PVMA Keystone Veterinarian Winter 2021 - 10

WhICH Patients Are Good
Candidates For Cranial Cruciate
Ligament (CCL) Bracing?
By Clayton Bunk

Over the past decade, My Pet's Brace
in Morgantown, PA has been providing
custom orthopedic braces for dogs all over
the world. I have been with the company
for over six years and have developed a
deep understanding of my role in helping
your patients. I wanted to reflect on
lessons learned on what makes a " good "
brace candidate.
Eighty-five percent of our patients are seen for Cranial Cruciate
Ligament1 (CCL) injuries. As the surgical approaches evolve, so
have the conservative treatment options and clients wanting to
seek out safe, effective and affordable treatments.

How a Knee Brace Works
The knee brace allows the dog to bear more weight on the
injured leg and provides comfort through range of motion. The
anterior knee strap puts pressure on the tibial crest to help
prevent cranial drawer motion. Over time, the support of the
brace and prevention of the drawer motion helps develop stable
scar tissue. Dogs gradually return to their normal activity and
the muscle mass is restored.
In our experience, most dogs need to wear their knee brace for
6-9 months for good strong scar tissue to develop. Pet families
can start going for short, leashed walks the very first day with
the brace. For the first three months, recommended activity is
restricted to leashed walks, with no crazy running or ball playing.
The vast majority of dogs receive a knee
brace in lieu of surgery, but a brace can
be used post-operatively to provide
additional support to the leg, especially
for active or giant breed dogs.

To Brace or Not to Brace?
In my opinion, and what I have observed
clinically, there are lots of dogs that
benefit from a brace. Our most common
1

dogs are senior dogs. They are still active,
but clients do not want to put their dogs
through surgery. I typically see dogs who
received a surgical procedure years ago,
and recovered well, but clients do not want
to put their dogs through another invasive
procedure. I also see plenty of dogs with
concurrent health issues that make them
a higher surgical risk. If you or the client are concerned about
anesthesia, a more difficult than average surgical recovery, or
a higher infection risk, I would encourage you to make a brace
part of the conversation.
There are some clients who are very concerned with the surgical
recovery period. Using the brace is a longer time frame, but is
" easier " in some respects. Clients may have a busy household
with young children or lots of other animals to care for. I think
the risks of mismanaging the surgical recovery are high. The
brace makes these " management errors " a bump in the road
rather than having to come back for a surgical revision.
Along the same lines, there are some clients who just don't want
surgery. Or at least not without trying conservative management
first. To me, this paralells the progression of care in human
orthopedics for an ACL tear: management, lifestyle change and
physical therapy before a surgical procedure.
There are also dogs, young and old, that deal with varying levels
of separation and/or confinement anxiety. Crate/room rest for
those dogs can inadvertently cause more problems. Also, think
of the dogs we have all seen that have never been on a leash
before or given any sort of " rules " at home.
Asking those dogs or owners to go right to
crate rest post surgery is likely not going to
end well.

Challenging Candidates
Almost all dogs can be braced, but I wanted
to share some types of dogs or conditions
that can be more challenging.

The Use of Canine Stifle Orthotics for Cranial Cruciate Ligament Insufficiency: bit.ly/3n0ghEj

10 | Keystone Veterinarian

http://www.bit.ly/3n0ghEj

PVMA Keystone Veterinarian Winter 2021

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