Diagnostic accuracy of positive contrast computed tomography arthrography for the detection of injuries to the medial meniscus in dogs with naturally occurring cranial cruciate ligament insufficiency

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.

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Arthroscopic Articular Cartilage Scores of the Canine Stifle Joint with Naturally Occurring Cranial Cruciate Ligament Disease

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0040-1719064 ◽

2020 ◽

Author(s):

Kimberly A. Agnello ◽

Kei Hayashi ◽

Dorothy Cimino Brown

Keyword(s):

Articular Cartilage ◽

Cruciate Ligament ◽

Cartilage Damage ◽

Meniscal Tear ◽

Trochlear Groove ◽

Cranial Cruciate Ligament ◽

Stifle Joint ◽

Naturally Occurring ◽

Medial Meniscal Tear ◽

Severity Scores

Abstract Objective This study aimed to evaluate frequency, location and severity of cartilage pathology in dogs with naturally occurring cranial cruciate ligament (CCL) disease. Study Design Stifle arthroscopic video recordings (n = 120) were reviewed. A modified Outerbridge classification system (MOCS) (0–4) was used to score cartilage at 10 locations in the femorotibial (medial and lateral femoral condyles and tibial plateaus) and patellofemoral compartments (proximal, middle and distal locations of the patella and femoral trochlear groove) of the stifle joint. Synovial pathology was scored and the presence of a medial meniscal tear was recorded. A Kruskal–Wallis test was used to evaluate association of location and synovitis with cartilage score; and presence of meniscal tear with cartilage and synovitis scores. Bonferroni correction was utilized and p < 0.05 was considered significant. Results Cartilage pathology and synovitis were identified in all joints. Overall cartilage severity scores were low (median MOCS 1). The median MOCS of the proximal trochlear groove (2) was significantly higher than all other locations evaluated. Higher synovitis scores were significantly associated with higher cartilage severity scores and a medial meniscal tear had no association with cartilage severity scores or synovitis. Conclusion Arthroscopic articular cartilage lesions are common in dogs with CCL disease at the time of surgical intervention, although the severity of cartilage damage is mild. The proximal trochlear groove of the femur had the most severe cartilage score in the stifle joint.

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Does meniscal release confer similar clinical benefits to meniscal tear treatment when compared to meniscectomy?

Veterinary Evidence ◽

10.18849/ve.v5i4.339 ◽

2020 ◽

Vol 5 (4) ◽

Author(s):

Ben Garland

Keyword(s):

Cruciate Ligament ◽

Research Question ◽

Meniscal Tear ◽

Clinical Expertise ◽

Meniscal Tears ◽

Bottom Line ◽

Cranial Cruciate Ligament ◽

Long Term Outcome ◽

Time Of Surgery ◽

Naturally Occurring

PICO question In adult dogs with naturally occurring medial meniscal tears concurrent to cranial cruciate ligament disease does meniscal release confer the same benefits in lameness resolution as meniscectomy? Clinical bottom line Category of research question Treatment The number and type of study designs reviewed A single prospective cross-sectional study was reviewed, that fulfilled the criteria Strength of evidence None Outcomes reported Meniscal release, meniscectomy (partial, hemi- or complete), or the two combined performed for concurrent medial meniscal pathology at time of surgery for naturally occurring cranial cruciate ligament (CCL) rupture resulted in an acceptable long-term outcome. Difference in outcome between the techniques was not reported Conclusion There is no evidence that meniscal release provides an equal or superior treatment option for medial meniscal injury treated at the time of surgery for CCL rupture when compared to meniscectomy. The study critically reviewed performed meniscal release via radial transection through the meniscotibial ligament, and therefore does not represent mid-body abaxial radial release. Neither is this summary appropriate for considering prophylactic meniscal release of the normal meniscus. In addition, the surgical treatments for cranial cruciate ligament rupture were either ‘Tightrope’ or tibial plateau levelling osteotomy (TPLO) procedures. Further studies are required to compare clinical outcome between meniscal release or meniscectomy for treatment of concurrent meniscal tears 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.

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Evaluation of serum MMP-2 and MMP-3, synovial fluid IL-8, MCP-1, and KC concentrations as biomarkers of stifle osteoarthritis associated with naturally occurring cranial cruciate ligament rupture in dogs

PLoS ONE ◽

10.1371/journal.pone.0242614 ◽

2020 ◽

Vol 15 (11) ◽

pp. e0242614

Author(s):

Sarah Malek ◽

Hsin-Yi Weng ◽

Shannon A. Martinson ◽

Mark C. Rochat ◽

Romain Béraud ◽

...

