craniel cruciet tear

What is the best, least invasive, shortest recovery, repair for a cranial cruciet tear for my 23 lb cocker.
Where is the best place to take her and what is an average cost for the procedure.

[Arnold L Goldman, D.V.M.]

Dear Budduck,

Your question does not lend itself to a straightforward answer. There is no one right procedure for ACL injury in all cases. Several procedures exist that can provide an acceptable result.

The goals of ACL surgery are to:
1. re-create the joint stability that existed when the the ACL was still able to do its job
2. eliminate pain
3. eliminate inflammation from degenrating ligament that leads to scarring of the joint capsule, loss-of-range-of-motion and gliding cartilage deterioration

Most general practitioners perform some form of "extracapsular" repair, these days the most common form of which utilizes the Securos company system and falls into the category known as "lateral suture stabilization". It is an effective, simple and easy to learn procedure which allows the desired joint stability to be created.

The thing to understand is that in no procedure commonly performed in dogs is the ligament itself repaired, replaced or recreated. In fact ACL remnants are purposefully and uniformly removed to eliminate the inflammatory chemicals elaborated as they degenerate further. The procedures allow stability via mechanical substitution of function.

There are other procedures: Tibial tuberosity advancement, now performed with a specialized set of hardware which requires added training to accomplish, the tibila plateau leveling osteotomy most often performed in large to giant breed dogs and by boarded surgical specialists, and others of varying commonality.

Most dogs of your dogs size and age can have a good outcome with any procedure. Obesity is a major negative factor as it means the opposite leg's ACL is probably also compromised and now will be under added strain as the "bad" leg heals. If necessary deal with that weight! Very important for good outcomes.

Most important is whether the procedure your trusted doctor wants to perform has been successful in his/her hands and he/she has confidence for a good outcome in your dogs case. If you are not comfortable then get a second opinion, perhaps even from a baorded surgeon (Credential is DACVS).

Do ask your doctor:

how many ACL repairs have you done in your career?
how many have you done in the last 12 months?

Having done 10 or more over a career means the doctor should be capable of predicting acceptable results. Doing at least 2 or 3 a year is enough to demonstrate an acceptable level of familiarity.

Again you can always seek a second opinion.

Finally cost varies by procedure, doctor, state region etc. Expect to pay anywhere from
$750.00 to $2500.00, it can range that much. There my not be a relationship between oost and outcome however. The good news is, most smaller dogs who are not obese do well.

Good luck

Dr G