The cranial cruciate ligament (CCL) — often called the ACL — is a stabilising ligament inside the knee joint (stifle). It prevents the shin bone (tibia) from sliding forward under the thigh bone (femur).

When it stretches or tears, the knee becomes unstable and painful, leading to limping, reluctance to exercise, and eventual arthritis. Partial tears are painful and worsen over time. A full rupture causes significant lameness almost immediately.

Diagnosis starts with a physical exam, checking for swelling, pain, and instability. A full diagnosis often involves general anaesthesia so we can perform a cranial drawer or tibial thrust test, along with X-rays to look for swelling, joint effusion, and arthritic changes.

If instability isn’t obvious but pain persists, a partial tear or strain may be suspected.

A strain may improve with strict rest, anti-inflammatory medication, and joint support therapy. However, repeated strain weakens the ligament, increasing the risk of rupture. We may recommend weight control, Cartrophen injections, and careful monitoring — but persistent pain often leads to the need for surgery.

TPLO (Tibial Plateau Leveling Osteotomy) changes the angle of the tibia so the knee remains stable even without the cruciate ligament.

At PAH, TPLO is performed by specialist Dr. Eugene Buffa. Our all-inclusive package includes:

• Pre-anaesthetic blood testing

• Anaesthesia and monitoring

• The TPLO procedure

• Pain relief and IV fluids

• Antibiotics before and after surgery

• Cartrophen injections

• Suture removal

• X-rays before surgery and at 6 weeks post-op

• All standard rechecks with Dr. Jill King

We recommend capped-fee overnight monitoring at NEVS for the first night, although same-day discharge is possible.

Recovery takes 6 weeks of strict rest — no stairs, no off-leash running, and no jumping. Controlled exercise is reintroduced gradually.

We provide detailed aftercare instructions, calming medication if needed, and a 6-week follow-up with X-rays. Hydrotherapy or rehabilitation may follow to rebuild strength and mobility.

Yes — as with any major surgery, risks include infection, delayed bone healing, implant issues, or anaesthetic complications. These are rare when surgery is performed by experienced teams.

Long-term, TPLO has a very high success rate, with most dogs regaining full function.

Without surgery, the knee remains unstable. This often leads to arthritis, chronic pain, and reduced mobility. Some dogs adapt, but many develop ongoing lameness or injure the opposite leg.

Non-surgical care focuses on weight management, pain relief, and physiotherapy but requires ongoing commitment.

Yes. If the meniscus (a cushion in the knee) is torn, it can cause sharp, sudden pain, like grit in a joint. TPLO surgery addresses this by removing the damaged part, which usually gives immediate pain relief.

Alternatives include:

• Anti-inflammatory medication

• Joint supplements

• Cartrophen injections

• Hydrotherapy or physiotherapy

• Weight loss programs

• Restricted exercise routines

We also focus on protecting the other knee, as it’s at higher risk when one is unstable.

Dogs under 10kg, especially if calm and easily confined, may recover with rest and non-surgical management. However, arthritis and recurring lameness are still common over time. Each case needs an individual assessment.

Yes — we work closely with local hydrotherapy and rehabilitation centres. Gentle water-based exercise helps rebuild muscle without straining the joint and is ideal after the initial healing stage.

Dr. Jill King manages all cruciate consultations at PAH, explains your options, and coordinates TPLO procedures with Dr. Eugene Buffa. Our nursing team provides attentive care from surgery through to recovery.

If your dog is limping or you suspect a cruciate injury, book an appointment with Dr. Jill King. We’ll assess your dog and create a personalised treatment plan.