Ätiologie, Pathogenese, Diagnostik und Therapie der Ruptur des kranialen Kreuzbandes beim Hund

J. Knebel; A. Meyer-Lindenberg

doi:10.1055/s-0038-1623745

Tierärztliche Praxis Ausgabe K: Kleintiere / Heimtiere, Inhaltsverzeichnis

Tierarztl Prax Ausg K Kleintiere Heimtiere 2014; 42(01): 36-47
DOI: 10.1055/s-0038-1623745

Übersichtsartikel

Schattauer GmbH

Ätiologie, Pathogenese, Diagnostik und Therapie der Ruptur des kranialen Kreuzbandes beim Hund

Aetiology, pathogenesis, diagnostics and therapy of cranial cruciate ligament rupture in dogs

J. Knebel

¹Chirurgische und Gynäkologische Kleintierklinik der Ludwig-Maximilians-Universität München

,

A. Meyer-Lindenberg

¹Chirurgische und Gynäkologische Kleintierklinik der Ludwig-Maximilians-Universität München

› Institutsangaben

Abstract

Zusammenfassung

Die Ruptur des vorderen Kreuzbandes stellt die häufigste Lahmheitsursache der Beckengliedmaße beim Hund dar und ist häufig mit einer Verletzung des medialen Meniskus vergesellschaftet. Die Ätiologie wird kontrovers diskutiert. Im Vordergrund scheint eine Degeneration des Lig. cruciatum craniale zu stehen, die zur Teilruptur des Bandes führt, auf die nach einem unbedeutenden Trauma die komplette Bandruptur folgt. Diagnostisch ist die Auslösung des Schubladenphänomens beweisend, doch lassen sich vor allem partielle Kreuzbandrisse klinisch nur schwer diagnostizieren. Generell kann die Untersuchung des Patienten mit einem Riss des kranialen Kreuzbandes in Narkose die Diagnosesicherheit erhöhen. Sowohl die Kernspintomographie als auch die Arthroskopie können die Ruptur im Zweifelsfall bestätigen und ermöglichen, sekundäre Kniegelenkerkrankungen zu erkennen. Zur Behebung der Instabilität im kranialen Kniegelenkbereich dienen extraund intraartikuläre Stabilisierungsmethoden sowie Umstellungsosteotomien. Das Prinzip der tibialen Umstellungsosteotomien besteht in der muskulären Kompensation der vorderen Schubladenbewegung, wobei die Ergebnisse zufriedenstellend, aber nicht einwandfrei sind. Der Übersichtsartikel stellt die umfangreiche Problematik der Ruptur des vorderen Kreuzbandes beim Hund in Kurzform dar. Die detailliertere Betrachtung der sekundären Erkrankungen und Komplikationen würde den Umfang dieser Arbeit übersteigen und bedarf einer weiteren Aufarbeitung.

Summary

Cranial cruciate ligament rupture is the most common cause of hindlimb disease in dogs and is often associated with an additional lesion of the medial meniscus. The exact aetiopathogenesis of this condition in dogs is unknown. Normally, the degeneration of the ligament first leads to a partial rupture which progresses to a complete rupture following an unspectacular trauma. The positive cranial drawer test confirms the cranial cruciate ligament rupture, however, in some cases, particularly in partial ligament lesions, the diagnosis is not obvious. Therefore, the reexamination of the sedated patient is recommended to generally increase the sensitivity of clinical tests. Magnetic resonance imaging and stifle joint arthroscopy are useful methods to evaluate the cruciate ligaments in indistinct cases or to assess the joint for secondary changes. The therapy of cranial cruciate ligament ruptures can be divided into extraand intracapsular as well as tibial osteotomies. The principle of the different tibial osteotomies is the muscular compensation of stifle joint instability. The results are successful but not uncritical. This article presents a short review on the substantial problems associated with cranial cruciate ligament rupture in dogs. A more detailed description of secondary problems and complications would exceed the scope of this article and should be considered in another study.

Schlüsselwörter

Kreuzbandriss - degenerative Erkrankung - diagnostische Sensitivität - Arthroskopie

Keywords

Cruciate ligament rupture - degenerative joint disease - diagnostic sensitivity - arthroscopy

Volltext

Referenzen

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