One of the most common orthopedic conditions that our canine population develop is a torn, or partially torn cranial cruciate ligament, which the equivalent in human anatomy is the anterior cruciate ligament, or ACL. This ligament serves several purposes including preventing the rear leg from hyperextending, preventing excessive internal knee rotation, and preventing the lower leg (tibia) from moving too forward. In essence, the ACL is a major structure that keeps the knee stable.
Unlike humans, however, the reason for ACL tears in dogs is not primarily traumatic in nature. Degenerative changes occur over months to years that lead to rupture of the ligament with potentially relative ease. This degenerative change is also the reason for the other ACL to tear within 6 months to 2 years in well over 50% of the cases.
There are several methods of surgical correction. In our experience, the TTA is the superior surgical technique. The theory behind this surgery is to shift the front tibia forward to the point that the patellar ligament (ligament holding the "kneecap") reaches 90 degrees. At this point, all of the forces on the ACL are shifted toward the upper thigh muscles thus relieving pain within the knee itself. This technique is superior to other methods as it allows a quicker return to function, less muscle atrophy, and oftentimes a higher quality of life.
Immediately following surgery, the patient should have their knee iced at least three times a day for approximately 15 minutes at a time. A homemade icepack can be made by using a gallon freezer bag filled with equal parts of water and rubbing alcohol. Placing this solution in the freezer will create a malleable pack that can conform to the leg. It can be reused multiple times. Another option would be a frozen vegetable pack (such as sweet peas or corn) that can also be conformed to the leg. This should be done for the first week.
It is also ideal for the patient to immediately begin range of motion exercises following surgery. THIS SHOULD ONLY BE DONE IF THE PATIENT IS COMFORTABLE AND NOT PAINFUL. This exercise is accomplished by placing the pet on their side with the affected leg up. With GENTLE and SLOW motion, grasp the foot/ankle with one hand and support the knee with the other hand. Then move the limb as if they were walking normally. Do this procedure 3 times a day for 15-20 reps at a time. This should be done for the first week.
Weeks 2 and 3 after surgery, stop the cold therapy and use warm heat. A homemade rice sock can be microwaved for 1-2 minutes and applied to the knee for 15 minutes, three times a day. Leash walks can be started slowly by week 2. DO NOT GIVE THEM FREE ROAM OR OFF-LEASH CAPABILITIES. The first week following surgery, the pet should be confined to a small room to limit movement, and especially running or jumping.
By weeks 6-8, your pet can be walked on longer leashes. Weeks 9-10, the pet can have monitored off-leash abilities. We would like to x-ray the pet at 6 and 10 weeks to evaluate healing.