Dr Malcolm Ness
BVetMed, CertSOA, DipECVS, MRCVS, RCVS
European Specialist in Surgery
Functional failure of the cranial cruciate ligament (CCL) in dogs, whether by traumatic rupture or following a slower degenerative metaplasia of the ligament remains a very common cause of chronic lameness and secondary osteoarthritis (OA) in dogs. Indeed, a survey conducted by the British Veterinary Orthopaedic Association revealed CCL failure to be the single most common cause of chronic pelvic limb lameness in the dog. (BVOA, 1996). It is likely that a further substantial cohort of dogs evades specific diagnosis because the same survey recorded many cases of unspecified stifle OA – most likely caused by previously undiagnosed CCL failure.
While lameness attributable to CCL failure is considered by most experienced clinicians to be a surgical diagnosis, it is impossible to be dogmatic because any diligent review of the published, peer-reviewed veterinary literature provides scant support for that position. Sadly, the veterinary surgical evidence base is remarkably poor and the overwhelming majority of cruciate literature comprises simple case series reports. Crucially, there is a dearth of comparative data and neither is there a single, properly controlled review. In short, we simply do not know what might have happened to the dogs recruited into our surgical series had they been managed conservatively or medically: there is a supposition, even a consensus, that lameness would progress to the point of disability but that remains supposition.