Does a fabella-tibial suture alter the outcome for dogs with cranial cruciate ligament insufficiency undergoing arthrotomy and caudal pole medial meniscectomy?

M.S. Tivers; E.J. Comerford; M.R. Owen

doi:10.3415/VCOT-08-03-0025

Veterinary and Comparative Orthopaedics and Traumatology, Inhaltsverzeichnis

Vet Comp Orthop Traumatol 2009; 22(04): 283-288
DOI: 10.3415/VCOT-08-03-0025

Original Research

Schattauer GmbH

Does a fabella-tibial suture alter the outcome for dogs with cranial cruciate ligament insufficiency undergoing arthrotomy and caudal pole medial meniscectomy?

A retrospective owner assessment

M.S. Tivers

¹University of Bristol, Division of Companion Animals, Department of Clinical Veterinary Science, Langford House, Langford, Bristol, UK

²Department of Veterinary Clinical Sciences, Royal Veterinary College, Hatfield, UK

,

E.J. Comerford

¹University of Bristol, Division of Companion Animals, Department of Clinical Veterinary Science, Langford House, Langford, Bristol, UK

³Faculty of Veterinary Science, The University of Liverpool, Leahurst, Neston, UK

,

M.R. Owen

¹University of Bristol, Division of Companion Animals, Department of Clinical Veterinary Science, Langford House, Langford, Bristol, UK

› Institutsangaben

Abstract

Summary

Objectives: The objective of this study was to evaluate the effects of fabella-tibial suture (FTS) on long-term outcome in dogs with cranial cruciate ligament (CCL) insufficiency and concurrent medial meniscal tear (MMT) that were managed by an open, caudal pole medial meniscectomy (CPMM).

Methods: A retrospective review was performed of the clinical records of dogs treated for CCL insufficiency with concurrent MMT by open CPMM, with or without the non-random addition of a nylon FTS according to surgeon preference, during the period of 2001 to 2004. The Bristol Osteoarthritis in Dogs questionnaire was modified for owner assessment of outcome using a visual analogue scale based on several criteria: level of activity, disability, severity of lameness and frequency of lameness before and after surgery.

Results: Completed questionnaires from 31 dog owners were received. A FTS was used after CPMM in 22 dogs (FTS group), but in nine dogs (control group) only a CPMM was performed. The median time to follow up was longer in the FTS group (25 months) than the control group (16 months) (P=0.03). There were not any significant differences between the two groups before and after surgery for the following: disability, activity, frequency of lameness, severity of lameness, ability to climb stairs and ability to sit down.

Clinical Significance: The placement of a FTS following stifle joint arthrotomy and CPMM in dogs with CCL deficiency and concurrent MMT may not be a significant factor affecting the ultimate surgical outcome, although our study is limited by the non-randomised study design.

Keywords

Medial meniscus - cranial cruciate ligament insufficiency - questionnaire - VAS - fabellatibial suture.

