The anterior cruciate ligament has a special importance in the knee joint - it allows a hinge movement of the joint and prevents "sliding back and forth" of the bony structures. The cruciate ligament rupture is still one of the most common orthopedic diseases in dogs.
The diagnosis cruciate ligament rupture is a typical sports injury in humans. With our four-legged friends it behaves somewhat differently. In addition to the traumatic causes, it is usually a "degenerative process", i.e. the cruciate ligament shows signs of wear over the years, becomes thinner and thinner and finally tears. The changes in the ligament structure increase with age and with increasing body weight of the dog (negative effects are also caused by poor training).
The final tear of the cruciate ligament (cruciate ligament tear dog) usually causes only minor to moderate pain. Although many dogs initially no longer load the affected leg at all, an apparent improvement occurs within 2 to 3 weeks - the dogs partially load again, until suddenly a deterioration occurs again: this is not infrequently the moment when the inner meniscus is massively damaged (quasi a "shock buffer" between the bony parts of the joint).
The instability of the joint causes the dog enormous discomfort, with every load the bones shift against each other - the dog feels insecure. The situation is aggravated over time by the first signs of arthrosis or a painful joint effusion.
Ursachen für Kreuzbandrisse bei Hunden
Einige Hunderassen sind aufgrund ihrer Anatomie anfälliger für Kreuzbandrisse. Vor allem bei größeren Hunden wie Rottweilern, Neufundländern und Staffordshire Terriern treten sie häufiger auf. Die Kniegelenkbiomechanik bei Hunden unterscheidet sich von der des Menschen, weshalb man nicht einfach Operationstechniken aus der Humanmedizin übertragen kann.
Anatomie des Kniegelenks
Das Kniegelenk ist ein Scharniergelenk mit etwa 30° Rotationsmöglichkeit. Es besteht aus dem Oberschenkel (Femur), dem Schienbein (Tibia), dem Wadenbein (Fibula) und der Kniescheibe (Patella). Die Stabilität des Gelenks wird durch zwei gerade Seitenbänder und die beiden Kreuzbänder gewährleistet. Die Kreuzbänder verhindern eine starke Verdrehung des Knies und ein Vorwärtsgleiten des Unterschenkels. Zwischen den Knochen liegen die Menisken, die stoßdämpfende und stabilisierende Funktionen haben.
The cruciate ligament as one of the most important tendons of the knee
Together with the collateral ligaments, the cruciate ligaments stabilize the knee joint. Each knee joint has an outer and an inner cruciate ligament, which are actively involved in the extension of the leg. The cruciate ligament gets its name because the two ligaments cross in the middle of the knee joint. If one of the cruciate ligaments tears, the stability and mobility of the knee is severely limited.
The main symptoms and signs of a cruciate ligament rupture in dogs
Hunde mit einem Kreuzbandriss zeigen typischerweise Anlaufschwierigkeiten, eine Beugehaltung des betroffenen Hinterbeins und Berührung des Bodens nur mit der Fußspitze. Die Muskulatur des Hinterbeins schwindet, und beim Sitzen wird das Knie unter den Bauch gelegt oder seitlich abgespreizt. Schmerzäußerungen treten nur auf, wenn das Band weiter einreißt.
Kreuzbandriss Hund Gangbild
The cruciate ligament rupture dog is characterized in most cases by a so-called"start-up lameness". Depending on the degree of injury, the lameness varies. With minor tears, your dog may limp slightly for a few days and then walk normally again. Such a previous injury increases the risk of a sudden jerk if your dog moves spontaneously and jerkily. Dogs also tense their hind leg and put it in a bent position. Normally, they do not lift their paw: if at all, only the tip of the paw touches the ground.
Your dog alternates between running fast and walking very slowly. The affected leg becomes thinner due to muscle breakdown. The cruciate ligament hurts with each subsequent cruciate ligament tear dog (otherwise dogs do not show pain with degenerative tears). In a traumatic cruciate ligament tear, your dog will show sudden, severe lameness and pain at the time of the accident. Your four-legged friend stretches his leg out to the side while sitting. The knee joint is swollen. The knee of your hairy nose becomes "hot"(high heat development).
How is the cruciate ligament rupture diagnosed in dogs?
