The Royal Veterinary College (RVC) has published new research in Preventative Veterinary Medicine which concluded that surgical management of cranial cruciate ligament (CCL) ruptures in dogs causes better outcomes for reducing lameness compared to non-surgical management1.

The study was based on VetCompass anonymised clinical records from more than two million dogs under first opinion veterinary care in the UK in 2019.

The study applied causal inference methods to the analysis of random samples of 815 dogs with CCL rupture aged between 1.5- and 12-years-old to replicate a randomised clinical trial and explore the impact of the different treatment methods.

Balancing the arms of the study for variables including age, breed and bodyweight, the researchers compared the outcomes for the dogs who received surgical management for CCL ruptures to those that were managed non-surgically.

The results showed that dogs managed surgically were 25.7% less likely to show short-term lameness at 3 months post-diagnosis and 31.7% less likely to show long-term lameness at 12 months post-diagnosis than dogs managed non-surgically.

Surgically managed dogs were 38.9% less likely to have a pain relief prescription at 3 months post-diagnosis, 34.1% less likely at 6 months and 32.7% less likely at 12 months than dogs managed non-surgically.

The RVC says these findings also similarly demonstrate lower longer term pain in surgically managed dogs.

Camilla Pegram, VetCompass PhD student at the RVC and lead author of the paper, said: “This study used an exciting new approach that allowed us to determine ‘cause’ rather than being limited to ‘association’.

"Surgical management for CCL rupture is often considered as providing better outcomes than non-surgical management, but this study now provides an evidence base to support this.

"Whilst surgical management might not always be feasible for some dogs, the findings allow vets to quantify the benefit in their discussions with owners.” 


  1. PEGRAM, C., DIAZ-ORDAZ, K., BRODBELT, D. C., CHANG, Y., FRYKFORS VON HEKKEL, A., WU, C., CHURCH, D. B. & O’NEILL D.G. 2024. Target Trial Emulation: Does surgical versus non-surgical management of cranial cruciate ligament rupture in dogs cause different outcomes? Preventive Veterinary Medicine 

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