Incidence of Medial Meniscus Injury Detected by Arthroscopy in Toy Breed Dogs (≤5 kg) with Cranial Cruciate Ligament Rupture

Abstract

Objective

To investigate the frequency and factors of medial meniscal injury (MMI) associated with cranial cruciate ligament rupture (CrCLR) in toy breed dogs by arthroscopic evaluation.

Methods

Toy breed dogs (≤5 kg) diagnosed with CrCLR using stifle arthroscopy were included. Age, sex, body weight, breed, medial patellar luxation grade, degree of lameness at diagnosis, and duration of lameness until diagnosis were obtained from medical records. The tibial plateau angle was evaluated using preoperative radiography. On arthroscopic evaluation, degree of CrCLR was classified as partial or complete; MMI was classified as no, mild, or severe injury. MMI grade was used as objective variable; ordered logistic regression was used, and the final model was created using forward–backward stepwise selection.

Results

Overall, 202 stifles of 178 dogs were evaluated. Arthroscopic evaluation revealed partial and complete CrCLR, and MMI in 58, 144, and 74 stifles, respectively. MMI with mild and severe damage was noted in 50 and 24 stifles, respectively. Final model included body weight, lameness score, and degree of cranial cruciate ligament damage. A grade 3 lameness score had a higher MMI factor than grade 1. Higher body weight was associated with MMI, and complete rupture had a higher MMI factor than partial tears.

Conclusion

Arthroscopic evaluation of CrCLR cases showed MMI in toy breed dogs. Cases with complete CrCLR or severe lameness are at high risk of MMI and should be evaluated cautiously.

Keywords

toy breed dog - cranial cruciate ligament rupture - medial meniscus injury - arthroscopy

Authors' Contribution

Y.K. and M.S. contributed to the conception of the study, study design, data acquisition, data analysis, interpretation, and drafting of the manuscript. A.H., H.A., and F.T. contributed to data acquisition, data analysis, and interpretation. S.Y. contributed to study conception, study design, and data acquisition. All the authors have revised and approved the manuscript.

^* These authors contributed equally to this work.