Ein Kreuzbandriss Test beim Hund wird mit dem so genannten Schubladentest diagnostiziert (Tibiakompressionstest beim Kreuzbandriss Hund). Mit diesem Test überprüft der Tierarzt die Beweglichkeit des Kniegelenks. Ziehen Sie dazu den Unterschenkel in Richtung der Vorderbeine. Wenn der Unterschenkel im Gegensatz zum Oberschenkel wie eine Schublade nach vorne gezogen werden kann, deutet dies auf einen Riss des vorderen Kreuzbandes hin. Außerdem ist ein Erguss deutlich zu spüren. Dieser Test ist bei kleinen Hunden in der Regel einfacher durchzuführen als bei größeren Rassen. Größere Hunde haben mehr Muskelmasse, die sie während des Tests kontrahieren. Aus diesem Grund kann der Schubladentest negativ ausfallen, auch wenn Ihr Schützling einen Kreuzbandriss hat. Zur Bestätigung der Diagnose wird ein zusätzliches Röntgenbild oder CT angefertigt.
How does a cruciate ligament tear occur in dogs: degenerative or traumatic cruciate ligament tear?
A cruciate ligament tear (tear) can occur in two different ways:
a) Traumatic injury
On the one hand, an injury / cruciate ligament rupture dog may occur as a result of an accident. In this case, it is called a trauma or traumatic rupture.
b) Degenerative rupture / degenerative cruciate ligament rupture dog
When the cruciate ligament tears due to long wear and tear, medical science refers to it as a degenerative rupture. Aging processes, poor posture and constant overuse can lead to tears in your dog's cruciate ligament that become deeper over time. Therefore, this type of cruciate ligament tear should be assumed to be pre-damaged. Excess weight, heavy physical exertion, or unusual tibial formation all favor degenerative cruciate ligament tears. The difference between a cruciate ligament tear in dogs and in humans lies in the intensity of the tear. In dogs, the cruciate ligament does not tear completely in most cases, but fiber by fiber (cruciate ligament tear dog hind leg).
Häufige Fragen - FAQs:
Can a torn cruciate ligament dog heal by itself?
A healing of a cruciate ligament rupture dog by itself is unlikely to impossible, the dogs during a cruciate ligament rupture rather the not damaged side increased load and thus on the not yet damaged side also damage can arise.
What happens if you do not have a cruciate ligament rupture in a dog operated on?
An untreated cruciate ligament tear can lead to arthrosis and meniscus damage and thus further aggravation of the clinical picture.
Wie schnell muss ein Kreuzbandriss beim Hund operiert werden?
Die Dringlichkeit der Operation hängt von verschiedenen Faktoren ab, einschließlich der Schwere der Verletzung, dem Alter und der allgemeinen Gesundheit des Tieres sowie der individuellen Umstände.
Bei vollständigen Kreuzbandrissen und in Situationen, in denen eine konservative Therapie nicht erfolgreich ist, ist eine Operation zur Wiederherstellung der Gelenkfunktion in der Regel erforderlich. Die Dringlichkeit der Operation variiert je nach den oben genannten Faktoren, aber im Allgemeinen sollte der Eingriff so bald wie möglich durchgeführt werden, um die bestmögliche Prognose zu gewährleisten. In vielen Fällen wird eine Operation innerhalb von 1-2 Wochen nach der Diagnose empfohlen, um das Risiko von sekundären Schäden am Gelenkknorpel und anderen Strukturen zu minimieren. Eine frühe Intervention kann dazu beitragen, die Entwicklung von Arthrose und anderen degenerativen Veränderungen im Gelenk zu verlangsamen oder zu verhindern. In einigen Fällen kann jedoch eine längere Wartezeit vor der Operation in Betracht gezogen werden, beispielsweise wenn der Hund unter anderen gesundheitlichen Problemen leidet, die zunächst behandelt werden müssen.
Was passiert, wenn man einen Kreuzbandriss nicht operieren lässt?
Wenn ein Kreuzbandriss beim Hund nicht operiert wird, können verschiedene Komplikationen auftreten. Die Stabilität des betroffenen Gelenks bleibt beeinträchtigt, was zu erhöhter Instabilität und Schmerzen für das Tier führen kann. Langfristig besteht ein erhöhtes Risiko für die Entwicklung von Arthrose und anderen degenerativen Veränderungen im Gelenk. Diese chronischen Gelenkveränderungen können die Mobilität des Hundes einschränken, seine Lebensqualität reduzieren und die Notwendigkeit einer späteren chirurgischen Intervention erhöhen. Daher sollte die Entscheidung, einen Kreuzbandriss nicht operieren zu lassen, sorgfältig abgewogen und in Absprache mit einem erfahrenen Tierarzt getroffen werden.
