Conservative Management for Canine ACL and CCL Injuries

Knee injuries are one of the most common orthopedic ailments affecting dogs. The cranial cruciate ligament (CCL), also called the anterior cruciate ligament (ACL), is very important in stabilizing the knee joint, and when it is damaged, it hurts! It’s likely that any dog with a sudden lameness in one hind leg has ruptured that ligament.


There are two distinct types of dogs that suffer from a ruptured cruciate ligament. The first is the young active dog that runs and plays hard, and injures his knee. The other is the older dog, often overweight, and over the years his cruciate ligament has stretched and become weaker.  The ligament can partially tear, but this may not be easy to detect until it completely ruptures. These dogs may present with a low grade chronic lameness that becomes suddenly worse when the ligament ruptures.

But there are also “sports injuries”.  My Chester had a traumatic tear of his CCL when running and his paw got caught in a hole in the field.

There have been suggestions that neutering at a young age may predispose to cruciate ligament injuries, because it changes the way the bones grow and affects the conformation of the knee.

There is no “best way” to treat a ruptured CCL. A number of treatments are available, broadly split into surgical or conservative methods and your veterinarian will help you decide on what’s best for your dog.

Surgical methods are aimed at adjusting the angle of the main bones involved in the knee joint so that there is less reliance on the cruciate ligament for stability. Other techniques involve using synthetic materials to replace the ligament. Specifics of surgical techniques vary, with no significant differences among them in terms of outcome.

Surgery usually results in a better outcome particularly for larger dogs, but it is more expensive. You need to also be aware that any surgery has risks, such as adverse reactions to anesthesia or infection of the wound to name a few.

Conservative treatment is aimed at supporting your dog’s body and helping it to heal itself. It is more affordable and smaller dogs (less than 30lbs) will usually recover well with time. It can take several months of care before the best results of this type of treatment will be seen.

The specifics of conservative treatment vary from practitioner to practitioner, but the general guidelines are as follows:

  • Strict rest for 8 weeks or longer. This means that your dog needs to be confined to a small area and taken outside to go to the toilet on a leash. After this time, you can gently ease him into a more active lifestyle. Hydrotherapy is excellent for exercising his joint without him needing to bear weight on it.
  • Weight loss. If your dog is at all overweight, this will put extra stress on his injured joint.
  • Acupuncture can help with pain relief, but it’s likely that your dog will benefit from some anti-inflammatory medication. Be aware that if he feels better, he may want to use his leg and he may do even more damage, so keep him confined.
  • Joint supplements such as glucosamine and green lipped mussel extract can be useful.
  • Physical therapy with passive range of motion exercises will keep his joint flexible.
  • Some people like to use a brace to support their dog’s injured knee.

Rupture of the CCL is the most common orthopedic injury in dogs. Conservative treatment works very well for small dogs, but its track record with larger dogs is mixed. However, there is no harm in attempting conservative treatment with a large dog, then electing surgery in a few months if your dog is not recovering as well as you’d like.


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