What is the Cranial Cruciate Ligament (CCL)?  The CCL is one of the ligaments that stabilises the stifle joint (knee) of your dog. Animal Health and Hydro  sees many CCL injuries weekly. They can be caused from wear and tear over time or from a traumatic incident.  They also vary in severity, from a slight tear in the CCL or a complete rupture of the CCL. A dog with a CCL injury might present from a slight limp on the hind limb or be completely non-weight bearing. 

There are also many ways to treat a CCL injury. 1. Surgical. A veterinary surgeon will either replace the ligament or change the biomechanics of that stifle joint by cutting bone and plating.  This should be followed with rehabilitation to build range of motion and muscle strength. 2. Conservative. These options can include custom made braces, prolo-therapy, platelet rich plasma, controlled rest and exercise, and any combination of the above. 

Prolotherapy is a treatment where the dog is placed under sedation and is injected with a natural irritant substance to kick start the body’s healing response to lay down scar tissue over the damaged ligament. The scar tissue then replaces the function of the CCL in the joint. 

Platelet rich plasma (PRP), is when the patient’s own platelets are injected back into the injury site to speed up the healing process in that area. 

Case Study: Fai the German Shepherd, aged 10yrs

Fai has been an amazing, fit and healthy dog for the majority of his life. He is a very active dog and has never looked a day older than 4. Once a week Fai goes to his favourite plot to have a run around and swim in the pool. After seeing the neighbour’s dogs while he was having a run around, Fai bolted up the driveway to chase the dogs off and suddenly started to lift his left hind leg up off the ground. 

Fai had traumatically tore his CCL. His guardian believes in a holistic approach to medicine and considering his age, we decided to treat Fai’s CCL injury conservatively. 

Fai had a custom brace made and fitted to support his stifle joint. He also received a series of prolotherapy treatments. 

Rehabilitation can begin as early as one week after the procedure. Within two weeks Fai was in the underwater treadmill to strengthen his muscle in his hind limb. Because scar tissue is non-elastic it is critical to start rehab sooner. Fai would wear his brace during the exercises as well as at home. Once he was slightly stronger we would remove his brace while in the underwater treadmill (as the water provides him with support). Fai responded really well with the combination of underwater treadmill, massage and controlled exercises.

A year later the CCL on the right hand side tore. There is a 40-60% chance of this happening, regardless of whether a conservative or surgical route is taken. 

A prolotherapy treatment was given on the right as well as PRP on both stifles. Fai bounced back like a young puppy. A therapy program was put into place to work both hind limbs, which also include periods of time without the braces until he was strong enough to not need them anymore.  Fai is now on a maintenance program including home based exercises and check-ups at AHAH.