Hat ein Hund Schmerzen bei einem Kreuzbandriss?
Ja, ein Hund kann bei einem Kreuzbandriss Schmerzen verspüren. Die Schmerzen resultieren aus der Instabilität des betroffenen Gelenks, der Entzündungsreaktion und möglichen Begleitverletzungen, wie z.B. Schäden am Meniskus. Die Schmerzintensität kann je nach Schwere der Verletzung und individuellen Faktoren variieren. Eine adäquate Behandlung ist daher wichtig, um Schmerzen zu lindern und die Lebensqualität des Hundes zu verbessern.
How much does cruciate ligament surgery cost in dogs?
Cruciate ligament rupture treatment in dogs is never a cheap affair. Simple procedures like capsular ligament repair start at 900 EUR plus physiotherapy etc. TPLO / TTA surgery start at 2500 EUR plus physiotherapy and aftercare. Artificial cruciate ligament replacement methods cost similarly, but the subsequent physiotherapy costs and medication costs are lower, as the healing time is usually much faster. Therefore we recommend dog owners of particularly endangered dog breeds (we observe cruciate ligament ruptures especially in young dogs increasingly in Labradors, Golden Retrievers, all Bulldog breeds or heavier dog breeds) to take out a surgery insurance or a veterinary health insurance at an early stage.
Cruciate ligament rupture dog surgery yes or no?
Kreuzbandriss Hund Heilungsdauer ohne OP: Bei kleinen Hunden ist manchmal eine konservative Behandlung vom Kreuzbandriss beim Hund möglich. Die nichtoperative Therapie umfasst eine spezielle Ernährung, Gelenkschutz, Physiotherapie und die Verabreichung von Medikamenten. Ziel dieser Heilmethode ist es, eine schmerzfreie Belastung des Kniegelenks zu ermöglichen. Dies wird jedoch in der Regel nicht von Tierärzten empfohlen. Grund dafür ist, dass beim nicht operierten Kreuzband die Gefahr einer Meniskusschädigung (Kreuzbandriss Hund ohne OP) besteht. Im schlimmsten Fall reißen beide Kreuzbänder deiner Fellnase mit der Zeit durch extreme Überlastung des gesunden, verbliebenen Bandes.
Auch nicht operierte Kreuzbandverletzungen können zu Knorpelschäden und Arthrose führen. Eine Operation hat den Vorteil, dass Folgeschäden nur selten auftreten. Welche chirurgischen Techniken gibt es bei einem Kreuzbandriss beim Hund? Bei einem Kreuzbandriss haben Tierärzte die Wahl zwischen mehreren verschiedenen Operationsmethoden. Einerseits gibt es Techniken, bei denen die Strukturen des Bindegewebes des Körpers oder künstliche Materialien verwendet werden.
Kreuzbandriss Hund Operationsmethoden
The path of the many surgical methods developed for this purpose for cruciate ligament rupture led via intracapsular and extracapsular techniques to the modern conversion osteotomies. Common to all is the assessment and, if necessary, treatment of the menisci (cleaning up, meniscectomy, etc.) and, as a decisive measure, stabilization of the knee joint. A distinction is made between intra- or extra-articular techniques and those with or without ligament replacement. In our small animal center, all common and proven surgical methods are used:
- Capsule cassia shirring according to Meutstege
- lateral thread control and a mixture of 1&2 or
- Zlig (formerly: VetLig - intraarticular cruciate ligament replacement) or
- TTA Rapid or
- TPLO
Welche Kreuzbandoperationsmethode ist für Ihr Tier die Richtige?
This depends on many factors, which we will be happy to discuss with you in advance by phone without obligation after receiving your documents (below you will find an inquiry form).
The choice of surgical method depends on the patient's physical conditions (methods 1&2 are often not advisable for heavier patients), the degree of arthrosis of the joint, the involvement of the menisci and is ultimately also a question of cost. This means for you as the patient owner that together we determine the right way in the consultation .
To give you a comprehensive overview of all major surgical methods of cruciate ligament rupture in small animals (dog / cat), you will find here an overview with the respective advantages and disadvantages from our own experience (as we offer and master all methods). from our point of view:
TPLO(Tibial Plateau Leveling Osteotomy)
In this surgical method of cruciate ligament rupture, a quarter-circular bone incision is made at the upper end of the tibia. The joint surface of the tibia is then rotated backwards according to a previously calculated measure. It is fixed in this new position with a bone plate and screws. The rotation reduces the tilt of the joint surface. The goal is a postoperative inclination of 5°.
