Stifle - Goh Flashcards
What is the most common scenario for CCL disease
Middle aged, larger breed, with minimal trauma
“Weekend Warrior”
CCL in young athletic dogs
Most likely an acute avulsion injury
Dogs with ____ ____ conformation have a higher risk for CCL, due to higher ____ ____ angle
Straight legged
tibial plateau
E.g. Pyreneese
Dogs that are ______ at a young age have a higher predisposition for CCL dz, lack of hormonal
neutered
What about CCL and small breeds?
Older, overweight small breed dogs. The often have acute complete rupture and it may be secondary to MPL
Lameness that may be prolonged, intermittent and mild
partial CCL tear
Lameness may be acute and severe
Complete CCL tear
Lameness may partially improve then becomes and stays severe
Secondary Meniscal Injury
What do you see in the Gait of dogs with CCL dz?
Significant lameness
+ sit test
What do you find on standing exam in dogs with CCL dz?
muscle atrophy (quads)
medial buttress (firm - almost bone-like)
What do you find on stifle manipulation in dogs with CCL dz?
Pain on hyperextension
Creptius/clicks
What joints are we testing with the Sit Test?
Stifle and tarsus
Where are your hands during the drawer test?
Proximal hand on the patella and the lateral flabella
Distal hand on the tibular tuberosity and the fibular head
Do you have the stifle extended or flexed during the drawer test?
Do it both extended and flexed!
Where are your hands during a Tibial Compression Test?
Proximal thumb is on lateral flabella, index finger on the tibial tuberosity
Distal hand cups around the tarsus
What position should the stifle be during the Tibial Compression Test?
Extended! Don’t let it flex
What are you looking for on rads? (CCL)
Position
Effusion
DJD - Osteophytes
Cranial Tibial Subluxation
Where do we see osteophytes on rads?
Tibial plateau, trochlear ridges, distal or proximal aspect of patella, fabellae
What are the meniscus and what do they do?
Paired semicircular fibrocartilages
Provide stability and protects articular cartilage
Meniscal tears - _____% incidence secondary to CrCl rupture
50-90%
Which part of the meniscus is most often injured?
Caudal part of MEDIAL meniscus
Meniscal injury causes ______. The meniscus must be inspected at ______. What can we do at time of sx of injury is found?
significant lameness/pain
time of sx
Partial or hemi-meniscetomy warranted if torn
Should we just do a prophylactic meniscal release at time of sx (TPLO or TTA)?
Probably not… do it if there is some damage there. Doing a release will cause loss of meniscal fx and alter the contact mechanics. Can also result in lameness and secondary OA.
Should we be doing arthroscopy/arthrotomy on these cases?
ALWAYS!!!
“More mistakes are made from not looking, as compared to not knowing”
