by Jill Mullen

Created on: February 04, 2009   Last Updated: March 22, 2009

There are three broad categories of treatment for Cranial Cruciate Ligament (CCL) damage to consider.

Medical, Surgical Stifle Stabilization, and Surgical Osteotomy.

Medical treatment - allows relief from discomfort and inflammation and allowing the stifle to adapt to a lack of the CCL. By developing greater muscle strength in the muscles of the back of the thigh, thickening of the joint capsule that reduces joint mobility and an altered gait the limb will gradually bear more weight. Osteo-arthritis will also occur, and may be severe further limiting the range of movement of the stifle. Arthritis will develop quite rapidly whilst the joint is unstable and remains in use, often necessitating long term medication. Medical management alone will not allow visual inspection of the menisci (cartilages) which may be simultaneously damaged. Non-steroidal anti-inflammatory drugs (NSAID's) such an MELOXICAM and CARPROFEN are the most commonly used for the relief of pain and inflammation, but PENTOSAN POLYSULPHATE SODIUM and using supplements that contain GLUCOSAMINE and CHONDROITIN can significantly reduce the impact of arthritis.

Surgical Stifle Stabilization - mimics the action of the CCL by providing support for the stifle, it allows more rapid return to use than medical management alone as muscle adaptation is accelerated and arthritis development is reduced by the rapid resolution of joint instability. Two major techniques are commonly used. The Over The Top technique requires a strip of strong fascia from the outer thigh that is still attached at the level of the stifle to be passed through the middle of the joint and secured on the outer surface of the lateral condyle of the femur. This needs quite a large wound into the stifle joint but allows the menisci to be examined. A more recent method has evolved so that the CCL is mimicked by surgical nylon' placed outside the joint capsule in a Lateral Fabella Sling. A small hole is drilled in the top of the tibia and a loop passed from this, through the back of the patella ligament and around the small sesamoid bone at the back of the stifle. This is less invasive, as the menisci can be examined via a much smaller medial or lateral incision into the joint. Both of these techniques will be accompanied by the same medical management outlined already to speed return to use and minimize arthritis.

Surgical Osteotomy these are much more recent techniques for dealing with CCL damage and essentially are available only from Orthopedic

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