Cranial Cruciate Ligament Disease

CCL explained in dogs.

What is cranial cruciate ligament disease?

Cranial cruciate ligament disease (i.e. partial or complete tearing or rupture of the CCL) is the most common cause of hind limb lameness in dogs. Whereas ACL rupture in people is typically caused by trauma, CCL disease in dogs is usually degenerative in nature, and in approximately 50-60% dogs, it eventually affects both stifle joints. Although rupture often seems to occur during intense physical activity, such as jumping or running, in the vast majority of cases, CCL degeneration has begun prior to that event. Once CCL degeneration begins, it is unable to heal and it will progress to a complete tear over time. Much less commonly, true acute traumatic CCL ruptures do occur in dogs, and can be associated with damage to other ligaments in the stifle joint..

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Risk factors for cranial cruciate ligament disease

Although any dog can develop a CCL rupture, young to middle-aged, large-breed dogs are at greatest risk. Other predisposing factors include:

Genetics
Obesity
Poor fitness level
Early neutering

Excessive tibial plateau slope (TPS; i.e., the slope of the top of the tibia)
Breed (i.e., large-breed dogs)
Concurrent medial patellar luxation (MPL)

Genetics
Obesity
Poor fitness level
Early neutering
Excessive tibial plateau slope (TPS; i.e., the slope of the top of the tibia)
Breed (i.e., large-breed dogs)
Concurrent medial patellar luxation (MPL)

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Cranial cruciate ligament instability and arthritis

A dog’s CCL is under the most stress during weight bearing, since it is responsible for keeping the femur and tibia in proper alignment despite the downward angle of the top of the tibia, also known as the tibial plateau. Once the ligament’s structure is compromised, the femur slides backwards relation to the tibia during weight bearing. The resulting instability and joint inflammation is largely responsible for the pain present in dogs with this injury. The instability can also lead to tearing of the meniscus, which results in significant pain as well. Osteoarthritis occurs hand-in-hand with CCL disease, as joint inflammation and instability lead to early loss of cartilage health and eventually complete cartilage loss in end-stage arthritis. Surgery often slows the progression of arthritis in dogs with CCL rupture.

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