Meniscal injury following initial cranial cruciate ligament stabilization surgery in 26 dogs (29 stifles)

OBJECTIVE: To describe clinical signs, arthroscopic findings, and outcome in a group of dogs undergoing second look arthroscopy for the treatment of meniscal tears following original surgery to correct a CCL deficient stifle joint. METHODS: The medical records of 26 dogs from the Veterinary Teaching Hospital at Texas A&M University and the Veterinary Orthopedic Center (Round Rock, Texas) that had second look arthroscopy for lameness following an original surgical procedure were reviewed. Pre-operative clinical findings, 2nd look arthroscopic findings and owner assessed outcome were documented. RESULTS: Postliminary bucket handle tears of the medial meniscus were detected in 22 (75.9%) cases. Other postliminary meniscal injuries included frayed caudal horn tears of the medial meniscus 6 (20.7%), and longitudinal tears of the lateral meniscus 1 (3.4%). An audible or palpable click was present in 27.6% of cases. An improvement or resolution of lameness was reported in 96.5% of cases reported. In conclusion, tears of the medial meniscus are a significant cause of lameness in dogs subsequent to surgery for cranial crucial ligament ruptures. Increased lameness or acute onset of lameness after surgery for cranial crucial rupture is a consistent finding. In rare cases, a palpable or audible click will be appreciated. Arthroscopic evaluation and partial meniscectomy improve or resolve lameness in the majority of cases. CLINICAL SIGNIFICANCE: Sudden or increased lameness in dogs with historical CCL stabilization surgery should be evaluated and treated arthroscopically for postliminary meniscal injury if another cause for lameness can not be determined.     

Arthroscopic evaluation of menisci in dogs with cranial cruciate ligament injuries: 100 cases (1999-2000)

OBJECTIVE: To determine prevalence of meniscal injuries by use of arthroscopic examination in dogs with cranial cruciate ligament (CCL) injuries. DESIGN: Retrospective study. ANIMALS: 94 dogs with 100 injured CCLs. PROCEDURE: Records for 94 large dogs (> 20 kg [44 lb]) with 100 naturally occurring CCL injuries that were examined arthroscopically were reviewed. Pathologic findings in the CCL (complete or partial tears), prevalence and type of meniscal injuries, and periarticular osteophytes were recorded. RESULTS: 77% of joints had tears of the lateral meniscus; most were a series of small radial tears of the cranial horn. Fifty-eight percent of joints had tears of the medial meniscus. Positive correlation between complete tears of the CCL and medial meniscal damage was found. No significant relationships were detected between periarticular osteophyte formation and meniscal injury, medial and lateral meniscal injury, or degree of CCL tear and lateral meniscal injury. CONCLUSIONS AND CLINICAL RELEVANCE: There is a strong association between CCL injury and lateral and medial meniscal injuries in dogs. Clinical importance of lateral meniscal lesions is not known; a much higher percentage of dogs had such injuries than has been reported previously, possibly because of use of arthroscopy.     

Tibial tuberosity advancement in 92 canine stifles: initial results,clinical outcome and owner evaluation

Objective To investigate the clinical outcomes, complications and owners' evaluation of the tibial tuberosity advancement (TTA) procedure in canine stifles. Methods A retrospective study of hospital records was performed to identify dogs diagnosed with partial or complete cranial cruciate ligament (CCL) rupture that had undergone TTA repair. Information obtained included signalment, period of lameness, surgical report, evidence of meniscal injury, postoperative recovery and peri-operative complications. Owners were asked to assess the long-term outcome. Results In a total of 72 dogs (median age, 6 years; median body weight, 34.8 kg), TTA was performed in 92 stifles. Twenty breeds were represented, with Labrador Retrievers and Rottweilers the most common. The period of lameness ranged from 3 days to 24 months. The median pre-operative lameness score was 3/4 and meniscal injury was present in 51 stifles. Minor complications occurred in 29% of cases. Major complications occurred in 6.5% of cases and consisted of meniscal injury and two tibial tuberosity fractures. All were successfully managed, with good limb function when subsequently assessed. In the owner evaluation, 96% reported moderate to great improvement postoperatively, with no lameness at rest and mild to no lameness after vigorous exercise. Conclusion Clinical outcome and owner evaluations in this case series indicate favourable results can be expected when CCL-deficient stifles are treated with TTA.     

