Client Education

Bonnie ruptured the cranial cruciate ligament in her left stifle.  Bonnie's stifle is 
equivalent to our knee.  The purpose of Bonnie's cranial cruciate ligament is to keep her 
knee joint from twisting or extending too far, and it also helps keep her leg aligned.  A 
rupture the cranial cruciate ligament is one of the most common causes of rear leg pain 
and limping in the dog.  Labs have an increased susceptibility to rupture of their cranial 
cruciate ligament.   We suspect that Bonnie ruptured her ligament while playing in the 
back yard.  It could have been something as simple as stepping into a hole while running 
that ruptured her ligament.  

Bonnie needs to have corrective surgery to repair her ligament.  The name of the surgery 
is "Intracapsular Under and Over reconstruction."    Basically, we are taking tissue from 
Bonnie's own knee and attaching it with a screw and washer to her femur in order to 
mimic the function of her ruptured cranial cruciate ligament.  

After her surgery we are placing Bonnie on a strict diet to help her lose weight.  The extra 
weight she's carrying around is hard on all her joints not only her knees.  Losing the 
weight will make Bonnie healthier overall.  We would like for you to feed her 2 cups of 
W/D Science diet twice daily.  W/D is a weight reducing diet that will help take the 
weight off of Bonnie, but you will be feeding the same amount so she will feel full after 
eating and not beg for treats.  We also need to restrict Bonnie's treats.  She can have 1-2 
raisins daily, but no more.  

After her surgery she'll wear a bandage for 7 to 10 days.  You will need to make sure her 
bandage stays clean and dry.  You will also need to monitor her toes and other visible 
parts or her leg for swelling.  If you see any of these things please bring Bonnie in and we 
will change her bandage.  If she is allowed to wear a wet or dirty bandage it could make 
her skin very irritated and inflamed and could cause her incision site to become infected 
and delay healing.  When we remove her bandage at 7 to 10 days we will check her 
incision and if it has healed nicely we will remove her sutures.

During the first 10 to 14 days, you will need to keep Bonnie confined in a crate so that 
she will not damage her "new" ligament.  

Bonnie will need exercise restriction for approximately 12 weeks.  At approximately 2 
weeks after surgery Bonnie can begin a controlled exercise program.  At 2 weeks you can 
start Bonnie on controlled leash walks, swimming, and some physical therapy, which I 
will demonstrate for you, to keep her joint healthy.  At 6 months after surgery we can 
remove the screw and washer that were used in her surgery.

There are basically 2 possible complications with this surgery, one being a failure of the 
"new" ligament and the other being irritation from the screw.  However, there is an 80-
90% success rate with this surgery, so her prognosis is good.  But, I want to make sure 
you know that it is very likely that Bonnie could rupture the cranial cruciate ligament in 
her right knee at some later time, especially is she stays at her current weight.  We will 
also monitor Bonnie for the possibility of developing arthritis in her knee.  If necessary 
we will give her a prescription for pain.


So to sum things up, Bonnie will have surgery and then you'll give her cage rest for 10 to 
14 days while monitoring her bandage.  Her sutures will be removed at around 10 days.  
At 2 weeks after surgery you can begin Bonnie on a controlled exercise program and at 
12 weeks she should be ready to return to normal performance.   Also Bonnie will have 
been on her new diet the entire time and we will be monitoring her weight loss.  At 6 
months we can go in and remove the screw and washer.