Incidence and Type of Meniscal Injury and Associated Long-Term Clinical Outcomes in Dogs Treated Surgically for Cranial Cruciate Ligament Disease

2014 ◽  
Vol 43 (8) ◽  
pp. 952-958 ◽  
Author(s):  
Meghan E. Ritzo ◽  
Brandon A. Ritzo ◽  
Adrienne D. Siddens ◽  
Stephanie Summerlott ◽  
James L. Cook
2020 ◽  
Vol 5 (2) ◽  
Author(s):  
Tafara Mapuvire

PICO question In dogs weighing under 15 kg with unilateral cranial cruciate ligament disease, does tibial tuberosity advancement lead to better long-term functional outcomes than lateral fabellar suture?   Clinical bottom line Category of research question Treatment The number and type of study designs reviewed There were no papers that answered the PICO question Strength of evidence Zero Outcomes reported Between TTA and LFS none of the techniques was shown to provide better long-term functional outcomes than the other in dogs weighing less than 15 kg Conclusion Given the absence of evidence answering the PICO question, choice and recommendation of procedure between TTA and LFS in dogs weighing under 15 kg should be guided by what the surgeon deems to be in the best interest of the patient   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.  


2017 ◽  
Vol 30 (01) ◽  
pp. 20-27 ◽  
Author(s):  
Barry Brower ◽  
Ann Peruski ◽  
Antonio Pozzi ◽  
Jonathan Dyce ◽  
Kenneth Johnson ◽  
...  

SummaryObjective: To describe a cohort of dogs with medial patellar luxation managed with a distal femoral lateral closing wedge ostectomy (DFO) as a component of comprehensive treatment, and to report radiographic and long-term clinical outcome of this technique.Methods: Medical records of dogs that had a lateral closing wedge DFO as part of management of medial patellar luxation at three veterinary teaching hospitals were reviewed. Surgical reports as well as the preoperative, postoperative, and follow-up radiographs were reviewed. The anatomical lateral distal femoral angle (aLDFA) was determined. Long-term clinical outcome was assessed by telephone interview with the owner.Results: A lateral closing wedge DFO was performed on 66 limbs. The mean pre- and postoperative aLDFA was 107.6° ± 5.8° and 94.1° ± 4.2°, respectively. Cranial cruciate ligament disease was identified in 28/66 affected limbs. Tibial angular deformity, torsional deformity, or both was identified in nine of the 66 limbs. Ostectomy healing was confirmed radiographically in 51/66 limbs. The mean time to union was 73 ± 37 days. All patellae were in the normal position and stable. Complications included infection (2/51), fixation failure (1/51), delayed healing (2/51), and persistent lameness (1/51).Clinical significance: In this cohort of cases, DFO was a highly successful and repeatable component of surgical treatment for dogs with medial patellar luxation associated with femoral varus. This study also provides more evidence of the high rate of concurrent cranial cruciate ligament disease in cases of medial patellar luxation complicated by fe-moral varus, and supports an association between stifle instability and medial patellar luxation.


2008 ◽  
Vol 21 (02) ◽  
pp. 125-128 ◽  
Author(s):  
D. B. Fox ◽  
J. L. Cook ◽  
D. B. Guastella

Summary Objectives: To compare tibial plateau angle (TPA) among Labrador Retrievers, Rottweilers, Boxers, and German Shepherd Dogs that had undergone tibial plateau leveling osteotomies (TPLO) for cranial cruciate ligament disease, and to determine if higher TPAs are associated with increased risk for concurrent meniscal injury. Methods: This was a retrospective study including 275 client-owned dogs of one of the four aforementioned breeds that received TPLO radiographs between 1999 and 2005 prior to undergoing the TPLO procedure. The TPA measured by the original surgeon was compared among four breeds and analyzed with respect to presence or absence of meniscal injury diagnosed via arthroscopy or arthrotomy at the time of surgery. Results: Labrador Retrievers, Rottweilers, Boxers, and German Shepherd Dogs had mean TPAs of 25.9°, 26.2°, 25.9°, and 28.2°, respectively. The TPA of German Shepherd Dogs was significantly higher than that of the other breeds of dogs examined. TPA higher than the mean for dogs in this study did not significantly increase the risk for concurrent meniscal injury. Clinical significance: German Shepherd Dogs with cranial cruciate ligament disease had a significantly higher TPA compared to the other breeds examined. Higher TPA did not increase the likelihood of meniscal tears in this study. However, several variables that were not assessed, including the degree of cranial cruciate ligament integrity at the time of surgery and the time between original CrCL deficiency and surgical assessment, could have affected this analysis.