The angle between the patellar ligament and the joint surface is then about 90°. Experiments have shown that with this inclination the cranial tibial thrust is neutralized and the tension of the anterior cruciate ligament (if it is not yet completely torn) is significantly reduced.
Vorteile TPLO:
✓ Permanent and reliable stabilization of the knee joint even under heavy load, even in animals with high body weight
✓ For certain breeds and associated joint problems. only possible solution (especially for dogs that are generally prone to cruciate ligament tears due to their anatomy (e.g. Old English Bulldog))
✓ the leading cruciate ligament surgery method in Germany
Nachteile TPLO:
X Serious surgery with sawing of the bone
X Redirection of forces in a non-natural way
X long healing process
X Relatively high price with all after roge costs like physiotherapy
TTA(Tibial Tuberosity Advancement)
A method similar to TPLO is the TTA (Tuberositas Tibia Advancement). Here, the rupture of the cruciate ligament is also used to modify the biomechanics of the knee joint by means of a bone incision. As in TPLO, a forward displacement of the patellar ligament results in an almost right angle between the patellar ligament and the tibial joint surface, as in TPLO.
Vorteile TTA:
✓ Loading of the operated leg immediately postoperatively is somewhat faster than after a TPLO.
Nachteile TTA:
X The load on the operated leg 1 year after a TTA is slightly worse than one year after a TPLO.
X Greater progression of knee joint arthrosis
X Significantly higher number of meniscal injuries postoperatively than after TPLO
X Less stability postoperatively than after a TPLO (current studies by Prof. Böttcher, University of Leipzig).
You can find a comprehensive comparison between the two surgical methods TPLO & TTA (classic) in the Dissertation by Dr Monika Höpfl here.
TTA-Rapid
With the relatively new TTA-Rapid method, better results can now be achieved than with the classic TTA method. The success rates are comparable to the TPLO methods, which is why we will offer this method for special breeds for which the Vetlig method is not suitable.
Current studies on TTA-Rapid can be found here:
https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0039-1684050
https://pubmed.ncbi.nlm.nih.gov/25330358/
And the following study explains why the TTA Rapid implant made of pure titanium grade 1 with dodecahedron unit cell structure stimulates bone growth:
https://pubmed.ncbi.nlm.nih.gov/32344664/
The procedure of the TTA-Rapid method can be seen in the following video:
What is the difference between TPLO and TTA?
When the veterinarian performs a TPLO, he cuts the dog's tibia with a circular incision. He then places special plates in the appropriate locations and screws the tibia and plates into a different position. The goal of this method is to prevent biomechanical slippage of the leg so that the support function of the cruciate ligament is no longer needed. In a TTA, additional plates and a spacer are screwed into the lower leg. Variations in the angle of the patellar tendon and altered fusion of bone structures also prevent sliding of the lower leg.
The advantage of both surgical techniques (over ligament replacement) is that the cruciate ligament can no longer tear because it has not been replaced. So it is possible that your dog can participate in sports and protective activities again after the healing and physiotherapy is completed. A significant disadvantage especially in very young dogs or very old: A renewed operation of the cruciate ligament is then with high probability no longer possible and in the worst case an amputation must take place. Our experience with artificial cruciate ligaments such as the Zlig or Novelig from more than 200 operations, however, is very positive. Especially in cases of bilateral cruciate ligament ruptures, our Petlig-Method® has proven its worth.
Tape replacement, extracapsular (Ruby, Tightrope, tape replacement according to Flo / Meutstege)
The extracapsular ligament replacement is used in the cruciate ligament rupture dog is often used in smaller dogs. Here, a plastic band is attached outside the joint in the direction of the anterior cruciate ligament. The method of fixation varies with each surgical method. This can be done with bone anchors in the femur and tibia (Ruby), with drilled holes in the femur and tibia (Tightrope) or on the sesamoid bone of the femur and with a drilled hole on the tibia (Flo).
Vorteile Bandersatz extrakapsulär:
✓ Shorter anaesthesia and surgery duration
✓ Lower price
✓ good experience with small and medium dog sizes
✓ Faster healing process than with the aforementioned methods
Nachteile Bandersatz extrakapsulär:
X Replacement ligament can tear again just like a normal cruciate ligament
X "Wearing out" (osteolysis) of the bone drill holes in the tigthropic method with the consequence of renewed instability
Ligament replacement, intracapsular - Zlig (formerly: VetLig)
This method has been used on humans for 25 years. The body's own or artificial material (tendons, parts of the patellar ligament, fascia) is used as a ligament replacement instead of the torn cruciate ligament.