Volltext

Referenzen

References
1 Johnson JA, Austin C, Breur GJ. Incidence of canine appendicular musculoskeletal disorders in 16 veterinary teaching hospitals from 1980 through 1989. Vet Comp Orthop Traumatol 1994; 7: 56-69.
2 Ness MG, Abercromby RH, May C. et al. A survey of orthopaedic conditions in small animal veterinary practice in Britain. Vet Comp Orthop Traumatol 1996; 9: 43-52.
3 Aragon CL, Budsberg SC. Applications of evidence-based medicine: cranial cruciate ligament injury repair in the dog. Vet Surg 2005; 34: 93-98.
4 Moore KW, Read RA. Cranial cruciate ligament rupture in the dog – a retrospective study comparing surgical techniques. Aust Vet J 1995; 72: 281-285.
5 Vasseur PB, Berry CR. Progression of stifle osteoarthrosis following reconstruction of the cranial cruciate ligament in 21 dogs. J Am Anim Hosp Assoc 1992; 28: 129-136.
6 Conzemius MG, Evans RB, Besancon MF. et al. Effect of surgical technique on limb function after surgery for rupture of the cranial cruciate ligament in dogs. J Am Vet Med Assoc 2005; 226: 232-236.
7 Chauvet AE, Johnson AL, Pijanowski GJ. et al. Evaluation of fibular head transposition, lateral fabellar suture, and conservative treatment of cranial cruciate ligament rupture in large dogs: a retrospective study. J Am Anim Hosp Assoc 1996; 32: 247-255.
8 Denny HR, Butterworth SJ. The Stifle. In: A guide to canine and feline orthopaedic surgery (4^th ed). Denny HR, Butterworth SJ (eds). Oxford: Blackwell Science; 2000: 512-553.
9 Elkins AD, Pechman R, Kearney MT. et al. A retrospective study evaluating the degree of degenerative joint disease in the stifle joint of dogs following surgical repair of anterior cruciate ligament rupture. J Am Anim Hosp Assoc 1991; 27: 533-540.
10 Innes JF, Costello M, Barr FJ. et al. Radiographic progression of osteoarthritis of the canine stifle joint: a prospective study. Vet Radiol Ultrasound 2004; 45: 143-148.
11 Rayward RM, Thomson DG, Davies JV. et al. Progression of osteoarthritis following TPLO surgery: a prospective radiographic study of 40 dogs. J Small Anim Pract 2004; 45: 92-97.
12 Bennett D, Tennant B, Lewis DG. et al. A reappraisal of anterior cruciate ligament disease in the dog. J Small Anim Pract 1988; 29: 275-297.
13 Hurley CR, Hammer DL, Shott S. Progression of radiographic evidence of osteoarthritis following tibial plateau leveling osteotomy in dogs with cranial cruciate ligament rupture: 295 cases (2001–2005). J Am Vet Med Assoc 2007; 230: 1674-1679.
14 Metelman LA, Schwarz PD, Salman M. et al. An evaluation of 3 different cranial cruciate ligament surgical stabilization procedures as they relate to postoperative meniscal injuries – a retrospective study of 665 stifles. Vet Comp Orthop Traumatol 1995; 8: 118-123.
15 Flo GL. Meniscal injuries. Vet Clin North Am Small Anim Pract 1993; 23: 831-843.
16 Flo GL, Deyoung D. Meniscal injuries and medial meniscectomy in canine stifle. J Am Anim Hosp Assoc 1978; 14: 683-689.
17 Bennett D, May C. Meniscal damage associated with cruciate disease in the dog. J Small Anim Pract 1991; 32: 111-117.
18 Innes JF, Bacon D, Lynch C. et al. Long-term outcome of surgery for dogs with cranial cruciate ligament deficiency. Vet Rec 2000; 147: 325-328.
19 Murrell GA, Maddali S, Horovitz L. et al. The effects of time course after anterior cruciate ligament injury in correlation with meniscal and cartilage loss. Am J Sports Med 2001; 29: 9-14.
20 Johnson KA, Francis DJ, Manley PA. et al. Comparison of the effects of caudal pole hemi-meniscectomy and complete medial meniscectomy in the canine stifle joint. Am J Vet Res 2004; 65: 1053-1060.
21 Thieman KM, Tomlinson JL, Fox DB. 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.