2019 ◽  
Vol 22 (4) ◽  
pp. 277-284
Author(s):  
Gudrun S Boge ◽  
Karolina Engdahl ◽  
Elena R Moldal ◽  
Annika Bergström

Objectives The aim of this study was to describe the characteristics and long-term outcome of surgically and conservatively treated cats with cranial cruciate ligament disease (CCLD). Methods A retrospective cohort study of cats with CCLD, diagnosed at two university animal hospitals between January 2011 and December 2016, was performed. Signalment, history, treatment and follow-up information were retrieved. Cat owners were contacted for additional long-term follow-up information. The cases were divided into two groups: one conservatively managed and one surgically treated with the lateral fabellotibial suture technique. A quality of life questionnaire, the Feline Musculoskeletal Pain Index (FMPI), was distributed to the owners of cats alive at follow-up for assessment of chronic pain as a long-term outcome. Univariable statistical methods were used to evaluate the data. Results Fifty cats were identified and were followed for a median of 41 months after diagnosis of CCLD. Seven cats (14%) developed bilateral CCLD. Twenty-eight cats (56%) were treated conservatively and 22 (44%) surgically. All surgically treated cats in which arthrotomy was performed (19/22) had total cranial cruciate ligament rupture and 9/19 (47%) had meniscal injuries. Postoperative surgical complications were recorded in 6/22 cats (27%). Owners of 24/29 (83%) cats still alive at follow-up completed the FMPI questionnaire. The conservatively treated cats had a lower FMPI score, indicating less chronic pain, than those cats treated surgically ( P = 0.017). Conclusions and relevance Conservatively treated cats with CCLD experienced less chronic pain at long-term follow-up than surgically treated cats. Bilateral disease is not uncommon in cats with CCLD.


2014 ◽  
Vol 10 (1) ◽  
Author(s):  
Sari H Mölsä ◽  
Heli K Hyytiäinen, ◽  
Anna K Hielm-Björkman ◽  
Outi M Laitinen-Vapaavuori

1996 ◽  
Vol 09 (01) ◽  
pp. 10-3 ◽  
Author(s):  
D.N. Aron ◽  
R. Roberts ◽  
J. Stallings ◽  
J. Brown ◽  
C.W. Hay

SummaryArthrographic and intraoperative evaluations of stifles affected with cranial cruciate disease were compared. Arthrography did not appear to be helpful in predicting cranial cruciate ligament pathology. The caudal cruciate ligament was consistently not visualized in the arthrograms and was normal at surgery. The menisci were visualized consistently in the arthrograms, but conclusions could not be made as to the benefit of arthrography in predicting meniscal pathology. Arthrography was not helpful in predicting joint capsule and femoral articular surface pathology. Survey radiographic evaluation was better than arthrography in evaluating joint pathology. When cruciate injury is suspected, after history and physical examination, survey radiographs are better than positive contrast arthrograms at supporting the diagnosis.Positive contrast arthrography was evaluated as a diagnostic aid in canine cranial cruciate ligament disease. It did not appear to be useful in predicting joint pathology. With arthrography, both menisci could be visualized and evaluated for abnormalities. Joint effusion and presence of osteophytes evaluated on survey radiographs was better than arthrography in evaluating joint pathology.


2017 ◽  
Vol 30 (03) ◽  
pp. 178-183 ◽  
Author(s):  
Michal Kyllar ◽  
Duncan Midgley ◽  
Martin Owen ◽  
Jan Janovec

SummaryObjectives: To investigate the conformation of the proximal tibia in small breed dogs with and without cranial cruciate ligament disease (CCLD) and to identify morphologic abnormalities that may predispose to development of CCLD.Methods: Mediolateral radiographs of the entire tibia of dogs <15 kg with surgically confirmed CCLD were retrospectively evaluated. Proximal tibial width (PTW), tibial plateau length (TPL), tibial plateau angle as described by Slocum and Slocum (sTPA), proximal tibial tuberosity angle (PTTA), tibial plateau angle as described by Inauen and colleagues (nTPA), and diaphyseal tibial width (DTW) were measured. The same variables were obtained from mediolateral radiographs of the entire tibia of dogs <15 kg without CCLD. In addition, a quotient nTPA/ PTW, relative tibial tuberosity width (rTTW), and relative body weight (rBW) were calculated for each dog. Independent two-sample t-test (p = 0.05) was used to compare mean ± SD of all measured variables between the two groups.Results: Gender, age, and weight mean ± SD were not significantly different between the two groups of dogs (p <0.05). Dogs with CCLD had significantly greater sTPA (p = 0.015) and rBW (p = 0.016).Clinical significance: In dogs of small breeds, a combination of an excessively steep tibial plateau and an increased relative body weight may predispose to early CCLD development. The slope of the tibial plateau was found to be caused by an abnormal caudal angulation of the proximal tibia, a phenomenon previously associated with CCLD development in small breed dogs in individual cases.


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