniscal tearing, and ultimately, the formation of osteoarthritis. No matter the treatment approach, there will be arthritic changes in the stifle joint following CCL rupture.

Surgery will always remain the best option for stabilization of the CCL-deficient stifle, and its goal is to primarily minimize the progression of osteoarthritis. While there are numerous options for surgical management, surgery is not always feasible. Possible reasons for either opting against surgery or delaying the procedure may include concurrent medical issues, pet owner financial concerns, or staging procedures for bilateral CCL insufficiency. One recent study reported that dogs treated surgically and with
nonsurgical methods (weight loss, administration of NSAIDs, and rehabilitation therapy) had better overall outcomes compared
with dogs that were treated via nonsurgical methods alone.

Options do exist for the conservative treatment of partial CCL tears and for complete CCL tears for which patients are unable to undergo surgical intervention. Though controlled prospective studies should be completed, these options provide veterinarians
and pet owners with alternative considerations.