Introduction
Anterior cruciate ligament (ACL) tears are one of the most common orthopedic injuries in dogs, especially in larger breeds like Labrador Retrievers. The ACL is an important stabilizing ligament in the knee joint. When it ruptures, it causes instability in the knee and leads to pain and arthritis. Surgery is often recommended to stabilize the joint and allow dogs to return to normal activity and quality of life.
The initial recovery after ACL surgery focuses on protecting the knee joint while it heals. Strict activity restriction and physical therapy are required during this time. The overall rehabilitation process takes 6-12 months before dogs can return to full function. Jumping and running usually aren’t recommended until at least 6 months after surgery when the knee is more stable. Close monitoring by a veterinarian is necessary during recovery to ensure adequate healing and prevent re-injury.
Causes of ACL Injuries
ACL tears are unfortunately very common in dogs. According to one study, around 1 million dogs suffer ACL injuries in the United States every year (https://topdoghealth.com/the-5-reasons-so-many-dogs-tear-their-cruciate-ligament/). There are several potential causes that can lead to ACL tears in canines:
Excessive strain on the legs – Dogs that are very active and energetic may put too much strain on their ACL over time, leading it to tear. Activities like running, jumping, and sharp turning can contribute to ACL strain.
Being overweight – Carrying excess weight puts increased pressure on a dog’s joints, including the ACL. Obese and overweight dogs are at higher risk of rupturing their ACL ligament.
Inconsistent exercise – Dogs that go from being very active to sedentary are at risk for ACL injury. Their ACL may be accustomed to high activity levels and is vulnerable when exercise is suddenly reduced.
Genetics – Some dog breeds may be genetically prone to ACL tears, including Labrador Retrievers, Rottweilers, Boxers, West Highland White Terriers, and Newfoundlands (https://furdunkin.com/what-you-need-to-know-about-dog-acl-tears/).
Age – Middle-aged and older dogs are at greater risk for ACL rupture as their joints age.
Previous injury – Dogs that have injured one ACL are more likely to tear the other one as well due to compensating for the first injury.
ACL Surgery Options
There are three main surgical techniques used to repair torn ACLs in dogs: TPLO (tibial plateau leveling osteotomy), TTA (tibial tuberosity advancement), and lateral suture technique.
The TPLO surgery involves cutting the tibia bone and rotating it to change the angle, taking pressure off the ACL and stabilizing the joint. This complex procedure requires special training and is one of the most common techniques used today (Leighton Vets).
The TTA method also changes the tibial plateau angle but by cutting and moving the tibial tuberosity rather than the whole tibia bone. This allows for earlier weight bearing than TPLO but has a longer recovery time (Top Dog Health).
The lateral suture technique uses sutures or material to replace the ruptured ACL. It is less invasive but may have a higher failure rate, especially in larger, active dogs. Strict exercise restriction is required during recovery.
Veterinarians consider factors like the dog’s size, age, and activity level when recommending the best surgical approach. Complications like infection are possible with any technique. Proper rehabilitation and aftercare are key for a successful outcome.
Initial Recovery
The initial recovery period after ACL surgery is critical for allowing your dog’s knee to heal properly. Vets typically recommend strict crate rest and very limited activity for the first 2 weeks after surgery.
Crate rest is essential to limit your dog’s mobility and prevent them from running, jumping, or playing, which could damage the surgical repair. Your dog should be confined to a crate or small space whenever they are not out for leashed bathroom breaks. During the first 2 weeks, bathroom breaks should be brief (5-10 minutes maximum) and your dog should be kept on a leash to prevent sudden movements or jumping.
You may be instructed to administer medication for pain and inflammation during this time, as well as provide ice packs to reduce swelling. Gentle range-of-motion exercises can help prevent stiffness in the joint.
While it’s difficult to restrict an energetic dog’s activity, following your vet’s recovery instructions carefully in the first 2 weeks can ensure proper initial healing and prevent re-injury of the ACL repair.
According to experts at PetMD, the first 2 weeks are focused on protecting the surgical site to allow for initial healing. Jumping, running, and playing are not advised during this crucial stage.
Rehabilitation Exercises
ACL surgery will require extensive rehabilitation exercises in order to restore strength and range of motion in the injured leg. Initially after surgery, the focus will be on gentle range of motion exercises to activate the joint and prevent stiffness. As healing progresses over the first 6-8 weeks, more intensive strengthening exercises will be incorporated to build muscle mass that was lost after injury and surgery (Lybbert).
Some key rehabilitation exercises after ACL surgery include (Lybbert):
- Flexion range of motion exercises like heel slides
- Extension range of motion exercises like prone hangs
- Strengthening exercises like leg raises, mini-squats, calf raises, and more
- Balance and proprioception exercises like weight shifting and balancing on an unstable surface
A physical therapist will provide a tailored rehabilitation program depending on factors like the surgical technique used and the patient’s age, activity level, and goals. Close supervision is extremely important to ensure proper form and gradual progression in the rehabilitation exercises (Lybbert 2022). Rehabilitation will take a minimum of 6 months but usually closer to 9-12 months for full recovery (Lybbert 2022).