MENISCAL OSSICLES IN LARGE NON-DOMESTIC CATS

Radiographs of the stifles of 6 species of 34 large, non-domestic cats were reviewed foremost for the presence of meniscal ossicles and then for the presence of the other potential four sesamoids. The animals in the review included 12 lions, 7 tigers, 7 cougars, 3 leopards, 3 bobcats, and 2 jaguars. Fluoroscopy, arthrography, computed tomography, necropsy, and histology were also used to evaluate the stifles of one tiger after euthanasia. Ossicles were found in the region of the cranial horn of the medial meniscus in most of the lions, tigers, leopards, and jaguars. These ossicles were found in half of the cougars but in none of the bobcats. Among the large, non-domestic cats, meniscal ossicles had been reported previously only in Bengal tigers. The lions, tigers, and leopards having meniscal ossicles appeared to have a lateral but often not a medial fabella of the gastrocnemius muscle, an observation previously unreported. Popliteal sesamoids and patellas were present in all the skeletally mature cats.     

Canine stifle positive contrast computed tomography arthrography for assessment of caudal horn meniscal injury: a cadaver study

Objective— To investigate the use of computed tomography (CT) arthrography in cadaveric canine stifles with particular emphasis on the diagnosis of meniscal injury.
Study Design— Prospective cadaver study.
Sample Population— Pelvic limbs from adult Beagles (n=10).
Methods— After survey CT scan of each stifle oriented in the dorsal plane, positive contrast stifle CT arthrogram (CTA) was performed using the same slice orientation. Each stifle was then randomly allocated into 1 of 2 treatment groups: group A—arthrotomy, cranial cruciate ligament (CCL) transection and simulated injury to the caudal horn of the medial meniscus; group B—arthrotomy and CCL transection only. CT scan was repeated as before and post-arthrotomy images were interpreted by a radiologist unaware of treatment grouping.
Results— The cranial and caudal cruciate ligaments, medial and lateral menisci, menisco-femoral ligament, and long digital extensor tendon were all identifiable on CTA images. CTA was 90% sensitive and 100% specific for diagnosing simulated caudal horn meniscal injury.
Conclusions— Stifle CTA enables identification of intra-articular structures within the stifle and is a reliable method for identifying simulated meniscal injuries in a cadaver model.
Clinical Relevance— CTA imaging of the canine stifle has potential clinical value for detection of meniscal injury.     

Meniscal Mineralization in Domestic Cats

Objective: To (1) determine prevalence of radiographically detectable meniscal mineralization in domestic cats and (2) to evaluate the association between meniscal mineralization and degenerative joint disease (DJD). Study Design: Prospective study. Animals: Client‐owned cats (n=100) and 30 feline cadavers. Methods: Randomly selected client‐owned cats were used to determine the prevalence of meniscal mineralization. Stifles from feline cadavers were used to evaluate the relationship between meniscal mineralization (using high‐resolution X‐ray), radiographic DJD, and cartilage damage. Menisci were evaluated histologically. Results: Forty‐six percent of the client‐owned cats had meniscal mineralization detected in 1 or both stifles. Pain scores were not significantly different between stifles with meniscal mineralization and those with no radiographic pathology (P=.38). Thirty‐four of 57 cadaver stifles had meniscal mineralization, which was always located in the cranial horn of the medial meniscus. Percentage mineralization of the menisci was significantly correlated with the cartilage damage score of the medial femoral (r²=0.6; P<.0001) and tibial (r²=0.5; P<.0001) condyles as well as with the total joint cartilage damage (r²=0.36; P<.0001) score and DJD score (r²=0.8; P<.0001). Conclusion: Meniscal mineralization is a common condition in domestic cats and seems to indicate medial compartment DJD. Clinical Relevance: Clinical significance of meniscal mineralization is uncertain. Further work is needed to determine if the meniscal mineralization is a cause, or a consequence of joint degeneration.     

