What is it?
The cranial cruciate ligament (CCL) sits inside the stifle (knee) joint and plays a vital role in stabilising the femur and tibia during weight-bearing.
Its key functions include:
- Preventing forward movement of the tibia (cranial tibial thrust)
- Controlling internal rotation of the tibia
- Providing overall joint stability
When the ligament partially or fully ruptures, the joint becomes unstable. This leads to inflammation, pain and rapid development of osteoarthritis.
Unlike in humans, cruciate rupture in dogs is often degenerative rather than purely traumatic, meaning it can develop gradually over time.
Clinical signs & changes
Owners may notice:
- Sudden hindlimb lameness
- Toe-touching or non-weight-bearing on one leg
- Sitting with the affected leg out to the side
- Difficulty rising or jumping
- Reduced muscle mass in the thigh
- Stiffness after rest
- Swelling around the knee joint
Many dogs will also place increased strain on the opposite limb, which increases the risk of rupture on the other side.
Veterinary diagnosis
Diagnosis is made by a veterinary surgeon through:
- Orthopaedic examination
- Positive cranial drawer or tibial thrust test
- Radiographs to assess joint changes
- Sedated assessment where required
Treatment options may include:
- Surgical stabilisation (e.g., TPLO, TTA or extracapsular repair)
- Conservative management in select cases
- Anti-inflammatory and analgesic medication
Physiotherapy should begin once veterinary stabilisation has occurred and referral has been provided.
Physiotherapy input
Rehabilitation following cruciate rupture — particularly post-surgery — is critical to restoring limb function and reducing compensatory strain.
A structured programme may include:
- Controlled weight-bearing progression
- Quadriceps and hamstring strengthening
- Stifle range-of-motion work
- Proprioceptive and balance training
- Gait re-education
- Core stability exercises
Without rehabilitation, dogs commonly develop:
- Persistent muscle atrophy
- Altered gait mechanics
- Secondary back or hip pain
- Early progression of osteoarthritis
Prognosis and long term management
Even with successful surgery, cruciate rupture results in some degree of osteoarthritis.
Long-term strategies include:
- Maintaining optimal body condition
- Ongoing strengthening exercises
- Regular mobility reviews
- Controlled exercise progression
- Environmental modifications where required
Proactive physiotherapy significantly improves long-term joint health and mobility.