My dog has a torn cranial cruciate ligament (CCL) and an unstable knee. Would you recommend a custom-made brace while I try to have him heal without surgery? And would the brace help stabilize the knee while he heals?
A variety of different treatment options are available for a tear of a CCL. We generally tailor treatment options depending on the dog's age, activity level, and weight as well as your expected functional outcomes for your pet. For instance, we may consider different treatment options for a Maltese whose job is a family pet than for a Border Collie who wants to go back to Flyball competitions. Your veterinarian and a board-certified surgeon could work together to help you sort through some of these options for your dog.
Stifle bracing is a relatively new treatment option that we have added to our toolbox for this disease and we are still learning the best uses for this tool. The outcome following the use of stifle braces in dogs with cranial cruciate ligament ruptures has not been clinically evaluated or reported, and at this time is anecdotal. In general, we may consider stifle bracing in dogs that cannot tolerate anesthesia because of other medical conditions or because they are senior patients; in young dogs for temporary use while their growth plates close; or, potentially, as an alternative when there are financial constraints for treatment.
For cranial cruciate ligament tears, functional-hinged braces have become the preferred support when this modality is chosen. These braces may help relieve the strain on the cranial cruciate ligament and improve comfort, allowing the dogs to continue their daily activities while using the leg. Unfortunately, these braces do little to speed healing, but can provide support and may help prevent further injury. When the brace is off, the dog will continue to walk on the unstable knee. It is important to realize that dogs do not always immediately tolerate a brace and that there is an adjustment period while we tailor the exact fit of the brace and get the pet used to wearing it. It is important that if you choose to have a brace made, you work with a clinician who is comfortable with the process of making a mold of the limb and then evaluating the fit of the finished product. Additionally, it is recommended that you work with a reputable company that has previous experience with canine stifle orthotics.
In most cases, in cases where surgery is an option if medical management fails, we do not routinely recommend bracing during the trial period for medical management. However, we do recommend you have an in-depth discussion with your vet - and potentially with a veterinary orthopedic specialist that your vet recommends - to see if this tool could be of benefit in your specific situation.