22 Hill CR, Conzemius MG, Smith GK. et al. Bacterial culture of the canine stifle joint following surgical repair of ruptured cranial cruciate ligament. Vet Comp Orthop Traumatol 1999; 12: 1-5.
23 Vasseur PB. Clinical Results Following Nonoperative Management for Rupture of the Cranial Cruciate Ligament in Dogs. Vet Surg 1984; 13: 243-246.
24 Piermattei DL, Johnson KA. Approach to the Stifle Joint Through a Lateral Incision. In: An atlas of surgical approaches to the bones and joints of the dog and cat (4th ed). Piermattei DL, Johnson KA. (eds). Philadelphia: Pa., Saunders; 2004: 342-345.
25 Flo GL. Modification of the lateral retinacular imbrication technique for stabilizing cruciate ligament injuries. J Am Anim Hosp Assoc 1975; 11: 570-576.
26 Olmstead ML. The use of orthopedic wire as a lateral suture for stifle stabilization. Vet Clin North Am Small Anim Pract 1993; 23: 735-753.
27 Roe SC, Kue J, Gemma J. Isometry of potential suture attachment sites for the cranial cruciate ligament deficient canine stifle. Vet Comp Orthop Traumatol 2008; 21: 215-220.
28 Innes JF, Barr AR. Can owners assess outcome following treatment of canine cruciate ligament deficiency?. J Small Anim Pract 1998; 39: 373-378.
29 Pacchiana PD, Morris E, Gillings SL. et al. Surgical and postoperative complications associated with tibial plateau leveling osteotomy in dogs with cranial cruciate ligament rupture: 397 cases (1998–2001). J Am Vet Med Assoc 2003; 222: 184-193.
30 Case JB, Hulse D, Kerwin SC. et al. Meniscal injury following initial cranial cruciate ligament stabilization surgery in 26 dogs (29 stifles). Vet Comp Orthop Traumatol 2008; 21: 365-367.
31 Stork CK, Gibson NR, Owen MR. et al. Radio-graphic features of a lateral extracapsular wire suture in the canine cranial cruciate deficient stifle. J Small Anim Pract 2001; 42: 487-490.
32 Caporn TM, Roe SC. Biochemical evaluation of the suitability of monofilament nylon fishing and leader line for extra-articular stabilisation of the canine cruciate-deficient stifle. Vet Comp Orthop Traumatol 1996; 9: 126-133.
33 Lopez MJ, Kunz D, Vanderby Jr R . et al. A comparison of joint stability between anterior cruciate intact and deficient knees: a new canine model of anterior cruciate ligament disruption. J Orthop Res 2003; 21: 224-230.
34 Jackson DW, Schreck P, Jacobson S. et al. Reduced anterior tibial translation associated with adaptive changes in the anterior cruciate ligament-deficient joint: goat model. J Orthop Res 1999; 17: 810-816.
35 Hulse DA, Butler DL, Kay MD. et al. Biomechanics of Cranial Cruciate Ligament Reconstruction in the Dog. 1. In vitro Laxity Testing. Vet Surg 1983; 12: 109-112.
36 Marshall JL, Olsson SE. Instability of the knee. A long-term experimental study in dogs. J Bone Joint Surg Am 1971; 53: 1561-1570.
37 Pond MJ, Nuki G. Experimentally-induced osteoarthritis in the dog. Ann Rheum Dis 1973; 32: 387-388.
38 Gordon WJ, Conzemius MG, Riedesel E. et al. The relationship between limb function and radio-graphic osteoarthrosis in dogs with stifle osteoarthrosis. Vet Surg 2003; 32: 451-454.
39 DeCamp CE. Kinetic and kinematic gait analysis and the assessment of lameness in the dog. Vet Clin North Am Small Anim Pract 1997; 27: 825-840.
40 Gingerich DA, Strobel JD. Use of client-specific outcome measures to assess treatment effects in geriatric, arthritic dogs: controlled clinical evaluation of a nutraceutical. Vet Ther 2003; 4: 56-66.
41 Hudson JT, Slater MR, Taylor L. et al. Assessing repeatability and validity of a visual analogue scale questionnaire for use in assessing pain and lameness in dogs. Am J Vet Res 2004; 65: 1634-1643.
42 Corr SA, Brown C. A comparison of outcomes following tibial plateau levelling osteotomy and cranial tibial wedge osteotomy procedures. Vet Comp Orthop Traumatol 2007; 20: 312-319.

Zusatzmaterial