Advances in the Canine Cranial Cruciate Ligament, 2nd edition

Rehabilitation for Dogs with Cruciate Ligament Rupture 345

Figure 42.2 A dog is standing with a non
weight-bearing stance on his operated pelvic limb
14 days after extracapsular stabilization of his cruciate
ligament-deficient stifle joint. A non weight-bearing
stance during the subacute postoperative period is
generally the consequence of chronic pain from a
biological or mechanical problem.

Preventing and recovering from a loss of
muscle mass and motor control

Muscle mass and neuromuscular control are
impaired in patients with CR, leading to a loss
of strength and dynamic joint stability (Risberg
et al. 2007). Controlled exercises promote limb
use, prevent loss of muscle mass, and acceler-
ate recovery of muscle mass after CR stabiliza-
tion (Figures 42.3 and 42.4) (Johnsonet al. 1997;

Marsolaiset al. 2002; Jerre 2009). Strengthening

exercises and a focus on normalizing muscle

activation/control via proprioceptive retrain-

ing may assist in reducing abnormal gait strate-

gies and optimize recovery in patients with CR

(Adrianet al. 2013).

Preventing and recovering from changes

in posture resulting from chronic pain

and limb disuse

Dogs with CR develop changes in posture that

include moving their center of gravity cranially

so that the loads resisted by their pelvic limbs

decrease (Figure 42.5). With time, these changes

in posture become deeply rooted. Therapeutic

exercises promote strategies to increase pelvic

limb muscle recruitment, improve motor con-

trol and proximal strength to help improve

posture.

Preventing mechanical complications

after surgery

Mechanical failure can occur after all forms of

CR stabilization, and its likelihood is increased

by falls and by owners’ unwillingness or inabil-

ity to control physical activity (Langenbach &

Marcellin-Little 2010). Physical rehabilitation

* *

*

*

# #

066 0

Time (months after surgery)

Limb function (PVF % BW) Limb function (VI % BW)

25

27

29

31

33

35

37

39

41

43

8

9

10

11

12

13

14

Figure 42.3 Peak vertical forces (PVF) and vertical impulse (VI) relative to body weight (BW) before and 6 months after
extracapsular stabilization of the stifle joint for dogs that were exercise-restricted (dotted lines) and dogs that underwent
rehabilitation (solid lines). PVF and VI were larger 6 months after surgery compared to before surgery in all situations
(∗,P<0.05) and were larger in dogs that underwent rehabilitation compared to dogs that were exercise-restricted
(#,P<0.05). Source: Marsolaiset al. 2002. Reproduced with permission from the American Veterinary Medical
Association.