Advances in Surgical Management of Cranial Cruciate Ligament Rupture in Dogs

Background:Cranial cruciate ligament (CCL) rupture is one of the most prevalent orthopedic conditions in dogs and a leading cause of stifle joint instability and pelvic limb lameness. Surgical intervention is widely regarded as the treatment of choice to restore joint function, alleviate pain, and improve long-term clinical outcomes. Over the past decades, multiple surgical techniques have been developed, yet controversy remains regarding the optimal approach for individual patients.Objective: This narrative review aims to critically evaluate and compare the most commonly employed surgical techniques for the management of canine CCL rupture, with particular emphasis on extracapsular stabilization, tibial plateau leveling osteotomy (TPLO), and tibial tuberosity advancement (TTA).Methods: A comprehensive literature search was conducted using PubMed, Scopus, and Web of Science databases to identify relevant peer-reviewed articles published between ۲۰۱۸ and ۲۰۲۵. Keywords included “cranial cruciate ligament rupture,” “TPLO,” “TTA,” “extracapsular stabilization,” and “canine stifle surgery.” Clinical trials, comparative studies, systematic reviews, and meta-analyses were reviewed and synthesized.Results: Current evidence indicates that osteotomy-based techniques such as TPLO and TTA generally provide superior postoperative joint stability and more consistent long-term functional outcomes compared to extracapsular methods, particularly in medium to large breed dogs. However, extracapsular stabilization remains a viable option for selected cases, especially in small dogs, due to its lower technical complexity and cost. Complication profiles differ among techniques, with implant-related issues being more commonly reported following osteotomy procedures.Conclusion: No single surgical technique is universally optimal for all dogs with CCL rupture. Surgical decision-making should be individualized based on patient-specific factors, surgeon expertise, and owner expectations. Future research should focus on standardized outcome measures and long-term comparative studies to further refine surgical treatment strategies for this common orthopedic condition.

Keywords:

Cranial cruciate ligament (CCL) , Canine stifle surgery , Tibial plateau leveling osteotomy (TPLO) , Tibial tuberosity advancement (TTA) , Extracapsular stabilization , surgical outcomes.