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  • Options for Cranial Cruciate Ligament (ACL) Injuries in Dogs

Is surgery the best option for your dog’s cruciate ligament injury? It might be. But you should be educated that there are other great options that may be appropriate for your dog. Many dogs do well without surgical management. Non-surgical treatment options include laser therapy, acupuncture, prolotherapy, stifle orthosis(brace), and physical therapy.
I love my profession of veterinary medicine. One of the things that I cherish most about being a veterinarian is working together with clients to choose the best option for their beloved pet’s care. 

I believe that each dog should be considered as an individual case when determining treatment for a cranial cruciate ligament injury. In my veterinary integrative and rehabilitation practice 70% of my cases involve one or both of the cranial cruciate ligaments. I work together with owners to determine the best course of treatment for them and their dog.

To illustrate, I will share with you a tail of 3 vibrant yellow Labrador Retrievers. Tedy, Nemo, and Reichert.

Tedy’s cruciate ligament injury was treated with a conservative approach of ice, rest, Class IV Laser Therapy, Prolotherapy, and a custom-tailored rehabilitation program. In addition, nutritional supplements and Chinese herbs were used. Tedy currently goes on a 2-mile walk daily, and regularly enjoys the swimming at the beach.

Nemo’s cruciate ligament injury was also treated with ice, rest, Class IV laser therapy, and a custom-tailored rehabilitation program. But Nemo received a custom brace otherwise known as an Orthosis. The brace provides support for the stifle joint while allowing Nemo at 11 years old, to partake in all of his desired activities.

Reichert had injury to both of his cruciate ligaments. I referred him to a surgeon who performed a TPLO on the more severe of the injuries. A custom Orthosis was made for the other limb. Reichert also followed a rehabilitation program. He is 10years old, swims often, and walks 30-45 minute twice daily.

Three different routes to success.  A different treatment protocol was chosen for each of these dogs. But the outcome for all was success!  Happy, active, healthy dogs. I shared the tail of these three dogs because they were the same breed, size, and personality type, but each was considered as an individual case.

To learn more about custom stifle braces visit

Injury to the cranial cruciate ligament (also referred to as ACL) is the most common orthopedic injury in the dog. This injury is due to a partial or complete tear of a ligament inside the stifle (knee). The resulting instability leads to pain and arthritis.

Stabilization is recommended for best short and long term function, quality of life, and comfort. Stabilization is traditionally done surgically with a joint realignment surgery (TPLO or TTA) or with a pseudo-ligament surgically placed outside the joint (tight rope or lateral suture). These procedures are considered the standard of care in general. However,  there is not adequate evidence that surgery prevents or hinders the development of arthritis of the stifle joint.  In the past 8 years, the use of custom orthosis (brace) has become available as an alternative to surgery when surgery is not appropriate for any reason. These reasons may include owner preference, other health issues, unacceptable surgical or anesthetic risk, advanced age, financial constraints among others.