Ruptures or tears of the Anterior Cruciate Ligament (ACL), also known as the Cranial Cruciate Ligament (CCL), are common in the dog. It can happen suddenly or gradually over a period of months.
What Causes a Cruciate Ligament Tear?

ACL (CCL) tears likely occur due to a combination of factors. Conformation, genetics, degenerative conditions and injuries may all play a role. Because some of these factors are present in both knees, dogs will tear the second ACL about 40% of the time.
Is Surgery Necessary to Repair My Pet’s Torn Anterior Cruciate Ligament?
Yes. A few dogs will do well without surgical repair of the ACL but most do poorly. Left untreated, most dogs develop arthritis and secondary tears of the meniscus. The result is chronic pain. Surgical correction always provides the best chance of the optimal outcome for your pet.
What Surgical Procedures are There For My Dog?

While there are multiple procedures available, there are three basic surgeries:
- The “Traditional Procedure”: A traditional procedure known as an “extracapsular” technique or a “Flo” technique or an “imbrication” (tightening) technique has been used for many years. It is still used very successfully in small dogs. Some large breed dogs return to good comfort and function with this procedure, others do not.
- TTA (Tibial Tuberosity Advancement): The TTA is used in large breed dogs and is a slightly less aggressive procedure than the TPLO. These patients tend to have less pain immediately after surgery compared to the TPLO. It is an excellent choice for some dogs although certain factors (age, obesity, conformation) may make the TPLO a better option in a given patient.
- TPLO (Tibial Plateau Leveling Osteotomy): The TPLO is used in large breed dogs and is the most commonly used of the two “gold standard” procedures (TTA and TPLO). It involves changing the slope of the joint angle so that the tibia doesn’t thrust forward when weight-bearing.
Benefits of TPLO Repair
- Best results
Perhaps the best option for large breed dogs, especially if older or heavy - Meniscus health
If the meniscus is not torn at the time of surgery, some dogs will tear the meniscus after ACL repair. TPLO provides the best prevention - Proven procedure
Tibial Plateau Leveling Osteotomy surgery is the current “Gold Standard” for large dogs with torn cruciate ligaments
Learn more about TPLO by downloading these useful handouts.
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