In humans, knee issues are the most frequently reported injury. Interestingly, dogs are not far behind when it comes to knee problems.
To be more precise, anterior cruciate ligament (ACL) tearing comprises for over 85 percent of all orthopedic cases. Consequently, and obviously, ACL tearing repairs are the most commonly performed orthopedic surgery in canines.
When someone mentions orthopedic surgery, the first thing that comes to mind is the hefty price tag accompanying the procedure. And it is true – ACL repairs in dogs are costly, but there is a reason why.
Keep reading to learn about the complexity of these surgeries and what to expect post-surgery – from vet costs through recoveries and potential complications.
A Dog's Knee Anatomy
The knee is the largest and most stress-exposed joint in the body. Therefore, it is also most likely to suffer injuries.
The knee is a complex, synovial-type of joint built from four bones – the thigh bone (femur), the sheen (tibia), fibula, and kneecap (patella).
To prevent rubbing between these bones, there is a synovial fluid-filled capsule. The four bones and their synovial cushion are held in standard position by ligaments. The two most important ligaments are the anterior and posterior cruciate ligaments, or as they are called in dogs – the cranial and caudal cruciate ligaments.
Causes of ACL Tears in Dogs
Many dog owners wonder what can cause ACL tears in dogs. Basically, ACL tears occur due to two main reasons – trauma and progressed arthritis. Let's take a look at both of them.
ACL Tear Due to Trauma
The ligament usually tears when the tibia rotates while the knee is flexed. This combination is most likely to occur during trauma-related events like sports competitions, intense playtime, and vigorous exercising.
ACL Tear Due to Arthritis
Arthritis is something all dogs will develop at a certain point as a result of natural joint wearing. The arthritic changes affecting the joint eventually impact the ligaments making them more prone to damage and tearing.
5 Risk Factors For ACL Tears in Dogs
There are many confirmed risks factors leading to ACL tearing in dogs.
1) Natural Overload
Unlike humans whose knees are in an upright position while walking, dogs walk with continuously bent knees. This means the dog's knee joints are constantly bearing weight, or in simple terms, they are regularly exposed to stress.
2) Breed Predispositions
Based on statistics, some dogs are more likely to experience torn ACLs than others. The reason is unknown, but the list of predisposed breeds includes:
- American Staffordshire Terrier
- Chesapeake Bay Retriever
- German Shepherd
- Labrador and Golden Retriever
- Newfoundland dog
- St. Bernard dog.
3) Hip Dysplasia
Dogs with hip dysplasia are at higher risk of sustaining ACL tearing because of compensation. Namely, dogs with hip issues will favor the hip joint, thus adding extra pressure on the next joint in line, in this case – the knee.
4) Overweight Dogs
Over one-half of the dogs with torn ACLs are either overweight or obese. This is entirely logical – the more weight the knee joint bears, the more likely it is for the surrounding structures to get damaged.
5) "Weekend Warrior Syndrome"
The dog's ancestor was a natural athlete. Sadly, modern dogs are wannabe athletes – spending all week snoozing on the sofa and then getting overly active on weekends.
The lack of continuous exercising weakens the joint structures making them more prone to inuring when engaged in physical activity.
Picking the Right ACL Surgery For Your Dog
There are various ACL repair options for dogs. Each surgical approach has its pros and cons and comes with a different price tag.
However, not every surgery is suitable for every dog – there are size and severity considerations before determining the ideal ACL surgery option for your dog.
These are the basic things you and your vet will have to consider:
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- The dog's age – invasive repairs are financially and physically overwhelming for older dogs, while in younger dogs, they are more likely to yield positive long-term effects
- The dog's size and weight – lateral suture technique is possible for dogs under 50 lbs, and TPLO and TTA are generally recommended for larger dogs
- The dog's lifestyle – active dogs, require a different knee stabilizing approach than dogs with more sedentary lifestyles
- Financial considerations – obviously you need to think about how much you can spend on the repair and which procedure will be most cost-effective
- Overall joint health – it is critical to evaluate the dog's joint health because if it has an additional joint issue, like for example, hip dysplasia it will put extra pressure on the newly stabilized joint
- Rehabilitation needs – basically all surgical repairs warrant cage rest followed by post-operative rehabilitation (low-impact exercises, hydrotherapy, passive range of motions, electric stimulations, acupuncture, etc.).
