Cruciate Ligament Injury
The cranial and caudal cruciate ligaments form part of the stifle, connecting the Femur and the Tibia, providing stability at the joint by regulating the movement and rotation of the bones.
Usually in dogs, the fibres of the cruciate ligaments will degrade over time, “like a fraying rope” (Fitzpatrick Referrals,2023) finally resulting in a rupture.
The exact cause remains unknown however as certain breeds such as Boxers, West Highland White Terriers and Labradors are predisposed to the condition, this suggests that there is a genetic component. Other factors which can accelerate the condition are an imbalance of hormones, other inflammatory joint conditions, obesity, and the conformation of the dog.
Due to the chronic nature of the condition, and the increasing laxity of the ligament, allowing abnormal movement of the tibia and femur, osteoarthritis will be present.
In canine athletes, it is not uncommon for cruciate ligament damage to be like that of humans where excessive trauma causes the rupture. In these cases, the owner will notice an instantaneous change from the dog being sound to being unable to weight bear.
Symptoms and Onset
With chronic cruciate ligament damage, the onset and symptoms are progressive. An owner is likely to see intermittent lameness, usually during or after periods of exercise. If a dog is affected in both knees, they will have an abnormal gait and may find it difficult to rise when lying down. If the damage is severe, the dog may not wish to rise at all. Other possible symptoms include
- Pain
- Sitting with the affected leg turned out
- “Toes just touching the floor in semi flexion” (Lenton,2018)
- Inflammation around the affected joint
If the injury is sustained due to excessive trauma, the onset is instantaneous, and dog will be unable to bear weight or will be lame on the affected limb.
How massage can help
- Improves blood flow bringing fresh blood and nutrients to the area
- Provides natural pain relief
- Improves the flow of lymph, reducing lymphoedema
- Assists with hypertonic muscles caused by overcompensation
- Improves mobility around the affected joint
- Improves muscle tone
Due to overcompensation most muscle groups will be affected by a cruciate ligament injury, such as the back, neck, and shoulder muscle groups, as well as the muscles of the hindlimbs.
Cruciate Ligament Surgery
There are two main types of surgery performed for a cruciate ligament injury. Surgeries which aim to replace the injured ligament and surgeries that alter the tibia so that the ligament isn’t required to maintain the stability of the joint.
Surgeries which aim to replace the injured ligament do so by using existing tissue from the dog’s body or an artificial replica. Procedures which aim to use existing tissue from elsewhere in the dog’s body possess a poor prognosis for normal limb function.
Prosthetic ligament surgery has a better prognosis, but rehabilitation can be lengthy with no guarantee that the pain would subside, or the stifle will become stable.
The two most common surgeries for altering the tibia are a tibial plateau levelling osteotomy (TPLO) and tibial tuberosity advancement (TTA).
A TPLO involves cutting the top of the tibia and rotating the plateau upon which the femur articulates so that the degree of steepness is reduced. Without the stability of the cruciate ligament, the femur is no longer prevented from slipping down the steep plateau of the tibia. Reducing the steepness of the plateau reduces the degree of mobility of the femur, therefore making the cruciate ligament redundant.
A TTA follows the same principle as a TPLO, however this procedure looks to amend the position of the tibial tuberosity to attempt to alter the angle of the tibial plateau so that is it perpendicular to the patellar ligament, preventing the femur from slipping down the slope previously presented by the plateau.
How Can Massage Help Following Cruciate Ligament Surgery?
- Improves blood flow bringing fresh blood and nutrients to the area
- Provides natural pain relief
- Improves the flow of lymph, reducing lymphoedema
- Assists with hypertonic muscles in other areas of the dog’s body caused by overcompensation
- Improves mobility around the affected joint
- Improves muscle tone in the affected limb
- Aids in post-surgery rehabilitation
Information sourced from
Fitzpatrick Referrals (2023) Cruciate ligament disease or injury, Fitzpatrick Referrals. Available at: https://www.fitzpatrickreferrals.co.uk/orthopaedic/cranial-cruciate-ligament-injury/
Lenton, N. (2018) Cruciate ligament, Canine Massage Therapy Centre. Available at: https://www.k9-massage.co.uk/conditions/orthopaedic/cruciate-ligament/
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