Regenerative Medicine and CCL Tears: My Two Cents on Regenerative Approach to Treating Cruciate Ligament Tears in Dogs

Are surgery or conservative management the only options for the treatment of CCL tears in dogs?

Your dog has injured their cruciate ligament; now what? Invasive surgery is scary and conservative management can be daunting and has a questionable chance of success. Are there any other treatment possibilities?

Could regenerative medicine work? Maybe.

What is veterinary regenerative medicine?

Regenerative medicine aims to repair, restore, or replace damaged tissue or organs. While the body already has healing mechanisms in place–regenerative medicine takes this ability to new levels.

It is a fascinating field of medicine with potentially amazing future.

Regenerative medicine is a broad field that includes:

• cellular therapies
• tissue engineering and biomaterials
• tissue transplantations

Cellular therapies in veterinary medicine mostly involve the use of stem cells and concentrated platelets. However, there is a lot more unlocked potential in this field. For example, tissue engineering using biometric scaffolds.

Regenerative medicine in treatment of CCL injuries

In the treatment of cruciate ligament tears, regenerative medicine offers two options:

• stem cell therapy
• platelet-rich plasma therapy (PRP)

Some veterinarians specializing in regenerative therapies for sporting dogs use a combination of both. They may use stem cells from your dog’s fat tissue or bone marrow. Pending studies showing a substantial outcome advantage of bone marrow stem cells, I am partial to those harvested from fat.

The benefits of cell therapy

Not only these treatments are minimally invasive and help tissue regeneration but also reduce:

• swelling
• inflammation
• pain

Further information: Veterinary Regenerative Medicine: My Interview with Dr. Robert J. Harman, D.V.M., M.P.V.M. – CEO and founder of Vet-Stem, Regenerative Veterinary Medicine

Can cell therapy heal a damaged CCL?

When dealing with a CCL injury, there are variables to consider. No regenerative therapy will regrow a fully busted ligament. Consequently, the likelihood of success depends on:

• the degree and type of ligament damage
• other stabilizing factors such as supporting muscle mass
• tibial plateau slope
• post-treatment measures (such as exercise restrictions, physical therapy, etc.)
• overall health (some conditions such as diabetes or poor thyroid function reduce healing)

The best way to evaluate the ligament damage is with arthroscopy. Then, based on the findings, your veterinarian can objectively assess the likelihood of success. Conversely, you can take your chance and go ahead with the treatment. The joint will still benefit and the worst-case scenario is that it won’t work.

That is a chance I’ve been willing to take. There is a big difference between injecting therapeutic cells and invasive surgery.

Our experience

When Jasmine partially tore her knee ligament(s), regenerative medicine was still in a cradle. The first time I learned about stem cell therapy as a potential treatment, though, it resonated with me. After a lot of deliberation and research, we decided to go ahead with it. Because of other unexpected complications, though, by the time we were able to proceed, she tore her ligament entirely. We had to reconsider surgery, and in the end, we did a combination of surgery and stem cell injections.

Even though things did get more complicated, we were happy with the final outcome.

Further information: CCL/ACL Injury in a Rottweiler: How The Odyssey Started—Jasmine’s ACL Injury

Several years later, our new adoptee, Cookie, got a diagnosis of a partial cruciate tear. I would have been happy to go with stem cell therapy. However, at that time we learned that platelet-rich plasma (PRP) could work as well. The whole process is simpler. It involves a blood draw, separating the platelets in a centrifuge, and injecting them into the joint.

We knew that it might not work but we took the chance. I’d rather try anything before going straight to an invasive surgery.

The treatment worked and we couldn’t be happier with our choice.

Further information: PRP Treatment for CCL Injury: Platelet-Rich Plasma (PRP) Treatment for Cookie’s Bad Knee(s)

In closing

Regenerative therapy, regardless of the method, can be successful in treating partial cruciate ligament tears in dogs. It is an exciting field full of potential and it has little downside.

It is high on my list of treatment considerations. Talk to your veterinarian to see whether it is a good option for your dog.

Related articles:
Talk to Me About CCL/ACL Injuries
Dog CCL Injury Grading: Cruciate Tears “All or None, or Partial?”
PRP Treatment for CCL Injury: Platelet-Rich Plasma (PRP) Treatment for Cookie’s Bad Knee(s)
Veterinary Regenerative Medicine: My Interview with Dr. Robert J. Harman, D.V.M., M.P.V.M. – CEO and founder of Vet-Stem, Regenerative Veterinary Medicine

Further reading:
Regenerative Medicine for Soft Tissue Injury & Osteoarthritis
Partial Cranial Cruciate Ligament Tears Treated with Stem Cell and Platelet-Rich Plasma Combination Therapy in 36 Dogs: A Retrospective Study