Concurrent or sequential development of medial meniscal and subchondral cystic lesions within the medial femorotibial joint in horses (1996–2006)

Reasons for performing study: Medial meniscal injuries and subchondral cystic lesions (SCL) are known to occur independently within the medial femorotibial (MFT) joint in horses. However, there are no reports of a potential clinical relationship between these 2 types of lesions. Objectives: To: 1) document the concurrent presence or sequential development of medial meniscal and SCL of the medial femoral condyle within the MFT joint; and 2) determine the prognosis with both types of lesions. Methods: Retrospective case series of horses with both a medial meniscal and SCL of the medial femoral condyle identified concurrently or sequentially by radiography, arthroscopy or post mortem examination. Case records and radiographs were reviewed, and a telephone survey of referring veterinarians, owners and trainers was conducted. Results: Twenty‐one horses (9.1% of all horses undergoing MFT joint arthroscopy) were identified to have both a medial meniscal injury and SCL of the medial femoral condyle. Thirteen horses had both abnormalities identified concurrently, 6 developed a meniscal lesion subsequent to SCL debridement, and 2 developed a SCL subsequent to a medial meniscal injury. Only 4/19 horses were classified as successful and returned to their intended use. The severity of the meniscal injury was significantly associated with the severity of lameness but not with outcome. Conclusions: A low percentage of horses may develop both a meniscal injury and SCL of the medial femoral condyle within the MFT joint and have a poor prognosis. Potential relevance: Trauma to the MFT joint may lead to both meniscal and subchondral bone damage of the medial femoral condyle that may be recognised concurrently or sequentially.     

Risk factors for medial meniscal injury in association with cranial cruciate ligament rupture

Objectives : To determine the significant risk factors for medial meniscal injury in naturally occurring cranial cruciate ligament rupture and to quantify the risk using multivariate analysis. Methods : A retrospective case control study was performed of dogs that had undergone surgery for cranial cruciate ligament rupture. Data recorded included patient signalment (age, breed and sex), the duration of the lameness, the extent of the cranial cruciate ligament rupture (complete or partial) and the condition of the medial meniscus. Logistic regression was used to analyse the relationship between these variables and tears in the medial meniscus. Results : One hundred and sixty-one of 443 stifles (36·3%) in 366 dogs had a medial meniscal tear. The risk of a medial meniscal tear was increased by 12·9 times in association with complete cranial cruciate ligament rupture (OR 12·9; 95% CI 6·8 to 24·2), by approximately 2·6% for each additional week of lameness (OR 1·026; 95% CI 1·009 to 1·043) and by approximately 1·4% for each additional kilogram of bodyweight (OR 1·014; 95% CI 1·000 to 1·028). Golden retrievers and Rottweilers were at increased risk and West Highland white terriers were at reduced risk of medial meniscal tears compared with Labrador retrievers. Clinical Significance : To minimise the risk of medial meniscal tears, surgical stabilisation should not be unnecessarily delayed.     

Meniscal Release in Cruciate Ligament Intact Stifles Causes Lameness and Medial Compartment Cartilage Pathology in Dogs 12 Weeks Postoperatively

Objective— To evaluate after 12 weeks the effects of caudal medial meniscal release (MR) in the cranial cruciate ligament-intact canine stifle.
Study Design— Blinded, prospective in vivo study.
Animals— Purpose-bred hound dogs (n=10).
Methods— Either MR (n=5) or a sham (SH) surgery (n=5) was performed via arthroscopy. Orthopedic examination and subjective lameness evaluation were performed in each dog preoperatively and at 4, 8, and 12 weeks after surgery. Twelve weeks postoperatively, ultrasonographic, radiographic, and arthroscopic examinations were performed on the operated stifles. Gross pathology of the articular cartilage, cruciate ligaments, and menisci was assessed. India ink staining of the femoral and tibial articular surfaces was performed to determine the percent area of articular cartilage damage.
Results— At 8 and 12 weeks after surgery, MR dogs were lamer than SH dogs. At 12 weeks, the degree of radiographic OA was significantly higher in MR stifles than in SH stifles. Gross and sonographic meniscal pathology was more severe in MR stifles compared with SH stifles. MR stifles had significantly more severe articular cartilage pathology compared with SH stifles 12 weeks after surgery; pathology was most severe in the medial compartment.
Conclusions— MR alone is associated with articular cartilage loss, further meniscal pathology, degenerative joint disease, and lameness.
Clinical Relevance— Subsequent osteoarthritis and dysfunction of the stifle joint should be considered when making clinical decisions regarding MR in dogs.     

