Hi Chris, I think there are several considerations when thinking about ACL surgery. First, is whether to do surgery or not...
As MaryAnn said, some dogs do regain good function with solid rest. But, I think that relates a good deal to the extent of their injury. If the cruciate is completely ruptured, as oppossed to partially torn, it's impossible for the ligament to re-attach. So, if the ligament is ruptured (ie: in two pieces), I'd expect the dog to have extreme instability in the joint and concurrent pain, regardless of rest. If the ligament is only partially torn, there may be enough stability in the joint to allow for weight bearing and relatively painfree movement once the torn tissues heal and the inflammation subsides. In the case of a minimal tear, it's possible that the dog will be fine unless the weakened ligament and/or joint instability leads to a full rupture at some point down the road. If surgery seems to offer the best opportunity for improving the situation, you have another consideration. There are (2) fundamentally different surgical proceedures currently being done. The traditional method is to 'reconnect' the ligament using wire or filament of some sort to hold things together while the tissues heal. This proceedure is pretty painful so pain management is essential (a consideration as pain meds can be tough on older dogs), and...the recouperation period is quite long. The dog will be ambulatory quickly, but the full recovery period (ie: no sign of lameness) is about a year. The first 8 weeks especially are slow going... The second surgical option (for many, not all, dogs) is called a TPLO. In this proceedure, the angle of the tibial plateau is modified (leveled) to provide greater support for the bone above it, thereby stabilizing the joint. Dogs rebound from this surgery VERY quickly and seem to have far less post-op pain. The down side is that it's not as widely available as the traditional proceedure...only a limited number of surgeons are trained in it. You might have to travel to find a surgeon who's been doing them for awhile and it might be more expensive than the conventional surgery. You'll find excellent discussion of ACL surgery on Laurie Bryce's website, http://www.lauriebryce.com/tplo/ Regardless of which choice you make for your girl, discuss with the ortho doc physical therapy. In my area, we have a canine/feline P.T. facility that includes aqua therapy and an equine facility that also offers canine therapy. -Sherri Venditti
