CCL injuries & tears: What are they and how are they treated?

The CCL (cranial cruciate ligament) in dogs is similar to the ACL in humans – it’s one of the ligaments in the stifle (knee) that connects the femur to the tibia. Its core functions are is to prevent abnormal motions in the stifle including overextension of the knee, excessive forward and backward movement (known as cranial drawer), and prevent internal rotation of the tibia.

CCL injuries are one of the most common orthopedic conditions in dogs, and they are something we treat often at ASOC. CCL injuries often require surgery as the fastest and most effective way to help dogs resume normal activity.

When the CCL is damaged, it makes the joint painful and unstable and eventually leads to arthritis. Your veterinarian might reference it as a CCL sprain or a CCL Rupture (CCLR) to describe the injury. However, it’s important to note that most dogs will start showing signs of limping before a full rupture occurs.

Keep reading to learn why the CCL becomes damaged, what signs to look for in your dog, and what happens if your dog does have a CCL injury.

Why does the CCL rupture?

CCL tears can be caused by traumatic injuries, similar to a sports injury in humans, but this is very rare. Rather, most dogs experience progressive CCL “disease”, where the ligament degenerates or weakens over time.  When any ligament, including the CCL, is injured, this is referred to as a sprain.

Some of the risk factors for CCL sprains include being overweight or obese or having a Medial Patella Luxation (MPL). Certain breeds such as Labrador Retrievers, Newfoundlands, Boxers, Rottweilers, Westies, Pit Bulls, and English Bulldogs are more likely to be prone to CCL disease. But pet obesity is one of the most important contributing factors that can increase the likelihood of a CCL sprain.

CCL sprains will lead to progressive arthritis in the stifle joint, so it’s important to resolve the issue quickly.

CCL disease is unfortunately found frequently in both hind legs, and approximately 50% of dogs who rupture one of their CCLs will rupture the second within 1-2 years.

What are the signs of a CCL rupture (or sprain)?

Most dogs with weak CCL’s will have a mild sprain at first, which may not be immediately apparent. But as they continue to participate in vigorous activities such as running or jumping, the CCL will partially or completely rupture, leading to significant lameness.

CCL sprains vary in severity, depending on how damaged the CCL ligament is, and how quickly the damage occurred.

Your dog will likely experience lameness, inflammation of the stifle (knee) joint, and some degree of pain, depending on the severity of the sprain.

The body’s natural reaction to a CCL injury is to stabilize the stifle joint with scar tissue over time. This will result in firm swelling around the joint and a decreased range of motion. Arthritis within the joint will also progress.

Surgery for CCL injuries:

If your dog has a CCL rupture, your veterinarian will likely recommend surgery.

The goal of surgery is to stabilize the joint and prevent the abnormal motion that causes discomfort and limping.

Note: Surgery does not prevent arthritis from developing in the stifle joint, but it can slow the progression of arthritis.

Surgery is also recommended for partial CCL tears. With partial tears, there may not be instability of the joint yet, but there is often pain, and progressive degeneration of the ligament is expected over time. The CCL generally doesn’t heal, and surgery can help return a dog to an active lifestyle faster.


It can take between 4-6 months after CCL surgery for a dog to return to their previous activity levels. Without surgery, the body’s natural scarring process will take many months to years.

With non-surgical management, it can take a year or more for dogs to return to activity, and generally there remains a significant degree of lameness whenever the dog runs or plays. Surgery to address CCL injury is the most common orthopedic surgery performed by veterinary surgeons and has an extremely high success rate of 85-90% of dogs returning to previous activity levels.

These surgeries are generally categorized into:

  • Osteotomy (Procedures to cut into the bone such as TPLO, TTA, and CBLO)
  • Extra-capsular procedures such as Lateral suture/ MRIT, or Tight Rope. Most studies support the TPLO procedure as the most likely to be successful in restoring normal limb function.

You can read more about TPLO surgery here.

If you think your dog might have a CCL injury, reach out to your veterinarian or call us at 206-545-4322.

Posted June 05, 2020 by Animal Surgical in Joint pain management, Obesity, Pet Health with No Comments

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