Dog CCL (ACL) Surgery: Cost and Recovery Timeline

The cranial cruciate ligament (CCL) plays an important role in normal knee function in dogs. It’s what a human would call their anterior cruciate ligament, or ACL. 

When the CCL becomes damaged or torn, surgery is required to repair it.

Let’s look at everything a pet parent needs to know about this procedure—from dog ACL surgery cost to canine ACL surgery recovery. 

What Is Dog ACL Surgery?

Because the torn cruciate ligament will not regrow, the veterinarian puts an implant in the knee that either changes how the knee functions or mimics the function of the original CCL.   

The knee joint is a complex joint, and the cranial cruciate ligament (dog ACL) plays an important role in the knee’s function and stability. The functions of the CCL include: 

• Preventing the tibia (shin bone) from sliding forward in relation to the femur (thigh bone) 

• Preventing hyperextension of the knee 

• Preventing the shin bone from turning inwards 

When the CCL tears, the ligament can no longer perform these functions, and the knee becomes unstable. This leads to pain, inflammation, lameness, and arthritis.  

The dog may experience: 

• Loss of range of motion 

• Difficulty getting up from a sitting or lying position 

• Difficulty climbing stairs 

• Difficulty jumping up on the couch 

• Decreased activity level 

• Muscle atrophy (loss of muscle) 

The goals of dog ACL surgery are to get a pup’s knee (stifle joint) back to a normal level of function and to limit future instability and pain. Several techniques are used, which we’ll describe further towards the end of this section. 

The dog’s knee also has C-shaped discs called menisci between the femur and tibia bones. These ligaments absorb shock between the thigh and shin bones. When a CCL tear occurs, the meniscus towards the inside of the dog’s knee (medial meniscus) can tear. If this occurs, the damaged part of the meniscus will be removed during surgery. 

To download this medical illustration, click here.

To download this medical illustration, click here.

If your dog has been diagnosed with a cruciate ligament rupture or tear, the chance that they will need surgery is high if they are a large or giant breed, young, and active.  

Types of ACL Surgery for Dogs 

Common types of dog ACL surgery include: 

1. Tibial plateau leveling osteotomy (TPLO): The top of the tibia is cut, and the tibia is rotated to prevent the femur from sliding backward. A metal plate and screws are used to hold the shifted bone in place. TPLO is most often recommended for medium to large, active dogs.

2. Tibial tuberosity advancement (TTA): A portion of the tibia is cut, advanced forward, then anchored in place with metal implants. This is another procedure which is more common in larger dogs. 

3. Extracapsular repair: With an extracapsular technique, the veterinarian stays outside of the joint capsule. These techniques are less invasive. Success rates are higher in small dogs than in large dogs. 

   • Lateral suture: A hole is drilled in the shin bone, and a large, strong suture is run through this hole and anchored around a small bone at the back of the thigh bone. This suture mimics the function of the CCL, preventing the shin bone from sliding forward. This procedure is more likely to be successful in small dogs. 

   • Tightrope CCL repair: Bone tunnels are made in both the tibia and femur, and a strong fiber-tape suture is passed through these tunnels. Again, this suture is mimicking the action of the CCL. Tightrope CCL may be more effective in large dogs than lateral suture techniques. 

Benefits of Dog ACL Surgery

Surgery offers the best chance at restoring normal function to the knee joint while minimizing a dog’s pain and inflammation. 

Before moving forward with dog ACL surgery, your vet will consider your dog’s size, weight, and activity level. Dogs of ideal body condition and young, active dogs are better candidates for surgery.  

Dogs that have partial CCL tears should still undergo surgery because partial tears can develop into full tears, which will worsen pain and lameness. 

ACL surgery in dogs can’t eliminate or prevent the development of arthritis, but it can slow it through the restoration of stability in the joint. 

Around half of dogs that tear one ACL will tear the other within about one to two years. By having surgery done on a torn ACL, you prevent your dog from having two unstable knee joints should they have a cruciate ligament rupture in the other knee. 

This surgery has an estimated 85–90% success rate, though this varies depending on several factors. This includes the degree of inflammation and arthritis already present in a dog, the surgical technique used, and skill of the veterinary surgeon. 

