Do dogs with non-surgically managed cranial cruciate ligament disease have better outcomes with rehabilitation?



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PICO question

In dogs with cranial cruciate ligament disease treated non-surgically with rehabilitation, is the outcome inferior/equivalent/superior as measured by owner and/or veterinarian evaluation to dogs treated non-surgically without rehabilitation?


Clinical bottom line

Category of research question


The number and type of study designs reviewed

Four papers were critically appraised. One paper reviewed was a prospective, randomised clinical trial. The remaining three papers were retrospective cohort studies

Strength of evidence


Outcomes reported

There are no studies available that directly compare dogs managed non-surgically with and without rehabilitation following cranial cruciate ligament injury. In one study, 66% of dogs treated non-surgically with rehabilitation are reported to have successful outcomes 1 year following initiation of treatment. For dogs managed non-surgically without rehabilitation, successful outcomes varied from 19%–90% of cases among several retrospective studies


There is evidence suggesting the addition of rehabilitation to conservative therapy is beneficial, but based on the current literature, it is impossible to say whether it is superior to conservative treatment without rehabilitation


How to apply this evidence in practice

The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.

Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.


Open Access Peer Reviewed


Chauvet, A.E., Johnson, A.L., Pijanowski, G.J., Homco, L. & Smith, R.D. (1996). Evaluation of fibular head transposition, lateral fabellar suture, and conservative treatment of cranial cruciate ligament rupture in large dogs: a retrospective study. Journal of the American Animal Hospital Association. 32(3), 247–255. DOI:

Pond, M.J. & Campbell, J.R. (1972). The canine stifle joint. I. Rupture of the anterior cruciate ligament. An assessment of conservative and surgical treatment. Journal of Small Animal Practice. 13(1), 1–10. DOI:

Vasseur, P.B. (1984). Clinical Results Following Nonoperative Management for Rupture of the Cranial Cruciate Ligament in Dogs. Veterinary Surgery. 13, 243–246. DOI:

Wucherer, K.L., Conzemius, M.G., Evans, R. & Wilke, V.L. (2013). Short-term and long-term outcomes for overweight dogs with cranial cruciate ligament rupture treated surgically or nonsurgically. Journal of the American Veterinary Medical Association. 242(10), 1364–1372. DOI:

Vol. 6 No. 2 (2021): The second issue of 2021

Section: Knowledge Summaries

Categories :  Small Animal  /  Dogs  /  Cats  /  Rabbits  /  Production Animal  /  Cattle  /  Sheep  /  Pig  /  Equine  /  Exotics  /