Are dog leg braces an acceptable alternative to prohibitively expensive knee surgery?

Question

We noticed our 4 year old Lab/Rottweiler mix limping on her right hind leg recently, and we took her to the vet to check her out. Our vet diagnosed the problem as a partially torn cranial cruciate ligament, and recommended a $2,500 surgery to fix it. She also mentioned there was a 50% chance our dog would injure her other knee due to the extra stress she's placing on it.

I love my dog, but I'm not willing to shell out $2,500 for surgery that may not even be completely effective. (Our vet made no mention of effectiveness rates, but some Googling seemed to cast doubt on a 100% chance of recovery for the particular type of surgery recommended.)

I also found several websites selling leg braces for dog ACL/CCL injuries that claimed rehabilitation was possible. They had anecdotal evidence that their methods were effective, but I couldn't find any documented research. Is using a leg brace a legitimate alternative to surgery?

Answer 1

Colorado State University Veterinary Teaching Hospital has a handout on Treatment options for cranial cruciate ligament injury/disease of the dog knee which states:

There is ample evidence that perioperative rehabilitation therapy by a trained rehabilitation practitioner can advance and hasten the recovery from surgery. There is little/no evidence to suggest that this is a consistent and predictable alternative to surgical management for most dogs, but occasionally the combination of concurrent injuries or diseases, advanced age, patient size and financial limitations lead pet owners to pursue this option. Custom knee bracing is relatively new to canine orthopedics and there is little/no scientific evidence on the topic applied to cruciate ligament injuries.

There have been some studies on the effectiveness of movement restriction and pain medication, however. In the following study, smaller dogs improved at a higher rate than large dogs. Of dogs over 15kg (such as a Lab/Rott mix), only 19.3% were classified as normal after the study period.

• Clinical Results Following Nonoperative Management for Rupture of the Cranial Cruciate Ligament in Dogs P. B. VASSEUR DVM, Veterinary Surgery Volume 13, Issue 4, pages 243–246, October 1984 web abstract

The following study does include a control group of rest and pain medication, but it's not clear from the abstract how well they did.

• Evaluation of fibular head transposition, lateral fabellar suture, and conservative treatment of cranial cruciate ligament rupture in large dogs: a retrospective study AE Chauvet, AL Johnson, GJ Pijanowski, L Homco and RD Smith Journal of the American Animal Hospital Association May 1, 1996 vol. 32 no. 3 247-255 web abstract

If you do decide to have the surgery done, your dog will likely not be back to "new", but will likely have an improved quality of life with less pain (as evidenced by a decrease in lameness). A retrospective study in an Australian journal determined:

Regardless of surgical technique, 85.7 to 91.0% of dogs showed clinical improvement after surgery. However, less than 50% of dogs became clinically sound on the operated leg and 9.0 to 14.3% of dogs remained persistently lame on the operated leg.

In addition,

Twenty-two percent of dogs ruptured their [opposite leg] CCL at an average of 14 months after the first.

• Cranial cruciate ligament rupture in the dog—a retrospective study comparing surgical techniques KW MOORE and RA READ Australian Veterinary Journal Volume 72, Issue 8, pages 281–285, August 1995 web abstract

Answer 2

My experience is anecdotal but we used a dog knee brace for my 10 year old mutt when she tore her ACL and we decided not to operate on the leg. She was older, a bigger dog, and it didn't seem right to put her through that expensive surgery (mostly for her sake!!) Maybe if this had happened to her when she was younger I would have given more consideration to the surgery. I had read from different online forums about people successfully recovering from this type of injury with the help of a knee brace.

I found a dog knee brace online after some more looking into things and it worked wonders for us. It wasn't like those rigid stifle braces you often find online, this one was more flexible and didn't completely prohibit movement. We did however have to put our dog on extremely limited activity for a minimum of 8 weeks, but we were able to continue to use the dog brace after she recovered and it's never seemed to bother her.

I would check with your vet if I were you to see if it's a viable option, but in my experience it worked and I know of other people where it's also worked.

Answer 3

OP here, following up after two years.

We opted for starting with a leg brace, which seemed to be more of a discomfort to our dog than a help. After trying that solution for about a month, we decided to just keep her calm and see how much rest could do for her.

Surprisingly, she's made almost a full recovery. For the first six months, we limited her activity to a minimal amount of walking, and leashed outdoor excursions to keep her from bolting after rabbits, squirrels, birds, etc. After that, we just tried to keep an eye on her when we had her out in the backyard, and check beforehand to make sure there wasn't anything present that would induce a sprint.

For the first year, we would notice her limping quite a bit if she overexerted herself. However, recently she's made a few mad dashes across the yard with no ill effects afterwards. We still try to discourage all out sprints, but she seems to be at a high level of functionality considering where she started.