Risks of Dog ACL Surgery

Though these are rare, dog ACL surgery risks may include: 

• Complications due to anesthesia, including death 

• Increased risk of joint infection 

• Bone fracture 

• Failure of the bone to heal (nonunion) or heal abnormally (malunion) 

• Excessive bleeding 

• Failure of the plate and screws to remain in place 

• Breakage of the implant device 

• Infection of the implant 

• Post-operative complications, such as infection or inflammation at the incision site 

Dog ACL Surgery Cost

The cost of dog ACL surgery varies, depending on location, type of surgery performed, and care facility. However, you may expect the cost to be anywhere from $1,500 to $7,000 or more. 

Most pet insurance companies typically cover some or all the cost, unless specifically stated in their terms and conditions. If your dog has torn an ACL in the past before enrolling in insurance, the condition may be considered preexisting. Be sure to review your policy. 

Other options may include applying for CareCredit or payment plans.  

How To Know if Your Dog Needs ACL Surgery

If your dog is suddenly holding a back leg up when walking, toe-touching lame, or limping on a back leg with no known injury, it’s worth getting a CCL tear ruled out.  

Most CCL tears in dogs are not due to traumatic injury, instead occurring due to degeneration of the ligament over time. Veterinarians can diagnose CCL tears with a physical exam and X-rays of the knee.  

If your dog has a torn CCL, surgery is usually recommended unless they have health conditions that may make surgery risky. 

Preparing for Dog ACL Surgery

The day before dog ACL surgery, you may be asked not to feed your pet overnight depending on when the surgery is scheduled. 

After the necessary paperwork is filled out, your dog will be hospitalized, have their blood drawn, and an IV catheter placed.

The vet will perform an exam, review your pup’s paperwork and blood work, and be given pre-medication—this includes pain medication and sedatives, which will facilitate anesthesia. 

An endotracheal tube will be placed so that your dog’s breathing can be monitored. Then, your pet will be prepared for surgery. 

To download this medical illustration, click here.

Canine ACL Surgery Recovery

Regardless of surgical technique, all pets that undergo dog ACL surgery should have some degree of post-operative exercise restriction (usually two to three months) consisting of slow leash walks and crate rest, especially when unsupervised. 

Some pups may benefit from calming medications (trazodone and/or gabapentin) or sedatives so they don’t cause further injury or failure of the surgery.  

Rehabilitation is slow and can take up to six months following surgery. However, most dogs will resume normal activity three to four months after surgery. 

Future visits may include additional X-rays of the knee to make sure the bones are healing and implants are working properly.  

Some exercises can be performed at home, such as passive range of motion exercises (gently flexing and extending the knee), but your vet may also recommend consultation with a rehabilitation veterinarian.  

Physical rehab can improve your dog’s recovery.  

Other treatments include icing the joint several times a day and laser therapy to help decrease pain and swelling, increase mobility, and promote healing. 

Pain medication and anti-inflammatory medications may be prescribed, such as: 

• Gabapentin 

• Tramadol 

• Galliprant 

• Rimadyl 

Your vet may prescribe the following supplements to help reduce pain, minimize cartilage damage and swelling, increase joint lubrication, and help with cartilage production. 

• Joint supplements, like Dasuquin or Cosequin 

• Glucosamine, chondroitin sulfate, omega-3 and omega-6 fatty acids 

Overweight dogs have a more difficult time during recovery. If your dog is obese, there’s a risk of them reinjuring their joint or causing future injury to their other knee. 

If this is the case, your vet may recommend a veterinary weight loss diet, such as Hill’s Meta-mobility j/d, or Royal Canin Advanced Mobility.  

Consult with your veterinarian on the best supplements and diet for your dog, based on their specific needs. 

Failure to follow your veterinarian’s advice could result in further ACL damage, additional complications, and necessitate more surgeries or treatments for your pup. 

Alternatives of ACL Surgery in Dogs

Surgery may not be an option for all dogs due to:  

• Advanced age 

• Underlying disease 

• Inability to undergo anesthesia 

• Financial constraints of their pet parent 

These dogs can often be managed conservatively. This includes exercise restriction for several weeks, weight loss, and the prescription of pain medications or anti-inflammatories (NSAIDs). 

This method doesn’t return the knee joint to normal function and doesn’t provide the necessary stabilization, but for smaller dogs—especially those that weigh less than 30 pounds—it does carry an estimated 85% success rate.