Small Animal Ortho: Cranial & Caudal Cruciate Ligament

Question 1

What are the functions of the CCL?

Answer 1

limits cranial translation of the tibia in respect to the femur

prevents hyperextension of the stifle joint

limits internal rotation of the tibia

limit degree of valgus-varus support to the flexed stifle

mechnoreceptors-proprioceptive feedback

Question 2

What are the ligaments and musculature involved in the cranial cruciate ligament?

Answer 2

Cranial cruciate ligament
caudal cruciate ligament
caudal belly of sartorius
gracillus
semitendinosous

Question 3

What does the caudal belly of sartorius, gracillus m. and semitendinosous m. function to do?

Answer 3

Stifle flexion
internal rotation

Question 4

Which meniscus is the one most often injured in a CCL & why?

Answer 4

The medial meniscus b/c it is tightly adhered to the tibia unlike the lateral meniscus which is attached to meniscofemoral ligament.

Question 5

What are the common signalment of animals affected by CCL rupture?

Answer 5

Females more than males
Large breed dogs
Active dogs
any age
straight legged breeds

Question 6

What is the etiology of a CCL tear?

Answer 6

1) acute trauma
2) chronic degenerative changes
3) conformation

Question 7

What are the contributing factors to acute trauma etiology?

Answer 7

acute history
distinct traumatic event
avulsion in young dogs

Question 8

What are the contributing factors to chronic degenerative changes etiology?

Answer 8

episodic lameness
declining strength of CCL with age
loss of fiber bundle organization & metaplastic changes of cellular elements

Question 9

What are the contributing factors to conformation etiology?

Answer 9

postural arthritis
stifle hyperextension
femoral conformation: narrowing intercondyler notch
tibial conformation: abnormal slope of TTA
Obesiety
excessive stress
chronic deterioration
eventual rupture

Question 10

How do you diagnose a CCL rupture?

Answer 10

history of sudden onset on non weight bearing lameness or prolonged weight bearing lameness
PE
imaging
arthroscopy
arthrocentesis
cranial drawer test

Question 11

What are the important information about CCL ruptures that you should tell clients?

Answer 11

30-40% of CCL ruptures will rupture the other ligament on the other leg within 2 years

progressive OA occurs after CCL rupture regardless of the treatment method

Question 12

What is the difference between a partial tear and a complete tear of the CCL?

Answer 12

partial will have no cranial drawer in extension but will have a drawer in flexion

complete will have a drawer on extension and flexion