Post-Operative Care after CCL Surgery

    One of the most common orthopedic injuries among medium and large breed dogs is a torn cranial cruciate ligament (CCL).  The CCL is a stabilizing ligament in the stifle (or knee), analogous to the human ACL.  If the CCL is torn, surgery may be prescribed to restore stability to the stifle joint.  There are several different techniques for CCL repairs — your surgeon will choose which technique is most appropriate for your dog.  If your dog has had or is planning to have CCL surgery, we advise that you engage in structured post-operative care in order to promote a smooth, successful recovery.

    The post-operative treatment plan outlined below is staged week by week, and should ideally be started as soon as your dog returns home from surgery. For the first few weeks, we introduce gentle, passive therapy techniques for maintaining flexibility and managing pain.  As you progress, we suggest more dynamic strengthening techniques to promote optimal bone healing and muscle growth.  We also provide recommendations for professional therapy techniques that you can pursue at an accredited canine rehabilitation center in your area.  To ensure your dog’s safety,  all of the techniques outlined in this plan should be implemented only under the direction of your veterinarian, and/or a certified canine rehabilitation specialist.

    Icing

    Icing helps reduce heat and swelling due to surgical trauma. Wrap ice pack in a thin towel, and apply for 10-15 minutes.

    Weeks 1-2: 

    1- Passive range of motion to affected limb 10-25 times twice a day

    2- Ice incision for 10-15 minutes three times a day for first 3 days, then warm compresses if residual swelling present.

    3- Assisted standing/weight shifting on to surgical limb

    4- Sling/Assisted walking

    5- Laser to surgical stifle and incision daily to weekly depending on access

    6- Massage to gluteals, hip flexors, back, shoulders, neck, and forelimbs

    Weeks 3-4:

    1- Passive range of motion to affected limb 25-50 times twice a day

    Sling Walking

    Walk your pet with a support or sling under his abdomen for the first couple weeks, especially if you need to use stairs.

    2- Stretching to hip flexors, hamstrings

    3- Controlled leashed walking for 10 minutes twice a day

    4- Assisted 3-legged stances on affected limb for 10-20 second intervals 2-3 times twice a day

    5- Sit-to-stands 5 times twice a day

    6- Massage to gluteals, hip flexors, back, shoulders, neck, and forelimbs

    7- Start comprehensive rehabilitation 1-2 times a week at an accredited canine rehabilitation facility if available. A good comprehensive plan should include some combination of passive/manual therapies, therapeutic exercises, modalities (laser therapy), and hydrotherapy.

    Weeks 4-8:

    1- Passive range of motion to affected limb 25-50 times twice a day

    laser

    Cold laser therapy is a great tool for maximizing healing by reducing inflammation and increasing circulation.

    2- Stretching to hip flexors, hamstrings

    3- Controlled leashed walking for 15-20 minutes twice a day

    4- Controlled leashed walks uphill or up stairs in a very slow, controlled manner

    5- Assisted or non-assisted 3-legged stances on affected limb for 20-30 second intervals 3 times twice a day

    6- Sit-to-stands 5-10 times twice a day

    7- Massage to gluteals, hip flexors, back, shoulders, neck, and forelimbs

    8- Continue comprehensive rehabilitation 1-2 times a week at an accredited canine rehabilitation facility if available. A good comprehensive plan should include some combination of passive/manual therapies, therapeutic exercises, modalities (laser therapy), and hydrotherapy.

    Weeks 8-12:

    1- Stretching to hip flexors, hamstrings

    IMG_1139

    The three-legged stand is a safe exercise for strengthening the muscles surrounding the stifle after surgery.

    2- Controlled leashed walking for 25-35 minutes 2-3 times a day

    3- Controlled leashed walks uphill or up stairs in a very slow, controlled manner

    4- 3-legged stances on affected limb for 20-30 second intervals 5 times twice a day

    5- Sit-to-stands 10 times twice a day

    6- Massage to gluteals, hip flexors, back, shoulders, neck, and forelimbs

    7- Continue comprehensive rehabilitation 1-2 minutes a week at an accredited canine rehabilitation facility if available. A good comprehensive plan should include some combination of passive/manual therapies, therapeutic exercises, modalities (laser therapy), and hydrotherapy.

    Bench resting

    Hydrotherapy provides an excellent form of low-impact or no-impact exercise, allowing the pet to strengthen the muscles without putting undue stress on the recently repaired joint.

    Free swimming