Effect of medial meniscal release on tibial translation after tibial plateau leveling osteotomy

OBJECTIVE: To evaluate the biomechanical effects of medial meniscal release (MMR) and medial, caudal pole hemimeniscectomy (MCH) on joint stability in the cranial cruciate ligament (CCL)-deficient canine stifle before and after tibial plateau leveling osteotomy (TPLO). STUDY DESIGN: Experimental study. ANIMALS: Thirty-one dogs. METHODS: In experiment 1, 16 pairs of normal hindlimbs randomly assigned to an intact or transected CCL group were studied to determine the magnitude of tibial translation after MMR and MCH under 20% body weight load using radiographic imaging of radio-opaque markers. In experiment 2, 15 pairs of CCL-deficient hindlimbs were randomly assigned to a TPLO or sham TPLO group. The remainder of the experiment was performed as described for experiment 1. The effect of CCL transection, MMR, MCH and TPLO were analyzed using 2-way repeated measures ANOVA; P<.05 was considered significant. RESULTS: We found a greater effect of MMR on tibial translation in transected CCL stifles than in intact stifles (P=.0016). We found no further effect of MCH after MMR (P>.05). We found a greater effect of MMR in sham TPLO than TPLO stifles (P=.0013) but no further effect of MCH after MMR (P>.05). CONCLUSIONS: By resisting tibial translation the medial meniscus might be at greater risk of tearing in CCL-deficient stifles. TPLO may spare the medial meniscus by neutralizing the tibial thrust and eliminating the wedge effect of the medial meniscus. CLINICAL RELEVANCE: MMR may not be indicated in the CCL-deficient stifle stabilized by TPLO.     

Cranial cruciate ligament rupture in the dog—a retrospective study comparing surgical techniques

SUMMARY Three surgical techniques, grouped as intra-articular techniques, extra-capsular techniques and fibular head transposition, were used for repair of the cranial cruciate ligament (CCL)-deficient stifle in 113 dogs over a 4 year 4 month period. The clinical outcome of the techniques were compared using information provided by the owners and physical examination. Regardless of surgical technique, 85.7 to 91.0% of dogs showed clinical improvement after surgery. However, less than 50% of dogs became clinically sound on the operated leg and 9.0 to 14.3% of dogs remained persistently lame on the operated leg. No statistical association was found between result after surgery and age, body weight, sex, duration of injury before surgery, association with injury, tibial plateau angle, degree of radiographic osteoarthritis before surgery or the presence of concurrent medial meniscal injury. On physical examination, extra-capsular techniques appeared superior to the fibular head transposition in terms of joint stability and limb function. Concurrent medial meniscal injury necessitating meniscectomy existed in 48.0% of cases. Twenty-two percent of dogs ruptured their contralateral CCL at an average of 14 months after the first.     

Potential Iatrogenic Medial Meniscal Damage During Tibial Plateau Leveling Osteotomy

Objective— To evaluate potential iatrogenic medial meniscal (MM) damage during tibial plateau leveling osteotomy (TPLO) and to establish a safe zone (SZ) for hypodermic needle (HN) identification of the medial aspect of the stifle joint.
Study Design— Prospective cohort.
Animals— Cadaveric canine stifles (n=40).
Methods— HN (20 or 25 G) were inserted through the medial collateral ligament (MCL) of the femorotibial joint and through the SZ insertion points. The medial meniscus was inspected for iatrogenic damage. Statistical comparison of MM damage caused by different needle sizes and insertion sites was performed using Fisher's exact test with significance at P <.05.
Results— Twenty-gauge group: 65% of stifles had minor MM damage with MCL insertion compared with 35% of stifles with SZ insertion ( P =.0049). Severe MM damage occurred in 25% of stifles with MCL insertion compared with 0% of stifles with SZ insertion ( P =.0014). Twenty-five-gauge group: 85% of stifles had minor MM damage with MCL insertion compared with 30% after SZ insertion ( P =.0011); however, no severe MM injury was noted.
Conclusions— HN insertion though the MCL can produce iatrogenic damage to the MM. Use of a 25 G HN and SZ site for insertion reduced the frequency and severity of MM damage.
Clinical Relevance— HN insertion into the medial aspect of the femorotibial joint during TPLO can cause gross iatrogenic MM damage, which may contribute to the incidence and misdiagnosis of latent MM injuries after TPLO.     

