What you need to know about CCL disease in dogs:
> The CCL (called ACL in people) stabilizes the knee, without it the joint is loose.
> It is painful to repeatedly walk or run on a joint when it is unstable.
> The TPLO surgery or a TTA surgery is designed to stabilize the joint.
> Those surgeries do not address the arthritis that will still happen in the joint.
> Surgery does not normalize the muscles and tendons around the joint - rehab exercise is essential!
> Non-surgical approach to full recovery is not necessarily less expensive than knee surgery, this is not easy and takes alot of time, medicine, and appointments to get through.
> Dogs with a partially torn CCL can still tear it more or fully later - despite rehab!
>> The best outcome for an athlete is obviously going to involve surgery to stabilize the knee and to remove debris from the joint.

> Full recovery takes about 12 weeks if rehab protocols are followed for symmetry and strength after surgery and pain is well managed in recovery.
> The best possible care for arthriits prevention and joint decay includes regenerative medicine.
> Treatments with platelet rich plasma and stem cells can modulate inflammation to improve healing.
> Treatments to improve joint lubrication and shock absorption can reduce needs for medications and slow joint decay.
>> Regular rehab fitness exercises for stability (not walking or running are essential to long term comfort and injury prevention!!

Surgery + PRP and Shockwave

Cranial Cruciate Disease (ACL disease)

Lucy has ACL degenerative disease as a young dog and was super active in her recovery period, it is hard to slow down this happy girl! 

At her 8 week recheck evaluation she was still sore and off-weighting this leg a bit.  She had some pain in the joint and early arthritic changes and some soreness stretching her patellar tendon (this is called this patellar tendonitis or "jumper's knee."

We sedated her briefly to use her own blood and platelets to inject into the knee to control inflammation and provide growth factors for healing.   We also shockwaved her patellar tendon and quadriceps.

With in two weeks we had her on the road to full recovery and at her 12 week recheck she was using her body normally and off all pain medications.  We will check her for arthritic pain and advance her supplements as needed every 6 months!

She is likely to benefit from shockwave of her patellar tendon from time to time if she gets sore from reoccurent tendonitis, most dogs come about every 3-6 months.  She will not need to be sedated for this, it is a pretty easy treatment for her!

ACL surgery is not a "magic fix."

We also have to treat the arthritis.

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Lucy's Therapy Goals: 

alleviate pain from arthritis and tendonitis 

protect the other knee from stress and injury with speedy recovery


to let her play and hike like the puppy she still is


One year of fun (so far) and counting!

> Progress exercises to peanut and balance work with jumping for ultimate core and spine strength
> Regular (3d week +) strength and fitness exercises at home with regular fitness workouts at the clinic monthly
> Many dogs see me monthly for acupuncture and chiropractic to keep the pain cascade from amping up and for a check up.
> Most dogs do need and will benefit from shockwave for the compensatory muscle soreness and to reduce overall fricition in the knees, back and hips on a 3-6 month interval.   We will see how it goes.
> Dog with very mild arthritis may benefit from a platelet rich plasma injection instead of Synamid.  We will discuss your particular dogs needs.

phase 5: regular pain prevention in the clinic and home exercise

> Exercises start to include stairs, circles, step ups, circles and things to prepare for jumping.
> We do a slow intro to trot in the treadmill, then on land, and gradually work up to running and playing!
> We transition off of pain meds and onto anti-inflammatory supplements (see the bottom of my Resource Hub page

phase 4: working up to sport and strength with symmetry to prevent re-injury - day 90-120

> Weekly therapeutic exercise at the clinic and home exercise 3 days per week to work on balance and stability
> Massage, stretching, and water therapy in the clinic in some sessions to work on flexibility and comfort of her spine and knees
> Exercise restriction from running or jumping to prevent negative progress

phase 3: rehabiliation exercise and rebuilding symmetry - day 60-90

>. Radiographs: spine, hips, stifles (both) for big picture assessment
> Surgical stabilization with TPLO by Dr. Moorer at Trek Veterinary Surgery
> A Joint injection with a lubricant that also improves shock absorption within the joint called Synamid
> Shockwave therapy to reduce myofacial pain (pain from muscle spasm), treat patellar tendonitis, and stimulate cartilage healing (more info on my You Tube video)

phase 2: surgical stabilization and myofascial care - day 30-60

> Medications to control the inflammation from arthritis (more info at the bottom of the Resource Hub Page)
> Medications to reduce maladaptive pain
> Home Laser therapy rental for two weeks - 15 min daily treatment

phase 1: Pain Management - day 1 to 30 days

"After her shockwave and PRP she has been great and has never looked back.  This was really hard because she is so young and I was afraid she was never going to come back to being a young active dog again after her surgery."

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Here is what Lucy's Mom says: 


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