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What is the CCL?

The cranial cruciate
ligament, or CCL, is an important support structure in the
knee of the dog. It runs between the femur (thigh bone)
and the tibia (shin bone), preventing excessive movement
between the two bones.
The CCL is made of dense connective tissue, with poor
ability to heal once the ligament has been injured. With
injury, the tibia and femur are less stable in relation to one
another, and that instability can lead to pain and further

Cranial Cruciate Disease in Dogs

In dogs, a CCL tear is rarely a sudden, acute injury like the ACL tears often seen in human athletes. Instead, it is typically a symptom of cruciate disease, characterized by a slow degeneration of the ligament that can begin months or even years before a complete tear occurs. This degeneration is often caused by factors such as joint injury, malfunction, or overuse, leading to inflammation and abnormal knee mechanics.

Common causes of cruciate disease include:

  • Concurrent luxating patellas

  • Hip dysplasia

  • Previous joint sprains

  • Hind leg conformation that increases impact on the knee

  • Obesity or excess weight, which puts additional stress on the knee joint

  • Age-related degeneration of the ligament

  • Immune-mediated disorders that cause inflammation in the joint

As the CCL slowly frays, dogs often develop scar tissue that helps stabilize the knee joint, minimizing the instability that might accompany an ACL tear in humans. However, regardless of the rate at which cruciate disease progresses, the end result is similar:

  • Inflammation in the joint and joint capsule

  • Potential for meniscal tears

  • Degeneration of cartilage and joint fluid

  • Long-term pain and dysfunction in the knee joint

  • Osteoarthritis development, leading to chronic pain and reduced mobility

  • Muscle atrophy due to decreased use of the affected leg

  • Compensatory injuries to other joints, such as the hip or opposite knee, due to altered gait and weight distribution

  • Decreased quality of life and difficulty performing daily activities

While sudden, complete CCL tears can occur in dogs, they are far less common than the gradual degeneration associated with cruciate disease.

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