Meniscal injury following initial cranial cruciate ligament stabilization surgery in 26 dogs (29 stifles)

Summary

Objective: To describe clinical signs, arthroscopic findings, and outcome in a group of dogs undergoing second look arthroscopy for the treatment of meniscal tears following original surgery to correct a CCL deficient stifle joint. Methods: The medical records of 26 dogs from the Veterinary Teaching Hospital at Texas A&M University and the Veterinary Orthopedic Center (Round Rock, Texas) that had second look arthroscopy for lameness following an original surgical procedure were reviewed. Pre-operative clinical findings, 2nd look arthroscopic findings and owner assessed outcome were documented. Results: Postliminary bucket handle tears of the medial meniscus were detected in 22 (75.9%) cases. Other postliminary meniscal injuries included frayed caudal horn tears of the medial meniscus 6 (20.7%), and longitudinal tears of the lateral meniscus 1 (3.4%). An audible or palpable click was present in 27.6% of cases. An improvement or resolution of lameness was reported in 96.5% of cases reported. In conclusion, tears of the medial meniscus are a significant cause of lameness in dogs subsequent to surgery for cranial crucial ligament ruptures. Increased lameness or acute onset of lameness after surgery for cranial crucial rupture is a consistent finding. In rare cases, a palpable or audible click will be appreciated. Arthroscopic evaluation and partial meniscectomy improve or resolve lameness in the majority of cases. Clinical significance: Sudden or increased lameness in dogs with historical CCL stabilization surgery should be evaluated and treated arthroscopically for postliminary meniscal injury if another cause for lameness can not be determined.

Keywords

Postliminary - meniscus - cranial cruciate ligament - arthroscopy

• References

• 1 Johnson JA. et al. Incidence of canine appendicular musculoskeletal disorders in 16 veterinary teaching hospitals from 1980 through 1989.. Vet Comp Orthop Traumatol 1994; 7: 56-69.
• 2 Metelman A. et al. An evaluation of three different cranial cruciate ligament surgical stabilization procedures as they relate to postoperative meniscal injuries.. Vet Comp Orthop Traumatol 1995; 8: 118-123.
• 3 Jackson J. et al. Pathologic changes in grossly nor mal menisci in dogs with rupture of the cranial cruciate ligaments.. J Am Vet Med Assoc 2001; 218: 1281-1284.
• 4 Arnoczky SP. Pathomechanics of cruciate ligament and meniscal injuries.. In: Bojrab MJ, ed. Disease mechanisms in small animal surgery. 2nd ed. Philadelphia: Lea & Febiger; 1993: 764-776.
• 5 Slocum B. et al. Tibial plateau leveling osteotomy for repair of cranial cruciate ligament rupture in the canine.. Vet Clin North Am Small Anim Pract 1993; 23: 777-795.
• 6 Ralphs SC. et al. Arthroscopic evaluation of menisci in dogs with cranial cruciate ligament injuries: 100 cases (1999-2000).. J Am Vet Med Assoc 2002; 221: 1601-1604.
• 7 Thieman KM. et al. Effect of meniscal release on rate of subsequent meniscal tears and owner-assessed outcome in dogs with cruciate disease treated with tibial plateau leveling osteotomy.. Vet Surg 2006; 35: 705-710.
• 8 Person MW. A procedure for arthroscopic examination of the canine stifle joint.. J Am Anim Hosp Assoc 1985; 21: 179-186.
• 9 Miller CW. et al. Examination of the canine stifle: arthroscopy versus arthrotomy.. J Am Anim Hosp Assoc 1985; 21: 623-629.
• 10 Henning CE. et al. Current concepts of meniscal function and pathology.. Clin Sports Med 1985; 4: 259-265.
• 11 Flo GL. Meniscal injuries.. Vet Clin North Am 1993; 23: 931-944.
• 12 Flo GL. The missed or subsequent meniscal tear following cruciate ligament surgery.. Proc Vet Orthop Soc. 1986 13:20.
• 13 Hoelzler MG. et al. Results of arthroscopic versus open arthrotomy for surgical management of cranial cruciate ligament deficiency in dogs.. Vet Surg 2004; 33: 146-153.