Proximal tibial intraarticular ostectomy for treatment of canine cranial cruciate ligament injury

OBJECTIVE: To report a technique for surgical alteration of the slope of the tibial plateau by a proximal tibial intraarticular ostectomy (PTIO) after injury to the canine cranial cruciate ligament (CCL) and to determine the outcome. STUDY DESIGN: Prospective clinical study. ANIMALS: Dogs (n=52) with CCL injury in 60 stifle joints. METHODS: CCL injury was treated by lateral stifle arthrotomy, removal of CCL remnants, and appropriate meniscal surgery. PTIO was performed to remove a wedge of bone from the proximal aspect of the tibia. The ostectomy site was reduced and stabilized using a bone plate and screws applied to the medial surface of the tibia as well as a craniocaudal positional screw. Dogs were evaluated at 6 weeks, 6, and 12 months by complication assessment, lameness scores, stifle range of motion (ROM), thigh circumference, radiographic assessment, degenerative joint disease (DJD) scores, and surgeon and owner evaluation of function. RESULTS: Lameness scores improved by 6 and 12 months in all but 1 dog. Thigh circumference and DJD were increased at 6 and 12 months. Complications occurred in 20% of dogs with all but 1 occurring perioperatively or within 6 weeks; most common were injury to the long digital extensor tendon (4 dogs) and plate failure (3); 2 other dogs required surgery to treat complications. Most owners (98%) reported that lameness had improved by 12 months; 90% were extremely or very satisfied with the procedure and 90% would have the same procedure performed on another dog. CONCLUSION: PTIO to level the tibial plateau provided a satisfactory clinical outcome in dogs >20 kg with CCL injury and the complication rate was similar to tibial plateau levelling osteotomy (TPLO). Stifle osteoarthritis continued to progress radiographically. CLINICAL RELEVANCE: PTIO represents an alternative to TPLO that does not require specialized surgical equipment.     

Association of meniscal injury to joint space width on standard tibial plateau leveling osteotomy lateral radiographic projections of the canine stifle

Up to 70% of dogs with cranial cruciate ligament tears have concurrent meniscal injury, and these injuries can increase the risk of developing osteoarthritis and persistent lameness. Studies assessing joint space width on knee radiographs in people have indicated associations between joint space width and meniscal injuries. The aim of this prospective analytical study was to determine if there was an association between stifle joint space width on three different radiographic projections (the standard tibial plateau leveling osteotomy projections and a standing lateral projection) and meniscal injuries identified at surgery in dogs. There was a significant association between dogs with a meniscal tear and the corresponding joint space width on standard tibial plateau leveling osteotomy lateral radiographic projections (P‐value = .0028). Based on receiver operator characteristic curve analysis, joint space widths measuring less than 3.43 mm may indicate a meniscal tear, with a corresponding 89.5% specificity and 40.5% sensitivity in dogs weighing 31 kg. Joint space narrowing is seen with meniscal tears in dogs, and radiography may be a noninvasive way to identify meniscal tears prior to surgery.     

Meniscal tears in horses: an evaluation of clinical signs and arthroscopic treatment of 80 cases

REASONS FOR PERFORMING STUDY: There is little published information available describing clinical signs, arthroscopic findings and prognosis of meniscal injuries in horses. OBJECTIVES: To evaluate the effect on the outcome not only of the arthroscopic findings and treatment, but also of the clinical and radiographic signs in these horses. METHODS: The following were recorded for each case: the meniscal injury, graded according to severity; clinical and radiographic findings prior to surgery; any concurrent injury in the joint seen at arthroscopy. The effect of these factors and the grade of injury on the outcome were analysed using Fisher's exact test or Chi-square analysis. Only horses whose meniscal injury was judged to be the primary cause of lameness were included in the series. RESULTS: A series of 80 meniscal injuries were diagnosed and treated arthroscopically by the authors at the Liphook Equine Hospital and 47% of horses returned to full use. Statistically, poor prognosis was associated with increasing severity of the meniscal injury, the presence of concurrent articular cartilage lesions and radiographic abnormalities in the joint. Arthroscopic treatment of many lesions was limited by the inaccessibility of parts of the femorotibial joint. POTENTIAL RELEVANCE: Further work is required to improve and evaluate arthroscopic techniques for the treatment of these injuries.     