Keyword(s):

Synovial Fluid ◽

Linear Regression ◽

Cruciate Ligament ◽

Discriminative Ability ◽

Cranial Cruciate Ligament ◽

Discriminative Performance ◽

Naturally Occurring ◽

Veterinary Pathologist ◽

Concentration Changes ◽

And Control

The purpose of this study was to evaluate matrix metalloproteinases (MMP) -2 and MMP-3 in serum, and keratinocyte-derived chemoattractant (KC), interleukin 8 (IL-8) and monocyte chemoattractant 1 (MCP-1) in synovial fluid (SF) as stifle osteoarthritis (OA) biomarkers in dogs. Dogs with naturally occurring cranial cruciate ligament (CrCL) rupture (OA group) and healthy controls were recruited. Stifles with CrCL deficiency were surgically stabilized. Serum, SF, and synovial biopsy samples were collected from the OA group preoperatively, whereas samples were collected once from control dogs. A blinded veterinary pathologist graded synovial biopsies. Serum and SF analyses were performed using xMAP technology. General linear regression was used for statistical comparisons of serum biomarkers, and mixed linear regression for SF biomarkers and temporal concentration changes. The overall discriminative ability was quantified using area under curve (AUC). Spearman’s correlation coefficient was used to assess correlations between synovial histology grades and the biomarkers. Samples from 62 dogs in the OA group and 50 controls were included. The MMP-2 and MMP-3 concentrations between the OA and control groups were not significantly different, and both with an AUC indicating a poor discriminative ability. All three SF biomarker concentrations were significantly different between the OA group and controls (P <0.05). The MCP-1 was the only biomarker showing an acceptable discriminative performance with an AUC of 0.91 (95% confidence interval: 0.83–0.98). The sum of the inflammatory infiltrate score was significantly correlated with all three SF biomarkers (P <0.01). Summed synovial stroma, and all scores combined were significantly correlated with IL-8 and MCP-1 concentrations (P <0.003), and the summed synoviocyte scores were significantly correlated with MCP-1 concentrations (P <0.001). Correlations between MCP-1 concentrations and synovial histopathologic grading and its discriminative ability suggest its potential as a synovitis biomarker in canine stifle OA associated with CrCL rupture.

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Diagnostic accuracy of a short-duration 3 Tesla magnetic resonance protocol for diagnosing stifle joint lesions in dogs with non-traumatic cranial cruciate ligament rupture

BMC Veterinary Research ◽

10.1186/1746-6148-9-40 ◽

2013 ◽

Vol 9 (1) ◽

pp. 40 ◽

Cited By ~ 6

Author(s):

Vladimir Galindo-Zamora ◽

Peter Dziallas ◽

Davina C Ludwig ◽

Ingo Nolte ◽

Patrick Wefstaedt

Keyword(s):

Magnetic Resonance ◽

Diagnostic Accuracy ◽

Short Duration ◽

Cruciate Ligament ◽

3 Tesla ◽

Cranial Cruciate Ligament ◽

Stifle Joint ◽

Ligament Rupture ◽

Cruciate Ligament Rupture ◽

Cranial Cruciate Ligament Rupture

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Association of mineralisations in the stifle joint of domestic cats with degenerative joint disease and cranial cruciate ligament pathology

Journal of Feline Medicine and Surgery ◽

10.1177/1098612x15606774 ◽

2016 ◽

Vol 19 (1) ◽

pp. 27-35 ◽

Cited By ~ 3

Author(s):

Katja Voss ◽

Philemon Karli ◽

Pierre M Montavon ◽

Hans Geyer

Keyword(s):

Medial Meniscus ◽

Cruciate Ligament ◽

Degenerative Joint Disease ◽

Joint Capsule ◽

Degenerative Changes ◽

Joint Disease ◽

Fat Pad ◽

Cranial Cruciate Ligament ◽

Stifle Joint ◽

Periarticular Tissue

Objectives The aim of the study was to evaluate the prevalence, size, location and appearance of mineralisations in feline stifle joints, and to evaluate their relationship with osteoarthritis and cranial cruciate ligament (CrCL) status. Methods Presence or absence, and size of mineralisations were determined from lateral stifle radiographs of 25 cats with CrCL rupture, and 44 cat cadavers without CrCL rupture. Mineralisations were classified as small, medium or large. Prevalence was compared between the clinically affected cats and the cadavers; the cadaver group was subdivided into an age-matched and an older group. Ten stifles with varying sizes of mineralisations were prepared as whole-knee specimens for histopathology. Location and appearance of the mineralisations, and degenerative changes in the cruciate ligaments, menisci, articular cartilage and joint capsule are described. Results Prevalence of articular mineralisations was 0.76 in stifles of cats with CrCL rupture (mean ± SD age 8.6 ± 4.5 years), 0.64 in stifles of age-matched cat cadavers and 0.74 in older cat cadavers (mean ± SD age 17.0 ± 2.4 years). Cats with CrCL rupture had a higher percentage of medium and large mineralisations than cats without CrCL rupture. Microscopically, small mineralisations were calcifications usually located in the cranial horn of the medial meniscus. Larger mineralisations were found to be ossifications, commonly located in the joint capsule and fat pad. Cats with larger mineralisations showed more signs of osteoarthritis, including degenerative changes in the CrCL. Conclusions and relevance Mineralisations in feline stifle joints were found to differ in size, appearance and location. Small mineralisations were usually confined to the medial meniscus, as described previously; larger mineralisations tended to be located in the tissues cranial to the menisci and seemed to be associated with osteoarthritis and CrCL pathology. Large mineralisations in feline stifles are ossifications in periarticular tissue and are associated with degenerative joint disease.

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