Does early neutering increase the risk of cranial cruciate ligament rupture?



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PICO Question

In bitches, does gonadectomy before 1 year of age compared to gonadectomy at 1 year of age or older, increase the risk of cranial cruciate ligament disease during their life?


Clinical bottom line

Category of research


Number and type of study designs reviewed

Eight studies were reviewed, four of which were retrospective cohort studies, two of which were prospective longitudinal cohort studies, one of which was a retrospective case-control study and one of which was a prospective case-control study.

Strength of evidence


Outcomes reported

The evidence was mixed, but overall was suggestive that gonadectomy before 1 year of age increased the risk of cranial cruciate ligament disease in bitches. Gonadectomy before 1 year of age was found to increase the risk of cranial cruciate ligament disease in seven of eight studies. Most studies assessed a narrow range of breeds and the generalisability of these results to all dogs is thus limited. The one study which assessed a range of 35 breeds noted an increase in risk of cranial cruciate ligament disease in 6 of 35 breeds associated with gonadectomy before 1 year of age. Direct comparison of studies is limited by the varying age stratifications, breed analyses, and study methodologies.


Gonadectomy before 1 year of age in Golden Retriever, German Shepherd, and Rottweiler bitches may increase the risk of cranial cruciate ligament disease. In other breeds, limited evidence is available to draw conclusions.


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.


Ekenstedt, K.J., Minor, K.M., Rendahl, A.K. & Conzemius, M.G. (2017). DNM1 mutation status, sex, and sterilization status of a cohort of Labrador retrievers with and without cranial cruciate ligament rupture. Canine Genetics and Epidemiology. 4. DOI:

Guy, M. K., Page, R. L., Jensen, W. A., Olson, P. N., Haworth, J. D., Searfoss, E. E. & Brown, D. E. (2015). The Golden Retriever Lifetime Study: establishing an observational cohort study with translational relevance for human health. Philosophical Transactions of the Royal Society of London. Series B. Biological sciences. 370(1673), 20140230. DOI:

Hart, B.L., Hart, L.A., Thigpen, A.P. & Willits, N.H. (2014). Long-Term Health Effects of Neutering Dogs: Comparison of Labrador Retrievers with Golden Retrievers. PLoS ONE. 9(7). DOI:

Hart, B.L., Hart, L.A., Thigpen, A.P. & Willits, N.H. (2016). Neutering of German Shepherd Dogs: associated joint disorders, cancers and urinary incontinence. Veterinary Medicine and Science. 2(3), 191–199. DOI:

Hart, B.L., Hart, L.A., Thigpen, A.P. & Willits, N.H. (2020). Assisting Decision-Making on Age of Neutering for 35 Breeds of Dogs: Associated Joint Disorders, Cancers, and Urinary Incontinence. Frontiers in Veterinary Science. 7. DOI:

Simpson, M., Albright, S., Wolfe, B., Searfoss, E., Street, K., Diehl, K. & Page, R. (2019). Age at gonadectomy and risk of overweight/obesity and orthopedic injury in a cohort of Golden Retrievers. PLoS ONE. 14(7). DOI:

Torres de la Riva, G., Hart, B.L., Farver, T.B., Oberbauer, A.M., Messam, L.L.M., Willits, N. & Hart, L.A. (2013). Neutering dogs: Effects on Joint Disorders and Cancers in Golden Retrievers. PLoS ONE. 8(2). DOI:

Waters, D.J., Fu, R., Carrillo, A.E., Chiang, E.C., Maras, A.H., Kengeri, S.S. & Suckow, C.L. (2023). Correlates of estimated lifetime cruciate ligament survival inform potential rupture risk reduction strategies: findings from the Exceptional Aging in Rottweilers Study. Scientific Reports. 13. DOI:

Whitehair, J. G., Vasseur, P. B., & Willits, N. H. (1993). Epidemiology of cranial cruciate ligament rupture in dogs. Journal of the American Veterinary Medical Association. 203(7), 1016–1019.

Vol. 9 No. 2 (2024): The second issue of 2024

Section: Knowledge Summaries

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