Cruciate Ligament Disease Flashcards
Where does the CCL originate?
Medial surface of lateral femoral condyle
What is the function of the CCL?
Prevent cranial drawer, excessive hyperextension, and excessive internal rotation
What type of legs are predisposed to CCL rupture?
Straight-legged dogs
What age is more frequently affected with CCL ruptures?
Middle aged to older
What types of presentation can be assoc. w/CCL rupture?
Acute lameness or chronic lameness that does not improve w/rest but may improve w/NSAID tx
What is a positive sit test?
Sitting w/knee rotated outward
What orthopedic exam findings are consistent with CCL rupture?
Positive cranial drawer, positive tibial thrust, painful on extension
What is a good indicator of chronicity of CCL disease?
Presence of medial buttress
What is a medial buttress?
Accumulation of fibrous tissue deposited in an effort to stabilize the knee
What will you hear if there is meniscal damage concurrent w/CCL rupture?
Clicking
What will you see on radiographs that is suggestive of CCL rupture?
Osteophytes, joint effusion
What are surgical treatment options for CCL rupture?
Lateral suture, TPLO, TTA
What dogs is a lateral suture usually performed on?
Smaller dogs <20kg
What are cons of a lateral suture?
Can cycle, stretch, and break
Where is the heavy suture placed for an extracapsular lateral suture repair?
Around lateral fabella and through a hole in the tibia
Where is the osteotomy of a TPLO performed?
Proximal tibia
Which part of the tibia is rotated and stabilized for a TPLO?
Tibial plateau
Does TPLO fix a cranial drawer?
No
Does TPLO fix a tibial thrust?
Yes
How does a TPLO distribute load within the joint?
More load on caudal cruciate ligament
Where is the osteotomy of a TTA performed?
Cranial aspect of proximal tibia
Which surgical correction of CCL rupture requires a cage?
TTA
Which surgical correction of CCL rupture requires a bone plate?
TPLO
What is the goal of a TTA?
Make patellar tendon perpendicular to the tibial plateau
Does surgery eliminate progression of osteoarthritis in the joint?
No, just slows it down
Can cage rest treat a CCL rupture?
In small dogs if very strict
What is the duration recommended for cage rest to treat a CCL rupture?
8-12 weeks
How will a CCL rupture progress if surgery is not performed?
Stabilized via fibrosis, quicker progression of arthritis
Why should you not give a CCL rupture corticosteroids?
Will weaken the ligaments
Which meniscus is more likely to be injured with a CCL rupture?
Medial
What type of injuries do you see to the medial meniscus assoc. w/CCL rupture?
Bucket handle tear or “crush” of the caudal horn