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Monitoring Progress
It’s important to monitor your dog’s progress closely after ACL surgery to ensure they are healing properly and meeting expected milestones. Regular vet checkups are crucial to assess how the surgical site is healing and to examine the functionality of the knee joint. Many vets will schedule checkups at around 2 weeks, 6 weeks, and 12 weeks post-surgery. At these appointments the vet will check factors like:
- Swelling and inflammation around the incision site
- Range of motion in the knee and leg
- Gait and weight bearing ability
- Muscle loss in the affected leg
Your vet will let you know if your dog is progressing as expected or if additional interventions are needed. Between vet visits, it’s important for pet owners to monitor the recovery milestones. Typically dogs progress through stages such as:
- Week 1: Strict crate rest
- Week 2: Sutures removed, short leash walks allowed
- Weeks 3-4: Physical therapy and range of motion exercises
- Weeks 5-6: Longer walks and swimming allowed
- Weeks 7-8: Weaned off joint supplements and medications
- Weeks 8-12: Focus on muscle strengthening
Tracking your dog’s abilities and mobility will help ensure they are ready to advance to the next recovery stage on schedule. Be sure to follow your vet’s specific recovery plan and exercise restrictions. With proper monitoring and milestone tracking, dogs can make an excellent recovery after ACL repair surgery.
Jumping After Surgery
After ACL surgery, dogs need time for the surgical site to heal before resuming high-impact activities like jumping. Most veterinarians advise restricting jumping for 8-12 weeks after surgery. This allows the bone to fully integrate the implant and helps prevent complications like implant failure or re-tear of the ACL graft (Middlesex Vets).
The exact timeline for returning to jumping depends on the surgical technique, your dog’s age and activity level, and how well they adhere to rehab protocols. For example, TPLO surgery requires a longer non-weight bearing period than extracapsular repair. Your vet will assess progress at follow-up appointments and clear your dog for gradually increasing activity.
When first allowed to jump again, your dog should start with low-impact hops and short heights. Avoid letting them jump on and off furniture or in and out of cars. Slowly increase jumping difficulty and height over 4-6 weeks. Supervise your dog during this transition period and stop them if they seem to overexert the surgically repaired leg (PetHelpful).
Be sure to follow your vet’s specific instructions for your dog. While waiting for clearance, use ramps, facilitate stairs, and prevent situations where your dog might be tempted to jump. With proper rehabilitation and monitoring, most dogs can return to normal activity levels several months after ACL surgery.
Preventing Re-injury
After ACL surgery, it’s crucial to take steps to prevent re-injury and protect the repaired knee joint. Some ongoing lifestyle changes include:
- Maintaining a healthy weight – Excess weight puts more strain on joints, so keeping your dog trim is key. Feed a nutritious diet tailored to your dog’s needs.
- Regular low-impact exercise – Gentle exercise like leash walks and swimming helps rebuild muscle and stability. Avoid high-impact activities like jumping initially.
- Physical therapy – Following the recommended therapy routine builds strength and flexibility. This aids recovery and prevents compensation by the other leg.
- Joint supplements – Chondroitin and glucosamine supplements support joint health and prevent arthritis.
- Providing orthopedic bedding – Memory foam dog beds evenly distribute weight and reduce pressure on joints.
- Ramp access – Use ramps instead of stairs to limit stress on the knees during the healing process.
With lifestyle adjustments tailored to your dog’s needs and activity limitations, most dogs can avoid re-injuring the surgically repaired knee. Check with your veterinarian for specific recommendations to promote long-term joint health.
Long-Term Outlook
The long-term prognosis for dogs after ACL surgery is generally good. Most dogs can return to normal activity levels and have an excellent chance for a full recovery with proper rehabilitation. According to one study, over 90% of dogs had a satisfactory or better outcome at an average of 50 months after surgery (https://pubmed.ncbi.nlm.nih.gov/11058021/).
The prognosis tends to be better with surgical repair compared to conservative management. In a long-term follow-up study, dogs who underwent TPLO surgery had superior outcomes compared to non-surgical treatment, with 98% of owners reporting being very/mostly satisfied with the surgery results (https://bmcvetres.biomedcentral.com/articles/10.1186/s12917-014-0266-8).
Larger dogs over 15 kg tend to have a better prognosis than smaller dogs. With rigorous rehabilitation, even dogs over 45 kg can return to normal function and activity levels (https://pubmed.ncbi.nlm.nih.gov/26568171/). Careful adherence to post-op protocols and exercise restrictions is key for a successful recovery.
While most dogs fully recover, complications like arthritis may develop over time. With proper care, regular vet checks, and weight management, dogs can remain active and healthy despite an ACL injury history.
Conclusion
Recovery from ACL surgery in dogs is a gradual process that requires patience, dedication, and care from pet owners. While jumping and high-impact activities need to be restricted for at least 8-12 weeks after surgery, dogs can eventually regain full function and resume normal activities. With appropriate rehabilitation exercises, monitoring from your veterinarian, and prevention of re-injury, most dogs go on to live happy, active lives after ACL repair.
In summary, the typical recovery timeline after ACL surgery involves:
- 2-4 weeks of restricted activity and gradual reintroduction of short leash walks
- 4-8 weeks of progressive physical therapy exercises to rebuild muscle and range of motion
- 8-12 weeks of advancing activity under supervision but avoiding jumping, running and playing
- 3-6 months return to full activity once adequate healing is confirmed
While each dog’s recovery protocol will vary, following your veterinarian’s instructions can help ensure your dog safely regains strength and function. With careful management, dogs can go on to live active lives after ACL surgery.