A cruciate ligament injury is one in which the ligament that stabilizes the knee joint breaks down or even completely ruptures. It can occur both acutely through an injury due to a sudden movement or chronically with a slow degermation over time which is actually more common.
Veterinarians are not entirely sure why these tears occur. However, evidence suggests it is largely genetic.
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Average Cost of Cranial Cruciate Ligament Surgery
Large dogs with medial patellar luxation, a condition where the knee cap moves outside of its normal position, are particularly susceptible to Cranial Cruciate Ligament tears (CCL). Rottweilers, Labrador Retrievers, Newfoundlands, and Akitas are some examples of breeds with higher risks of CCL ruptures.
In most situations’ surgery will be required to correct the injury, and there are several types of surgery to choose from. This, in addition to the specifics of your dog’s injury, will determine the cost to the owner.
The cost for CCL surgery varies depending on the severity of the injury, the area the surgery is done, the veterinarian professional fee, and the dog breed. On average, dog CCL surgery costs $500 to $4,000 per leg, depending on the surgical technique used and your location.
It is likely that pet insurance may not cover the entirety of the expense, due to the condition being largely genetic. Getting surgery is still beneficial though.
Diagnosing CCL in Dogs
Identifying a CCL tear is usually fairly easy. Dogs suffering from it may limp, walk only on three legs, have difficulty getting up, and may sit on one side, favoring opposite the leg with the torn ligament.
The dog will also likely experience pain and will indicate such. One should take their dog to a veterinary office if they see any of the previously listed indicators.
A basic exam will run about $50 and the doctor, along with the physical exam, will likely need imaging done. Although ligaments can not be seen on x-ray, it can reveal other secondary effects that arise from a tear.
X-rays cost between $70 to $250 based on the severity of the injury and how many images need to be taken. An MRI can also be used to diagnose the full scope of a CCL tear. It will give a lot more information than an x-ray, but comes with a price tag in the $2000 range.
Understanding the Differences Between ACL and CCL in Dogs
When discussing cruciate ligament surgery in dogs, it’s essential to distinguish between the Anterior Cruciate Ligament (ACL) and the Cranial Cruciate Ligament (CCL).
Although these terms are often used interchangeably, they refer to slightly different structures in canine anatomy. The ACL is a term more commonly used in human anatomy. It’s one of the key ligaments that help stabilize the knee joint.
In dogs, the equivalent structure is called the Cranial Cruciate Ligament or CCL. The CCL plays a similar role in stabilizing the dog’s knee (stifle) joint, preventing the tibia from sliding forward and away from the femur.
Surgical Techniques Used to Treat Cruciate Ligament Injury
Once diagnosed, there are generally four common choices for surgical techniques that can be employed:
- Tibial Plateau Leveling Osteotomy (TPLO)
- Extra-Capsular Lateral Suture Stabilization (ELSS)
- Tibial Osteotomy (TTO)
- TightRope Technique
ESLL is usually reserved for smaller dogs, with weights of 25 pounds or less. The surgery involves using sutures to create a false ligament on the outside of the joint.
TPLO and TTO are more recently developed surgeries and involve using a metal plate to stabilize the normal weight-bearing stresses of the knee joint. TPLO is by far the most common type of surgery to repair a cruciate ligament.
Tightrope technique is the most recent development in veterinary medicine and involves holes being first drilled into the knee joint and then a material called ‘Fibertape’ threaded through. This material is incredibly strong and is used to hold the knee back in its proper place.
Surgery costs can differ greatly based on your location and pet. For example, larger dogs will need more anesthesia to stay under.
Estimates are that TPLO and TTO surgeries run around $3,000 to $10,000 per knee, whereas ESLL costs about $1,500 to $3,500 per knee. ESLL is lower cost because it involves only sutures as opposed to more expensive metal rods/plates and also because it is usually reserved for smaller dogs.
Tightrope surgery can cost as low as $750 to $2,000 per knee and is actually the least invasive of the surgeries. However, it can only be done on dogs 40 pounds or more.
The dog knee surgery cost typically include day-hospitalization, anesthesia, and IV fluids. Most animals can go home following the procedures, which all take around 2 – 4 hours.
Post-Surgery Expenses
There are also post-operative costs to consider. Swelling for about a week following the surgery is common, so anti-inflammatory medications will be prescribed.
Additionally, the dog may need to be on joint health supplements and pain-management drugs long-term. These medications, depending on type and dosage, can run from $50 to $200 monthly.
Some dogs may also need rehabilitation following the procedures in order to regain proper usage and strength in the affected leg. The cost of this is extremely case variable.
But depending on the length of time needed, which may be anywhere from 2-5 months before fully recovered, it can cost from $500 to $3,000.
Alternative Treatments
Due to the high cost of CCL surgery, alternative treatments are available. Nonetheless, these are not as effective as surgery and are more beneficial to small dogs than large ones.
Firstly, once a CCL injury is suspected, exercise must be completely restricted to avoid further injury. This means remaining in a crate for several weeks except to go outside to the bathroom.
Moreover, the inflammation needs to be taken care of to prevent cartilage degeneration.
It is best to use non-steroidal anti-inflammatories for this.
Nutritional supplements specifically to help joints should also be administered. These too are recommended even when surgery is done.
The following are examples of the said supplements:
- Glycoflex (30 to 120 tablets), $16 to $60
- Wholistic Canine Complete Joint Mobility (from 4-oz to 18-lb jar), $17 to $310
- Ligaplex, Canine Musculoskeletal Support (20 to 90g), $16.50 to $62.50
- Adequan (injectable 100mg/ml 5 ml Vial), around $67
Your dog’s diet should also be controlled to discourage weight gain. Weight gain strains the knees more.
Physical therapy also helps. An exercise that is not weight-bearing is also advised like swimming.
Another alternative for surgery is prolotherapy which roughly costs you around $200 and up, depending on how many injections your dog needs. This alternative therapy entails injecting a sclerosing substance like dextrose in the joint.
This causes scarring around the ligament, thereby making the joint more stable. This is best for less severe CCL surgery, however.
Acupuncture and chiropractic care can also help with healing and pain relief. Acupuncture costs between $50 to $200 per session while chiropractic care also costs $50 to 200 per session.
Knee braces are also another nonsurgical alternative amounting to $195. This helps stabilize the joints just in time for scarring to occur.
If successful, ligaments may heal after 6 to 8 weeks. Fully torn ligaments however, will not be able to heal without surgery.
Thank you Dr. Khuly, for this very informative web-page. We just got back from our Vet who diagnosed a torn CCL in our Lab and told us, effectively, to expect to pay $2500 for surgery. Is there any reason to not insist on Tight Rope Technique? Is it as effective as the other options?
Thank you, this is very helpful. My almost 2 year old mix just got dx with CCL instability and surgery is recommended. I question whether I would go ahead if she was much older and not so active.
Thank you very informative! My 10 year old 44 lb Springer Spaniel border collie mix was recently diagnosed with an ACL tear. I have been looking into various locations trying to compare cost. I cannot believe the quotes I have been receiving, 5k to 8k depending on the type of procedure that is recommended. In reading your article I am very much interested in the threading procedure as the less cost procedure, I believe is for dogs under 25 lbs. Problem is we can’t seem to get in for a consultation until mid May. Can my dog stay with his tore ACL that long? Will he develope scarr tissue which will make the surgery more complex?