Influence of canine recombinant somatotropin hormone on biomechanical and biochemical properties of the medial meniscus in stifles with altered stability

OBJECTIVE: To determine biomechanical and biochemical properties of the medial meniscus in a semi-stable stifle model and in clinical patients and to determine the effect of canine recombinant somatotropin hormone (STH) on those properties. ANIMALS: 22 healthy adult dogs and 12 dogs with meniscal damage secondary to cranial cruciate ligament (CCL) rupture. PROCEDURE: The CCL was transected in 15 dogs, and stifles were immediately stabilized. Implants releasing 4 mg of STH/d were placed in 7 dogs, and 8 received sham implants. Seven dogs were used as untreated controls. Force plate analysis was performed before surgery and 2, 5, and 10 weeks after surgery. After 10 weeks, dogs were euthanatized, and menisci from surgical and contralateral stifles were harvested. The torn caudal horn of the medial meniscus in dogs with CCL rupture comprised the clinical group. Creep indentation determined aggregate modulus (HA), Poisson's ratio (v), permeability (k), and percentage recovery (%R). Water content (%W), collagen content (C), sulfated glycosaminoglycan (sGAG) content, and collagen type-I (cI) and -II (cII) immunoreactivity were also determined. RESULTS: Surgical and clinical groups had lower HA, k, %R, C, sGAG, cI, and clI and higher %W than the non-surgical group. Surgical stifles with greater weight bearing had stiffer menisci than those bearing less weight. Collagen content was higher in the surgical group receiving STH than the surgical group without STH. CONCLUSIONS AND CLINICAL RELEVANCE: Acute stabilization and moderate weight bearing of the CCLdeficient stifle appear to protect stiffness of the medial meniscus. Normal appearing menisci from CCL-deficient stifles can have alterations in biomechanical and biochemical properties, which may contribute to meniscal failure.     

Management of concurrent patellar luxation and cranial cruciate ligament rupture using modified tibial plateau levelling

Objectives : To evaluate a novel surgery aimed at managing concurrent medial patellar luxation (MPL) and cranial cruciate ligament (CCL) ruptures in dogs weighing more than 30 kg. Methods : Tibial plateau levelling osteotomy (TPLO) and femoral trochleopasty were performed. The principal tibial fragment was laterally translated by 3 to 6 mm and was externally and abaxially rotated to create a wedge measuring 1·5 to 2·5 mm at the medial and cranial aspect and 1 to 3 mm at the medial and distal aspect of the tibial plateau fragment. The fragments were stabilised with a narrow TPLO plate. Results : Thirteen surgeries were performed in 12 dogs with a mean weight of 39·8 kg. The mean postoperative tibial plateau slope was 8·1°. Additional surgery was required in two cases, one due to failure of fixation and another due to screw breakage. The mean lameness score was 3·5 (out of 5) before surgery, 0·7 after 8 to 12 weeks, and 0·3 at final follow-up. Median follow-up was 1115 days (range, 270 to 2040 days). No patella luxated after surgery. Clinical Significance : MPL and CCL ruptures may be successfully managed by performing a TPLO and simultaneously altering the relationship of the principal and tibial plateau fragments during surgery.     

Diagnostic accuracy of positive contrast computed tomography arthrography for the detection of injuries to the medial meniscus in dogs with naturally occurring cranial cruciate ligament insufficiency

