Detection of meniscal tears by arthroscopy and arthrotomy in dogs with cranial cruciate ligament rupture

R. Plesman; P. Gilbert; J. Campbell

doi:10.3415/VCOT-11-10-0153

Veterinary and Comparative Orthopaedics and Traumatology, Table of Contents

Vet Comp Orthop Traumatol 2013; 26(01): 42-46
DOI: 10.3415/VCOT-11-10-0153

Original Research

Schattauer GmbH

Detection of meniscal tears by arthroscopy and arthrotomy in dogs with cranial cruciate ligament rupture

A retrospective, cohort study

R. Plesman

¹Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada

,

P. Gilbert

¹Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada

,

J. Campbell

²Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada

› Author Affiliations

Abstract

Summary

Objectives: To evaluate and compare detection of meniscal tears associated with cranial cruciate ligament insufficiency by either arthroscopy or arthrotomy.

Methods: A retrospective, cohort study was completed with stifles (n = 531) of dogs with cranial cruciate ligament rupture. Either a medial parapatellar arthrotomy or an arthroscopy procedure was performed and groups were compared for significant differences in meniscal tears detected using logistic regression analysis.

Results: Arthroscopy was performed on 58.8% and arthrotomy on 41.2% of the stifles. In total, 44.4% of the examined stifles had meniscal tears. Meniscal tears were found in 38.8% of the stifles examined by arthrotomy, and 48.4% of those examined by arthroscopy. Overall, the rate of detection of a meniscal tear was significantly different (p = 0.019) between the groups, and meniscal tears were observed more frequently by arthroscopy than by arthrotomy (odds ratio 1.54; 95% confidence interval 1.07 – 2.22).

Clinical significance: These results suggest that arthroscopy may be more sensitive than arthrotomy for detection of meniscal pathology in clinical patients. However, these results must be interpreted with caution since this was a retrospective study. Randomized prospective clinical studies are required to further test this hypothesis.

Keywords

Meniscus - arthroscopy - arthrotomy - stifle - Cranial cruciate ligament

Full Text

References

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 Vasseur PF. The stifle joint. In: Slatter DH. editor. Textbook of Small Animal Surgery. Philadelphia: Saunders; 2003. pg. 2090-2132.
3 Innes JF, Bacon D, Lynch D. et al. Long-term outcome of surgery for dogs with cranial cruciate ligament deficiency. Vet Rec 2000; 147: 325-328.
4 Franklin SP, Gilley RS, Palmer RH. Meniscal injury in dogs with cranial cruciate ligament rupture. Compend 2010; Oct: E1-E11.
5 Thieman KM, Tomlinson JL, Dox 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.
6 Flo GL, DeYoung D. Meniscal injuries and medial meniscectomy. J Am Anim Hosp Assoc 1978; 14: 683-689.
7 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: 1601-1604.
8 Bennett D, May C. Meniscal damage associated with cruciate disease in the dog. J Small Anim Pract 1991; 32: 111-117.
9 Flo GL. Meniscal injuries. Vet Clin North Am Small Anim Pract 1993; 23: 831-843.
10 Mahn MM, Cook JL, Cook CT. et al. Arthroscopic verification of ultrasonographic diagnosis of meniscal pathology in dogs. Vet Surg 2005; 34: 318-323.
11 Metelman LA, Schwarz PD, Salman M. 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.
12 Damur DM, Tepic S, Montavon PM. Proximal tibial osteotomy for the repair of cranial cruciate-deficient stifle joints in dogs. Vet Comp Orthop Traumatol 2003; 15: 211-216.
13 Jerram RM, Walker AM, Warman CG. Proximal tibial intra-articular ostectomy for treatment of canine cranial cruciate ligament injury. Vet Comp Orthop Traumatol 2005; 34: 196-205.
14 Fitzpatrick N, Solan MA. Predictive variables for complications after TPLO with stifle inspection by arthrotomy in 1000 consecutive dogs. Vet Surg 2010; 29: 460-474.
15 Pozzi A, Litsky A, Field J. et al. Pressure distributions on the medial tibial plateau after medial meniscal surgery and tibial plateau leveling osteotomy in dogs. Vet Comp Orthop Traumatol 2008; 21: 8-14.
16 Luther JK, Cook CR, Cook JL. Meniscal release in cruciate ligament intact stifles causes lameness and medial compartment cartilage pathology in dogs 12 weeks postoperatively. Vet Surg 2009; 38: 520-529.
17 Samii VF, Dyce J. Computed tomographic arthrography of the normal canine stifle. Vet Radiol Ultrasound 2004; 45: 402-406.
18 Martig S, Konar M, Schmokel HG. et al. Low-field MRI and arthroscopy of meniscal lesions in ten dogs with experimentally induced cranial cruciate ligament insufficiency. Vet Radiol Ultrasound 2006; 47: 515-522.
19 Hoelzler MG, Millis DL, Francis DA. et al. Results of arthroscopic versus open arthrotomy for surgical management of cranial cruciate ligament deficiency in dogs. Vet Surg 2004; 33: 146-153.
20 Kivumbi CW, Bennett D. Arthroscopy of the canine stifle joint. Vet Rec 1981; 109: 241-249.
21 Pozzi A, Hildreth BE, Rajala-Schultz PJ. Comparison of arthroscopy and arthrotomy for diagnosis of medial meniscal pathology: an ex vivo study. Vet Surg 2008; 37: 749-755.
22 Whitney WO. Arthroscopically assisted surgery of the stifle joint. In: Beale BS, Hulse DA, Schulz KS. et al. editors. Small Animal Arthroscopy. Philadelphia, PA: Saunders; 2003. pg. 116-157.
23 Thieman KM, Pozzi A, Ling H-Y. et al. Contact mechanics of simulated meniscal tears in cadaveric canine stifles. Vet Surg 2009; 38: 803-810.
24 Kowaleski MP, Boudrieau RJ, Pozzi A. Chapter 62: Stifle Joint. In: Tobias KM, Johnston SA. editors. Veterinary Surgery Small Animal. St. Louis, MI: Elsevier; 2012. pg. 906-998.