Publication History

Received: 12 April 2024

Accepted: 23 March 2025

Article published online:
15 April 2025

• References

• 1 Ritzo ME, Ritzo BA, Siddens AD, Summerlott S, Cook JL. Incidence and type of meniscal injury and associated long-term clinical outcomes in dogs treated surgically for cranial cruciate ligament disease. Vet Surg 2014; 43 (08) 952-958
• 2 Ralphs SC, Whitney WO. Arthroscopic evaluation of menisci in dogs with cranial cruciate ligament injuries: 100 cases (1999-2000). J Am Vet Med Assoc 2002; 221 (11) 1601-1604
• 3 McCready DJ, Ness MG. Systematic review of the prevalence, risk factors, diagnosis and management of meniscal injury in dogs: part 1. [corrected]. J Small Anim Pract 2016; 57 (02) 59-66
• 4 Krupkova O, Smolders L, Wuertz-Kozak K, Cook J, Pozzi A. The pathobiology of the meniscus: a comparison between the human and dog. Front Vet Sci 2018; 5: 73
• 5 Slocum B, Devine T. Cranial tibial thrust: a primary force in the canine stifle. J Am Vet Med Assoc 1983; 183 (04) 456-459
• 6 Kanno N, Hara Y, Fukano S. et al. Tibial displacement with stifle joint flexion and cranial cruciate ligament transection in the dog. An ex vivo study using a robotic simulator. Vet Comp Orthop Traumatol 2014; 27 (04) 277-284
• 7 Tinga S, Kim SE, Banks SA. et al. Femorotibial kinematics in dogs with cranial cruciate ligament insufficiency: a three-dimensional in-vivo fluoroscopic analysis during walking. BMC Vet Res 2018; 14 (01) 85
• 8 Nečas A, Zatloukal J. Factors related to the risk of meniscal injury in dogs with cranial cruciate ligament rupture. Acta Vet Brno 2002; 71: 77-84
• 9 Hayes GM, Langley-Hobbs SJ, Jeffery ND. Risk factors for medial meniscal injury in association with cranial cruciate ligament rupture. J Small Anim Pract 2010; 51 (12) 630-634
• 10 Kalff S, Meachem S, Preston C. Incidence of medial meniscal tears after arthroscopic assisted tibial plateau leveling osteotomy. Vet Surg 2011; 40 (08) 952-956
• 11 Gatineau M, Dupuis J, Planté J, Moreau M. Retrospective study of 476 tibial plateau levelling osteotomy procedures. Rate of subsequent ‘pivot shift’, meniscal tear and other complications. Vet Comp Orthop Traumatol 2011; 24 (05) 333-341
• 12 Campbell KA, Payne JT, Doornink MT, Haggerty J. Outcome of tibial closing wedge osteotomy in 55 cranial cruciate ligament-deficient stifles of small dogs (<15 kg). Vet Surg 2016; 45 (08) 1056-1062
• 13 Cosenza G, Reif U, Martini FM. Tibial plateau levelling osteotomy in 69 small breed dogs using conically coupled 1.9/2.5 mm locking plates. A clinical and radiographic retrospective assessment. Vet Comp Orthop Traumatol 2015; 28 (05) 347-354
• 14 Amimoto H, Koreeda T, Ochi Y. et al. Force plate gait analysis and clinical results after tibial plateau levelling osteotomy for cranial cruciate ligament rupture in small breed dogs. Vet Comp Orthop Traumatol 2020; 33 (03) 183-188
• 15 Marin K, Unis MD, Horgan JE, Roush JK. Risk factors for short-term postoperative complications in the 8 weeks after tibial plateau leveling osteotomy in dogs weighing less than 15 kilograms: a retrospective study. PLoS One 2021; 16 (02) e0247555
• 16 Dyall B, Schmökel H. Tibial tuberosity advancement in small-breed dogs using TTA rapid implants: complications and outcome. J Small Anim Pract 2017; 58 (06) 314-322
• 17 Hoelzler MG, Millis DL, Francis DA, Weigel JP. Results of arthroscopic versus open arthrotomy for surgical management of cranial cruciate ligament deficiency in dogs. Vet Surg 2004; 33 (02) 146-153
• 18 Pozzi A, Hildreth III BE, Rajala-Schultz PJ. Comparison of arthroscopy and arthrotomy for diagnosis of medial meniscal pathology: an ex vivo study. Vet Surg 2008; 37 (08) 749-755
• 19 Singleton WB. The surgical correction of stifle deformities in the dog. J Small Anim Pract 1969; 10 (02) 59-69
• 20 Warzee CC, Dejardin LM, Arnoczky SP, Perry RL. Effect of tibial plateau leveling on cranial and caudal tibial thrusts in canine cranial cruciate-deficient stifles: an in vitro experimental study. Vet Surg 2001; 30 (03) 278-286
• 21 Fung C, Ficklin M, Okafor CC. Associations between meniscal tears and various degrees of osteoarthritis among dogs undergoing TPLO for cranial cruciate ligament rupture. BMC Res Notes 2023; 16 (01) 36
• 22 Shimada M, Takagi T, Kanno N. et al. Biomechanical effects of tibial plateau levelling osteotomy on joint instability in normal canine stifles: an in vitro study. Vet Comp Orthop Traumatol 2020; 33 (05) 301-307
• 23 Hulse D, Beale B, Kerwin S. Second look arthroscopic findings after tibial plateau leveling osteotomy. Vet Surg 2010; 39 (03) 350-354
• 24 Barger B, Piazza A, Muir P. Treatment of stable partial cruciate rupture (Grade 1 sprain) in five dogs with tibial plateau levelling osteotomy. Vet Rec Case Rep 2016; 4 (01) e000315
• 25 Shimada M, Mizokami N, Ichinohe T. et al. Long-term outcome and progression of osteoarthritis in uncomplicated cases of cranial cruciate ligament rupture treated by tibial plateau leveling osteotomy in dogs. J Vet Med Sci 2020; 82 (07) 908-916
• 26 Taylor-Brown FE, Meeson RL, Brodbelt DC. et al. Epidemiology of cranial cruciate ligament disease diagnosis in dogs attending primary-care veterinary practices in England. Vet Surg 2015; 44 (06) 777-783
• 27 Adams P, Bolus R, Middleton S, Moores AP, Grierson J. Influence of signalment on developing cranial cruciate rupture in dogs in the UK. J Small Anim Pract 2011; 52 (07) 347-352