Orthopaedic Surgery

Cruciate Ligament Surgery

What is Cranial Cruciate Ligament (CCL) trauma or disease in humans?

Cruciate ligament ruptures are typically seen as acute sporting injuries, in footballers and skiers for example. In dogs it is a little different. In most dogs the condition is a chronic degenerative condition. The ligament degenerates and gets weaker with time and at some point, will start to tear. The signs associated with the initial stages of the condition can be subtle and may be missed –such as stiffness on rising from rest and mild, occasional lameness.


The diagnosis is often made on palpation/manipulation of the stifle, although in many dogs this requires sedation. X-rays may show signs of osteoarthritis (OA or arthritis).

What is Cruciate Ligament Surgery?

Surgery to treat lameness caused by Cranial Cruciate Ligament (CCL) trauma or disease is one of the most common orthopaedic operations in dogs. Recently, a surgery has been developed called the Modified Maquet Procedure (MMP). This uses a titanium foam wedge insert in the knee joint.

The success rate is very high, and the complication rate is very low as compared to many older techniques. The costs for many CCL procedures can be very high. We pride ourselves on giving you a cost effective alternative when choosing where to send your pet for surgery.


Some small dogs (less than 15kg) may do well with a period of rest and anti-inflammatories alone, although surgery is generally considered to offer a quicker and more reliable recovery. Larger dogs are less likely to do well without surgery and so surgery is always advised. Surgery involves stabilisation of the joint.

Without an osteotomy, we can offer the Lateral Suture Technique which involves placing a special nylon crimped suture from behind the lateral fabella to a small hole drilled in the tibial crest. The concept of this repair is to stabilise the joint with the prosthetic suture by placing it in a similar direction and toughness to the original cruciate ligament.

Osteotomy techniques are very reliable and safe techniques, even in very active or large/giant breeds of dog. They include Tibial Plateau Levelling Osteotomy (TPLO), Tibial Tuberosity Advancement (TTA) and the Modified Maquet Procedure (MMP) amongst others. These operations are all designed to remove the shear forces on the joint thus alleviating pain and lameness. They are all more complex procedures and inevitably involve the risk of some complications but usually give a much better outcome and recoveries are quicker than lateral suture.