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ModerateSee Vet SoonðŸĶī Musculoskeletal SystemDog

Cranial Cruciate Ligament (CCL) Tear in Dogs

The most common orthopedic injury in dogs — equivalent to an ACL tear in humans. Causes sudden or progressive hind limb lameness. Most dogs require surgical stabilization for the best long-term outcome.

Last updated: 2026-05-10

Severity

moderate

When to Act

See Vet Soon

Symptoms & Signs

Sudden hind limb lameness

Acute non-weight-bearing lameness after activity, or gradual progressive lameness over weeks.

Always present

Sitting abnormally

Affected leg sticks out to the side when sitting ("sit test" positive).

Very common

Knee swelling

Medial buttress — firm swelling on the inside of the knee from scar tissue in chronic tears.

Very common

Clicking sound

Audible click when walking — may indicate meniscal tear (present in 50% of CCL tears).

Sometimes occurs

Difficulty rising

Struggles to stand, especially on slippery surfaces.

Very common

Behavioral Changes to Watch For

Pets can't tell us what's wrong. These behavioral changes are often the first clues that something is wrong.

ðŸū Reluctance to exercise

Dog that used to run and jump now hesitates.

What You May Notice:

Your dog stops jumping onto the couch or into the car when they used to do so easily.

Causes & Risk Factors

Causes

  • â€ĒAcute trauma — sudden twisting injury during running or playing
  • â€ĒChronic degeneration — ligament weakens over time due to genetics, obesity, and age
  • â€ĒMost CCL tears in dogs are degenerative rather than purely traumatic
  • â€ĒBilateral disease is common — 40-60% of dogs tear the other side within 1-2 years

Risk Factors

  • ⚠Overweight/obese dogs (single biggest modifiable risk factor)
  • ⚠Large and giant breeds: Labrador, Rottweiler, Golden Retriever, Newfoundland
  • ⚠Middle-aged dogs (5-8 years) for degenerative tears
  • ⚠Poor physical condition / "weekend warrior" syndrome
  • ⚠Certain conformational factors (straight stifle, steep tibial plateau)

How It's Diagnosed

  • 1Cranial drawer test — forward movement of the tibia relative to the femur
  • 2Tibial compression test
  • 3Radiographs — may show joint effusion and degenerative changes
  • 4Sedation often required for accurate palpation in painful dogs
  • 5Arthroscopy for definitive diagnosis and concurrent meniscal assessment

Treatment Options

procedure

TPLO Surgery (Tibial Plateau Leveling Osteotomy)

The most common surgical technique — alters knee biomechanics to eliminate the need for the CCL.

Steps

  1. 1.Cut and rotate the tibial plateau to a neutral angle
  2. 2.Bone plate fixation to stabilize the osteotomy
  3. 3.Meniscal evaluation and treatment if torn
  4. 4.8-12 weeks of strict post-operative recovery with progressive rehab

Expected Outcome

90-95% return to normal function. Gold standard for medium to large dogs.

Precautions

  • !Requires specialized surgical training and equipment
  • !$3,000-$6,000 per knee
  • !Strict post-op confinement is essential
lifestyle

Conservative Management (Non-Surgical)

For dogs <15 kg, or when surgery is not an option.

Steps

  1. 1.Strict rest for 8-12 weeks
  2. 2.Weight management — get to ideal BCS 4-5/9
  3. 3.Physical therapy and controlled rehab
  4. 4.Joint supplements and pain management
  5. 5.Custom stifle brace in some cases

Expected Outcome

60-70% of small dogs (<15 kg) regain acceptable function. Larger dogs have poorer outcomes.

Precautions

  • !Conservative treatment in large dogs often leads to progressive arthritis
  • !Meniscal tears may develop later causing acute worsening

Common Medications Used

MedicationUsageImportant Notes
Carprofen (Rimadyl)NSAID for post-operative pain and inflammationShort-term use for surgical recovery; longer-term if arthritis develops.
GabapentinAdjunctive analgesia for neuropathic painOften combined with NSAIDs post-operatively.

Prevention

  • ✓Maintain lean body weight
  • ✓Regular exercise to maintain muscle strength
  • ✓Avoid weekend warrior activity patterns
  • ✓Joint supplements for at-risk breeds

When to See a Veterinarian

  • ⚠ïļSudden non-weight-bearing lameness in a hind leg
  • ⚠ïļToe-touching lameness that doesn't improve after 48 hours rest
  • ⚠ïļLameness that waxes and wanes over weeks

Frequently Asked Questions

Will my dog need surgery on both knees?
About 40-60% of dogs that tear one CCL will tear the other within 1-2 years. This is because the underlying degenerative process affects both knees, and the dog shifts weight to the good leg after the first injury.

Prognosis

Excellent with TPLO surgery — 90-95% return to full function. Bilateral disease occurs in 40-60% within 2 years. Conservative management in large dogs leads to progressive osteoarthritis.

References

  • [1] ACVS — Cranial Cruciate Ligament Disease
  • [2] JVIM — TPLO Outcomes

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