My dog has a torn ACL: What are the treatment options?

When a dog is diagnosed with a torn ACL — more accurately called a cranial cruciate ligament (CCL) rupture — it can be an overwhelming and emotional moment for any pet owner. This ligament plays a critical role in stabilizing the knee joint (stifle), and when it's damaged, the dog often experiences pain, swelling, and lameness, usually in one of the hind legs.

One of the first signs that something is wrong is a noticeable limp or the dog completely avoiding putting weight on the affected leg. Over time, if left untreated, the instability can lead to secondary complications such as meniscal injuries and the development of osteoarthritis, making the situation progressively worse.

The treatment options for a torn ACL in dogs depend on several factors, including the dog's size, age, activity level, and the severity of the injury. In small, sedentary dogs, conservative management might be an option.

This approach involves strict rest, weight management, anti-inflammatory medications, and physical therapy. However, it's important to understand that this method doesn't repair the ligament or restore normal joint stability. Instead, it aims to reduce pain and inflammation while allowing the body to adapt to the joint's instability. In many cases, especially in large or active dogs, conservative treatment alone often fails to provide long-term results.

Surgical intervention remains the gold standard for treating a CCL rupture in most dogs, particularly those over 15 kg (33 pounds). Among the surgical options, TPLO (Tibial Plateau Leveling Osteotomy) is one of the most widely used and successful techniques.

This procedure alters the biomechanics of the knee by changing the angle of the tibial plateau, which helps stabilize the joint without the need for the ligament itself. Another common technique is the lateral suture or extracapsular repair, often used in smaller or less active dogs. This method involves placing a strong suture outside the joint to mimic the function of the original ligament.

A third surgical approach, TTA (Tibial Tuberosity Advancement), is also biomechanically effective and shares similarities with TPLO in terms of outcome.

Regardless of the surgical technique, post-operative care is just as important as the surgery itself. Recovery typically involves several weeks of controlled activity, pain management, and physical rehabilitation. Rehabilitation exercises help rebuild muscle mass, restore range of motion, and ensure proper healing.

Many dogs return to full function and even resume their normal activities once recovery is complete. However, there is always a risk of the opposite leg developing the same injury later, so long-term joint care is essential.

Ultimately, the best course of action should be determined in consultation with a veterinarian or veterinary orthopedic surgeon. Each dog is unique, and what works well for one may not be ideal for another. Prompt diagnosis and a well-planned treatment strategy significantly increase the chances of a full recovery and a pain-free life.

References:

Cook, J. L. (2010). Cranial cruciate ligament disease in dogs: Biology to therapy. Veterinary Clinics: Small Animal Practice, 40(1), 1–xxi.Bergh, M. S., Sullivan, C., Ferrell, C., Troy, J., & Budsberg, S. C. (2014). Systematic review of surgical treatments for cranial cruciate ligament disease in dogs. Journal of the American Animal Hospital Association, 50(5), 315–321.

About the autor

Felipe Garofallo is a veterinarian in Brazil, specialized in orthopedic and neurosurgical care for dogs and cats.

He is also the founder of Ortho for Pets – Veterinary Orthopedics and Specialties.