Treatment options for torn ACL in dogs

torn ACL in dogs

A torn ACL in dogs (anterior cruciate ligament) is the most common knee injury seen in dogs.  Dr. Anna Coffin will briefly describe this condition and then discuss treatment options available to fix a torn ACL in dogs.[Tweet “A torn ACL in dogs (anterior cruciate ligament) is the most common knee injury seen in dogs.”]

Knee anatomy

The knee joint is a fairly unstable joint because it doesn’t have any interlocking bones within the joint.  The femur (upper bone) and the tibia (lower bone) are held together by multiple ligaments.  There are two cruciate ligaments that cross from front to back of both of these bones which allow the knee to move back and forth like a hinge, but restrict side to side movement.  There are also two meniscus that act as shock absorbers between the femur and the tibia. 

The anterior (front) cruciate ligament is commonly ruptured due to some type of twisting injury. This type of injury usually happens when a dog is running and suddenly changes directions.  It is common for the meniscus to become damaged when this ligament ruptures.

A torn ACL in dogs is extremely painful.  The torn ligament results in an unstable knee joint and dogs typically present completely non weight bearing in the affect limb.  Without surgery damage will occur to the cartilage and the surrounding bones and lead to arthritis. 

Surgical repair

There are several surgical techniques that are used to correct torn ACL in dogs. 

Tibial Plateau Leveling Osteotomy (TPLO):

This is the procedure recommended by most board certified veterinary surgeons for torn ACL in dogs and is the procedure of choice performed at Oklahoma State University.  The purpose of this surgery is to change the angle of the top of the tibia from 20% to 6.5% to prevent the femur from shifting forward. 

  • The surgery involves making  a semicircular cut in the tibia.  This bone segment is then rotated to achieve a “level” tibial plateau.  The rotated bone segment is then secured with a specially designed orthopedic plate.

Tibial Tuberosity Advancement (TTA):

This procedure is more commonly performed in dogs with a steep tibial plateau.  Recovery may be slightly quicker with this procedure because it is a less invasive of a procedure.

  • The surgery involves making a cut through the front of the tibia where the patella ligament attaches.  A special orthopedic spacer is screwed into this space which brings the front part of the knee forward and up.  A bone plate is then attached to hold the front section of the tibia in the proper position.

External Capsular Repair (ECLS):

This is the oldest and traditional surgical correction for torn ACL in dogs.  The joint is stabilized from outside the joint capsule.  A special type of suture material acts as an artificial ligament to prevent joint instability.

  • The surgery involves drilling two holes, one through the front of the tibia and one through the back of the femur, so an artificial ligament can be passed through them.  Over the last decade, new materials and anchoring devices have been made available to make this surgery more successful than ever before.

TightRope procedure:

This is a slight variation to the ECLS repair using different materials and a slight variation in technique.  The TightRope procedure uses a customized needle, special suture material and bone anchors to stabilize the joint.

  • The surgery involves drilling bone channels through the femur and tibia.  The customized needle and suture is then run through the channels of both bones.  Bone anchors are used to reduce the need for additional suture material in the joint.

TPLO and TTA advantages: 

  • faster healing
  • resume normal activities quicker
  • better range of motion in the knee

TPLO and TTA disadvantages:

  • expensive
  • infection can be post op complication in < 10% of all patients

ECLS and TightRope advantages:

  • less expensive
  • less invasive

ECLS and TightRope disadvantages:

  • 15% failure rate
  • infection can be post op complication in 1-4% of all patients
  • knee joint must still be opened to remove damaged ligament and remove or repair damaged meniscus

If you have an Ask Dr. Anna question you would like answered, please post them in the comment section. Stay up to date on all the latest by subscribing to my blog.  Also “like” me on Facebook.

Dr. Anna was born and raised in Guthrie, Oklahoma. As a teenager, Dr. Anna found her beloved pet dead on the side of the road left to die without any help. That was the moment she decided to become a vet and vowed to help other people and their pets. After a few years of practicing in New Hampshire, Dr. Anna became homesick and decided to return to Guthrie to be with her parents and five other siblings. Family and friends are a major part of our lives which is why we treat our clients at Guthrie Pet Hospital as family.  Dr. Anna and her husband do not have children but are very proud pet parents and therefore, treat every four legged friend as part of the family.

If you have an Ask Dr. Anna question you would like answered, please post them in the comment section. Stay up to date on all the latest by subscribing to my blog.  Also “like” me on Facebook.

Dr. Anna was born and raised in Guthrie, Oklahoma. As a teenager, Dr. Anna found her beloved pet dead on the side of the road left to die without any help. That was the moment she decided to become a vet and vowed to help other people and their pets. After a few years of practicing in New Hampshire, Dr. Anna became homesick and decided to return to Guthrie to be with her parents and five other siblings. Family and friends are a major part of our lives which is why we treat our clients at Guthrie Pet Hospital as family.  Dr. Anna and her husband do not have children but are very proud pet parents and therefore, treat every four legged friend as part of the family.

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