Mar 12 2012

As Spring Arrives, Injuries Are On The Rise: ACL Rupture & Repair

It is spring and every dog knows it! Labrador Retrievers are frolicking in the fields. Boxers are racing through the grass. Pit-bulls are dancing on their hind legs, twisting and turning as they chase squirrls. Even the sedate Bichon is rambling along at a quicker pace, sniffing and shuffling forward in quick bursts of speed as he catches a new, spring time scent.

While these four-legged revelers enjoy the warmer weather, my phone starts to ring and I hear a familiar lament, “We were at the park (or in the yard, or at the beach) when my dog was chasing a ball (or a Frisbee, or a squirrel, or a butterfly) when he let out a yelp and starting limping on his hind leg. Now he barely puts his toe on the ground. What is wrong?”

I can almost diagnose it over the phone, although of course, my suspicion needs to be confirmed by an exam. “It sounds like he strained or ruptured his cranial cruciate ligament,” I reply. “I repaired three of them this week already. It occurs when a dog is playing, plants his foot, then twists sharply at the knee. The ligaments that hold the femur to the tibia are formed in a criss-cross, hence the name, cruciate ligaments. When one of them snaps, the dog can not support his weight correctly and he limps.”

“So it will heal?”

“No,” I reply sadly. “Ligaments do no heal on their own. Bones heal. Muscles heal. Even the liver heals, but ligaments do not. Supporting structures may make the knee better in time, but the essence of the knee stability is forever changed unless we repair the knee or replace the ligament surgically.”

This type of injury is COMMON.

It can affect the quality of the dog’s life. It can be repaired, but oddly, it is often misdiagnosed. In the past year, I have repaired several cruciate ruptures (known as ACL or RACL surgeries) that were left untreated for months due to misdiagnosis.

This results in long term and irreversible arthritic changes. So, if you are frolicking with your companion and he or she suddenly starts limping on a hind leg, yet is otherwise happy and seems ok, get him/her to the vet and ask, “Do you think it could be a ruptured cruciate ligament?”

There are many other possibilities of course, including medial patellar luxation, fracture, lyme disease, meniscal injury, muscle sprain, back or disc injury, neurologic injury… the list is very long. But don’t over look this crucial injury and be sure to ask your veterinarian to check for it by 1) a good physical and lameness exam, 2) possible sedation for an even better exam, 3) xrays if appropriate. I hope you do not have to endure the bittersweet recovery of cruciate surgery, but if you do, be glad your pet was diagnosed and fixed!

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