O bjective : To assess the usefulness of computed tomography arthrography of the stifle in diagnosing meniscal tears in dogs with cranial cruciate ligament insufficiency.
M ethods : A prospective clinical study was performed. Dogs were included if they had evidence of cranial cruciate ligament insufficiency or persistent or recurrent lameness following surgery for cranial cruciate ligament insufficiency. Dogs were sedated for a computed tomography scan of the affected stifle, orientated in the dorsal plane. A survey computed tomography scan was followed by a computed tomography arthrogram. A stifle arthrotomy was performed, and the surgical findings were recorded. The computed tomography scans were reviewed by three blinded reviewers, and the results were compared to the surgical findings.
R esults : Twenty-one computed tomography arthrograms from 20 dogs were included. At surgery, damage to the medial meniscus was identified in 14 stifles. Initial interpretation of computed tomography arthrography images was 57 to 64 per cent sensitive and 71 to 100 per cent specific for diagnosing medial meniscal injuries. Interpretation of the images on retrospective analysis was 71 per cent sensitive and 100 per cent specific, with an accuracy of 0·857.
C linical S ignificance : The accuracy of stifle computed tomography arthrography for the diagnosis of tears to the medial meniscus was found to be good. It is a minimally invasive and repeatable technique, which does not require general anaesthesia or specialist training to obtain the images. The ability to reliably diagnose meniscal injury without the need for surgery may be advantageous, particularly in dogs which had previously had surgery for cranial cruciate ligament insufficiency.     

Meniscal damage diagnosed by ultrasonography in horses: A retrospective study of 74 femorotibial joint ultrasonographic examinations (2000–2005)

This retrospective study reports diagnostic findings in 74 horses with ultrasonographic diagnosis of femorotibial joint damage; it describes the ultrasonographic features of meniscal tears and determines the prevalence of medial or lateral meniscal involvement and of associated synovial effusions. Horses were classified into four groups: with medial meniscal damage, with lateral meniscal damage, with lesions in both menisci, and with no ultrasonographic evidence of meniscal damage. After ultrasonographic appearance, meniscal lesions were described as central degeneration, horizontal tear, partial oblique tear of the distal angle, combined horizontal and oblique tears, or complex tear. Meniscal protrusion or other associated ultrasonographic or radiographic abnormalities were recorded. Of the 74 horses, 54 (73%) had medial meniscal damage, 5 (6.75%) had lateral meniscal damage, 5 (6.75%) had lesions in both menisci, and 10 (13.5%) had no meniscal lesion. Meniscal protrusion occurred in 20 cases (27%). Horizontal tears were the most frequent type of meniscal lesion (26 horses). Complex lesions were found in 6 lateral menisci and 14 medial menisci. Lesions of the cranial meniscal ligaments were seen in 10 horses. Synovial effusion of one or several joint compartments was found in 51 cases (68.9%).This study demonstrates the high prevalence of meniscal tears and synovitis in horses with ultrasonographic evidence of femorotibial derangement. Based on this series of clinical cases, horizontal tears of the medial meniscus appear to be the most frequent soft tissue injury of the equine stifle.     

Meniscal translocation and deformation throughout the range of motion of the equine stifle joint: an in vitro cadaveric study

Reason for performing study: By study of the translocation and deformation of equine menisci throughout the range of motion, it may be possible to identify potential mechanical factors in the pathogenesis of injury to the cranial horn of the medial meniscus. Objective: To quantitatively document meniscal translocation and deformation using radiographic and MR imaging, and to evaluate for potential variation between the medial and lateral menisci. Methods: Radiographic markers were embedded in the periphery of the menisci in 6 cadaver stifles. Proximal‐distal radiographs were taken at 15° intervals ranging from full flexion (30°) to full extension (160°). Magnetic resonance imaging sequences of 3 additional cadaver stifles were obtained in axial and sagittal planes at the predetermined stifle angles. Results: A significantly greater overall mean cranial‐caudal translocation (1.6 times) of the lateral meniscus relative to the medial was seen from full extension to full flexion (P = 0.002). The cranial horn of the medial meniscus was the least mobile of the 4 horns, yet a significant cranial displacement relative to the cranial horn of the lateral meniscus was seen in the terminal 10° of extension. MRI images revealed a significantly greater axial compressive strain in the cranial horn of the medial meniscus relative to the cranial horn of the lateral meniscus in the terminal 10° of extension (P = 0.017). Conclusion: The equine menisci exhibit a cranial‐caudal translocation over the tibia throughout the range of motion. While the cranial horn of the medial meniscus is the least mobile of the 4 horns, it undergoes significant cranial translocation and axial compression in the terminal 10° of extension. Potential relevance: Hyperextension of the stifle may place the cranial horn of the medial meniscus at risk of injury and thus explain the higher prevalence of meniscal tears at this location.