Traditional CCL Failure after 4 years?

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Traditional CCL Failure after 4 years?

Postby Reitz » Thu Mar 01, 2012 6:08 pm

Hi all,
It's been almost 2 years since I've posted here. Life gets busy, etc. But I'm back in a bit of a panic and hoping members with similar experiences can help me out. Skip down to "So the point" if you don't want to read the whole story.

My 8-9 year Magda had both her CCL's repaired within about 12 months of each other. The last one was done 3.5 years ago. No major issues along the way, and really I don't recall any limping since they healed.

This morning when we went for our AM walk she was a little uneasy on her left leg. As the day progressed she got worse, to the point that she looks exactly as she did before surgery (lameness, toe touching, limping, etc). Of course I panic. I give her half a buffered asprin and call the surgeon who is 2.5 hours away. Rather than get in the car he recommends 3 days of rest. Says that the traditional surgery does not rely on the suture after the healing period and that scar tissue is what is holding her knee together at this point. In other words, she shouldn't be able to re-tear the CCL 3.5 years after the fact. Does that sound right?

Of course knees are complicated, and he said that it could be any number of other injuries. However, figuring them out is more complicated than looking for a CCL rupture, and that before getting invasive just to give her anti-inflammatories and keep her calm.


So the point--if you don't want to read all of that: 1) Has anyone seen or heard of a CCL tearing years after traditional surgery was performed and scar tissue formed?

2) If not (any even if so, since I like to worry), what other horrible knee injuries should I be googling?

Thanks! Great to see some familiar names are still around!
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Re: Traditional CCL Failure after 4 years?

Postby Kingsgurl » Fri Mar 02, 2012 1:51 am

Says that the traditional surgery does not rely on the suture after the healing period and that scar tissue is what is holding her knee together at this point. In other words, she shouldn't be able to re-tear the CCL 3.5 years after the fact. Does that sound right?


Yes, that sounds right. Could be meniscus damage, could be arthritic changes. I hope she feels better. My boy had bi-lateral repairs about 4 years ago. Please keep us updated.
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Re: Traditional CCL Failure after 4 years?

Postby Reitz » Fri Mar 02, 2012 11:20 am

Thanks for the input.

She's doing much better today. Still limping a bit, esp if she tries to trot. But in normal walking it's unnoticeable. She's on a low dose of carprofen and I'll keep that up for another day or two. Yesterday the leg seemed totally lame. I checked the pad, squeezed the muscles, and got no pain response, so I assumed it must be the knee. Today she isn't lame, just has a slight limp. Except, of course, when she saw a squirrel on our walk. Then suddenly she forgot about the limp and picked up the pace.

If anyone else has a thought do let me know. I trust our old vet/surgeon (the one who is helping me) with stuff like this, but we recently moved and I haven't found anyone I really love yet locally. Fingers crossed she just tweaked it and we're back to normal without shopping for a local specialist.
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Re: Traditional CCL Failure after 4 years?

Postby Misskiwi67 » Fri Mar 02, 2012 11:25 am

Repair failure is a known possible complication, and they do have a typical "life" of about 3-5 years. Sometimes there will be enough scar tissue that the knee will be stable, sometimes it won't.

Its also possible there is arthritis, a soft tissue injury, a meniscal injury, or a reaction to the implant itself. Its time to see your vet...
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Re: Traditional CCL Failure after 4 years?

Postby Reitz » Fri Mar 02, 2012 12:14 pm

3-5 year life for the operation? I haven't heard that. Is that your experience in your practice? I was under the impression that failure was a complication, but it was only within the first year or so. After that the implant had done it's job and scar tissue took over. Why would anyone do the surgery if they're only good for 3-5 years?

In any case, I am in touch with the vet. He doesn't want to see her until she's been limping for 72 hours. So far we're 24 hours in and she looks much better than yesterday. His recommendation was 72 hours of restricted movement (just walks for the bathroom, no furniture, etc) and a low dose of anti-inflammatories.
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Re: Traditional CCL Failure after 4 years?

Postby Misskiwi67 » Fri Mar 02, 2012 6:29 pm

The implant in a traditional repair is heavy duty fishing line. It breaks, wears down, knots untie after a few years. Its entirely possible the implant is broken and is causing irritation and a repeated repair is not needed, only removal of the offending suture. You won't know until the knee is examined in depth.

In general, scar tissue does take over... but its not always enough for a permanent solution. This is why the more expensive metal implants are usually recommended for large breed or active dogs.
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Re: Traditional CCL Failure after 4 years?

Postby Reitz » Fri Mar 02, 2012 7:24 pm

Fair enough. I really do like our vet/surgeon, but he only does traditional CCL repairs. I'll take her soon. In the meantime, his recommendations seems to be working so far. She's not limping in the house, and only seems a little stiff on walks.
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Re: Traditional CCL Failure after 4 years?

Postby MarMar » Fri Mar 02, 2012 9:21 pm

Misskiwi67 wrote:The implant in a traditional repair is heavy duty fishing line. It breaks, wears down, knots untie after a few years. Its entirely possible the implant is broken and is causing irritation and a repeated repair is not needed, only removal of the offending suture. You won't know until the knee is examined in depth.

In general, scar tissue does take over... but its not always enough for a permanent solution. This is why the more expensive metal implants are usually recommended for large breed or active dogs.



I used to work in a specialty hospital that did many many TPLOs for cruciate injuries and this also was my understanding of traditional repairs. They would only do TPLOs on large dogs.
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Re: Traditional CCL Failure after 4 years?

Postby Reitz » Fri Mar 09, 2012 10:16 am

I guess maggie was at the cutoff. She was just under 50lbs when she had surgery (49). She's around 52 now.

Lameness is still gone, seems to walk normally, but when she trots she limps a bit and acts like her leg is stiff. So it's off to the vet next week.

Thanks for all the input, I really appreciate it.
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