Types and Costs of ACL Surgeries for Dogs
We understand that medical terms can be confusing. To make things simpler, we will describe the top three most common surgical techniques for dogs.
Lateral Suture Technique
The lateral suture technique is also known as extracapsular repair, meaning repairing the issue outside the joint itself. The lateral suture technique is the most commonly performed ACL surgery in dogs.
In fact, this is also the most straightforward ACL repair. The concept behind the procedure is stabilizing the knee with a plastic, monofilament suture.
Monofilament sutures are extremely strong, and when placed outside the joint, they can quickly restore stability. In simpler terms, the suture is placed in the same position as the torn ligament, thus taking on its responsibilities.
The lateral suture technique includes drilling through the tibia's frontal portion and looping the suture around the fibula, the back portion of the femur, alongside the knee, and finally through the drilled tibial hole.
Once the whole circle is made, the suture ends are clamped together using a clip made from stainless steel.
Generally speaking, the lateral suture technique is indicated solely for dogs weighing less than 50 pounds. However, because of the technique's simplicity and lower cost than other repair options, it is frequently performed on much larger dogs and has a considerable success rate.
The exact cost of the lateral suture technique depends on two factors – your living location and who performs the surgery – a board-certified veterinary surgeon or a general practitioner with experience in orthopedics. Based on these factors a lateral suture technique can cost between $1100 and $2500. All in all, we can safely say that the lateral suture technique is the most cost-effective ACL surgery for dogs.
Tibial Plateau Leveling Osteotomy (TPLO)
When invented by Dr. Barclay Slocum over 20 years ago, the tibial plateau leveling osteotomy was considered a radical procedure. Today, it is the most popular choice for dogs with torn ACLs.
The popularity is based on two main factors – yielding long-term results and warranting a shorter recovery time than most ACL repair options. Dogs that have undergone TPLO are usually weight-bearing the day after the surgery.
The concept behind the procedure is to completely change the knee's dynamics so that the torn ligament's original function becomes obsolete. This may sound complicated, but it is, in fact, quite simple.
Namely, when the dog stands, the normal knee position is slightly bent. This means the knee joint is always load-bearing and under tension. Therefore, when the ACL tears, the femur rubs against the backside of the tibia, causing pain.
The TPLO surgery is based on cutting and rotating the tibia and then fixing it with a metal plate. By changing the angle at which the tibia and femur communicate, the TPLO prevents rubbing.
The price of the TPLO surgery also depends on where you live and who does the procedure. Generally speaking, the prices vary from $3500 to $5500. In some places, these prices will also include post-surgical rehabilitation therapy, and in others, the rehab is an extra expense.
Tibial Tuberosity Advancement (TTA)
The goal of the TTA surgery is to change the position of the knee and stabilize the joint without relying on the ligament.
The procedure is based on making a linear cut in the frontal part of the tibia and pushing the cut bone forward. Then a particular implant called a bone spacer is placed between the two ends of the cut tibia. Finally, to ensure proper stability, the bone is fixed with a metal plate.
Based on your living location and the experience and certification of the surgery performing vet, you can pay anywhere between $3500 and $4500 for a TTA surgery. Once again, based on the hospital's policy, this price may include some level of post-operative rehabilitation therapy.
Like TPLO, TTA is considered a more invasive, complex, and therefore pricier ACL repairing option. Plus, it is not routinely performed by general practitioners but only by board-certified orthopedic veterinary surgeons because of its nature.
The Costs of ACL Surgery in Dogs
So to recap, here is a rundown of the costs of ACL surgery in dogs.
- Lateral suture technique cost may range between $1100 and $2500
- TPLO surgery cost may range from $3500 to $5500
- TTA surgery costs may range between $3500 and $4500
All in all, there are various surgical options for dogs with torn ACL, and there is no one-surgery-fits-all approach. Every dog is different and requires an individually tailored treatment plan. Also, every dog needs a unique recovery strategy.
Regardless of which surgical procedure you choose, your dog will need an extensive cage rest after the surgery and adequate rehabilitation therapy when the time is right. In some cases, the rehab period can be pretty long and last over a year. It is essential to be patient and follow your vet's instructions.