In the case of canine cruciate ligament rupture, this method did not prove successful for a long time. Due to the insufficiently controllable load on the knee joints in dogs after surgery, the ligament replacement tore again in many cases.
With the development of new materials in medical technology, it is now possible to offer dogs / cats a surgical method that is considered state of the art in humans because it best mimics the natural anatomy of the animal and, unlike TPLO / TTA, does not involve any stressful changes to the bones.
With Zlig (formerly: VetLig), a synthetic ligament for intra-articular cruciate ligament replacement in small animals is now available after long preliminary work by Dr. Jacques.Pillipe Laboureau.
A tunnel technique is used to insert the Zlig as a total replacement for the cruciate ligament. The braided extra-articular parts of the ligaments are anchored in femoral and tibial bone tunnels by canulated titanium interference screws.
This technique does not cause irreversible damage.
Vorteile Zlig:
✓ Can also be used for very heavy dogs >70kg
✓ Reproduction of the natural anatomy without serious intervention in the bone structure
✓ the patient's hind leg can be loaded again immediately (!) after the surgery without any risks
✓ Lower costs than with TPLO or TTA, if you look at the total effort incl. aftercare and physiotherapy
✓ especially with young animals This method does not obstruct the later application of Zlig or TPLO / TTA again - the latter, however, are unique and final.
✓ a good solution in case of bilateral ligament rupture in smaller dog breeds, because then both cruciate ligaments can be replaced in one operation with one-time anesthesia risk (Petlig Method®)
Nachteile Zlig:
X higher costs than with capsular fascia lifting according to Meutstege or lateral suture tightening
X not suitable for all breeds (see above - e.g. very rare for Old English Bulldogs)
You can find more info on our special Zlig page
Consultation without obligation
Here you can request a non-binding consultation with Ms. Arndt, veterinarian:
Physiotherapy with the dog
Regardless of the surgical technique, after surgery for cruciate ligament rupture dog / cat should get painkillers your furry nose and if necessary also cartilage rebuilding preparations. The cruciate ligament rupture healing time after a TPLO is about three months. In contrast, an artificial ligament replacement has a healing time of about one month. The most important measures during the healing process are consistent physical therapy, regular weight checks, and gentle exercise and leash restriction. We have summarized more information on physiotherapeutic measures here.
Prevention of cruciate ligament rupture in dogs / Cats
If your dog currently has healthy cruciate ligaments or has already had a ligament replacement, you can take active steps to prevent a (new) cruciate ligament tear. Since overweight dogs overstress their joints and cruciate ligaments more quickly, you should make sure that your dog maintains a normal weight. In addition, you can support his joints with nutritional supplements. We will gladly tell you which are the right means. If you want to do top sports with your dog, you should pay attention to the right age. High joint stress can lead to cruciate ligament tears in both puppies and older adults. A healthy, normal-weight adult dog, on the other hand, enjoys physical activity.
Um das Risiko eines Kreuzbandrisses bei Ihrem Hund zu reduzieren, sollten Sie einige vorbeugende Maßnahmen ergreifen:
1. Gewichtskontrolle
Übergewicht ist ein wesentlicher Risikofaktor für Kreuzbandrisse. Achten Sie darauf, dass Ihr Hund ein gesundes Gewicht hat, indem Sie ihm eine ausgewogene Ernährung anbieten und ihn regelmäßig wiegen.
2. Regelmäßige Bewegung
Sorgen Sie dafür, dass Ihr Hund regelmäßig Bewegung bekommt, um seine Muskulatur und Gelenke fit zu halten. Achten Sie jedoch darauf, dass die Aktivitäten nicht zu intensiv sind und vermeiden Sie plötzliche Richtungswechsel oder Sprünge, die die Gelenke stark belasten könnten.
3. Rutschfeste Böden
Vermeiden Sie rutschige Böden in Ihrem Zuhause, da diese das Risiko von Verletzungen erhöhen können. Verwenden Sie rutschfeste Matten oder Teppiche, um Ihrem Hund einen sicheren Halt zu bieten.
4. Frühzeitige Erkennung von Gelenkproblemen
Sollten Sie Anzeichen von Gelenkproblemen bei Ihrem Hund bemerken, suchen Sie umgehend einen Tierarzt auf. Frühzeitige Diagnose und Behandlung können das Risiko von Kreuzbandrissen reduzieren.