24/06/2025
Let’s talk… Cranial Cruciate Ligaments!
In light of a large percentage of my cases coming to me for rehabilitation from cranial cruciate ligament (CrCL) injury, I thought I’d make a post outlining what this injury is and what it could mean for your dog.
The CrCL attaches the femur to the tibia, prevents the tibia sliding forwards and stops the stifle (knee) from over extending or rotating. It’s the equivalent of the anterior cruciate ligament, ACL, in humans. However, this pesky ligament is notorious for degenerating over time and eventually going ping!
What types of injury can occur in the CrCL?
🤕Partial tear: Some fibers of the ligament are damaged, but it still functions to some extent.
🤕Complete tear: The ligament is fully torn, resulting in significant instability.
🤕Chronic degeneration: The ligament experiences micro damage over time, much like a fraying rope.
There are multiple factors that predispose the CrCL to injury including; genetics 🧬, conformation, hormone imbalances, obesity and inflammatory joint conditions🦴.
What symptoms might you see in your dog?
- Lameness in the affected hindlimb
- Difficulty getting up, jumping, or running
- Intermittent or persistent pain
- Swelling around the stifle
- Positive ‘cranial drawer’ test on physical exam where the tibia moves forwards when manipulated by the vet
Causes of CrCL injury:
⚠️ Acute trauma (e.g., a sudden twist or impact)
⚠️ Degenerative changes from age or overuse
⚠️ Obesity increasing joint stress
⚠️ Poor conditioning or muscle weakness
⚠️ Genetic predisposition
So after all that… what options do we have for treatment? There are a few!
Conservative management: no surgery! Starting with rest, rest and more rest! A rehabilitation plan can be put in place with plenty of exercises tailored to assist your and your dog to aid their recovery.
Ligament replacement sutures: Nylon sutures are placed in the femur to the tibia to replicate the original ligament.
Tibial Tuberosity Advancement (TTA): Alteration of the direction of traction from the quadriceps muscle group. Preventing the femur sliding down the tibia.
Tibial Plateau Levelling Osteotomy (TPLO): Perhaps the most common fix! A cut is made in the top of the tibia, the plateau segment is rotated in order to lose the slope. Plates and screws then fix the bones in place.
It is a very common occurrence that when one CrCL is injured the other will injure at some point. However, dogs tend to recover well from CrCL injury providing they receive intense physiotherapy and rehabilitation plans to follow! Over the next few weeks I’ll be putting together posts outlining exercises beneficial to dogs rehabilitating from injury so stay tuned!👀
Pictures from Fitzpatrick Referrals, Kings Street Veterinary Hospital, Belton Veterinary Clinic, and Kyon.