Understanding Cranial Cruciate Ligament (CCL) Damage in Dogs

The cranial cruciate ligament (often shortened to CCL) is one of the most important structures in your dog’s knee joint. Unfortunately, it is also one of the most commonly injured. Knowing what the ligament does, how it can become damaged, and what signs to look out for can help you support your dog’s long-term joint health.

What is the Cranial Cruciate Ligament?

Inside your dog’s knee (or stifle, in veterinary terms) are strong ligaments that keep the joint stable. The cranial cruciate ligament acts like a sturdy rope, holding the thigh bone (femur) and shin bone (tibia) in the correct position.

When this ligament weakens or tears, the knee becomes unstable, which leads to pain, inflammation, and reduced mobility.

Which dogs are most at risk?

A partial tear can happen to any dog, at any age, but is more common in:

• Large breeds like Rottweilers, Staffordshire Bull Terriers, New foundlands, Chows, Boxers, Akitas, St Bernards, and Labradors

• Dogs with an upright stifle (straight back legs)

• Dogs neutered early (can affect bone growth)

• Overweight dogs

  
  

Clinical Signs of CCL Injury

Dogs with CCL damage may show:

• Lameness in a back leg (sudden or gradual)

• Stiffness, especially after rest or exercise

• Difficulty getting up or jumping

• Resting the paw only lightly on the ground (toe touching)

• Swelling around the knee

• A clicking or popping sound from the joint in some cases

These signs may come and go at first but often worsen over time if the injury isn’t addressed.

Acute Injury vs. Gradual Degeneration

There are two main ways CCL injuries happen:

• Acute, sudden injury: A healthy ligament tears suddenly during activity, such as running, twisting, or jumping.

• Gradual degeneration: In many dogs, the ligament weakens over months or years due to genetics, inflammation, or conformation. Eventually, even normal daily activity can cause it to tear.

This degenerative type often affects both knees (bilateral), sometimes one after the other.

Predisposing Factors

Certain factors increase the risk of CCL damage, including:

• Genetics and conformation – Some breeds are more prone due to the shape of their knees.

• Excess body weight – Adds extra stress to the joint.

• Poor muscle support – Weak thigh and core muscles reduce joint stability.

• Chronic inflammation – Can gradually weaken the ligament.

• Lifestyle and exercise – Both over-exercising and under-exercising can contribute.

Why does it need attention?

A partial tear can progress to a full rupture if left untreated. This can lead to:

• More pain

• Severe lameness

• Faster joint degeneration (osteoarthritis)

Why Early Recognition Matters

If left untreated, CCL damage can lead to:

• Arthritis

• Meniscus tears (damage to the cartilage pad inside the knee)

• Progressive muscle loss

Prompt veterinary care, whether surgical or conservative - gives the best outcome. Rehabilitation and physiotherapy are especially valuable for helping dogs regain strength, balance, and comfort.

Treatment Options

Conservative Management

Often recommended for smaller dogs (under 15 kg) or for partial ligament tears. This includes:

• Strict activity restriction for several months (no running, jumping, or rough play)

• Controlled leash walks only

• Pain relief and anti-inflammatory medication

• Use of a custom stifle brace for extra stability

• Careful weight management

• Joint supplements (nutraceuticals) to support cartilage and joint health

Physiotherapy & Rehabilitation

Essential in both conservative and surgical cases. Physiotherapy helps by:

• Strengthening the thigh and gluteal muscles to stabilise the joint

• Improving core strength to reduce strain on the knees

• Maintaining joint flexibility and preventing stiffness

• Addressing compensatory pain in other areas (such as the back, front legs, and neck)

Surgical Options

For most medium to large breed dogs, or in cases of a complete ligament rupture, surgery is often the most effective treatment. There are different surgical techniques, but the most common are:

• TPLO (Tibial Plateau Leveling Osteotomy) – Changes the angle of the tibia to stabilise the knee.

• TTA (Tibial Tuberosity Advancement) – Alters the mechanics of the joint to prevent forward movement of the tibia.

• Lateral suture (extracapsular repair) – A synthetic ligament is placed outside the joint to provide stability (more common in smaller dogs).

Your veterinarian will recommend the most suitable option based on your dog’s size, lifestyle, and degree of injury.

How Owners Can Help

• Keep your dog at a healthy weight

• Provide regular, controlled exercise to maintain muscle strength

• Watch for any lameness or stiffness

• Seek veterinary advice early if you notice changes in mobility

• Consider physiotherapy as part of treatment or recovery