CCL I

Question 1

What is considered the most common canine orthopedic condition?

Answer 1

cranial cruciate ligament injuries

Question 2

what is the major cause of DJD in the canine stifle?

Answer 2

cruciate instability

Question 3

what is the pathophysiology of CCLD in dogs?

Answer 3

slow degenerative process - NOT result of sudden trauma to healthy ligament

Question 4

What is the most common cause of ACL tears in humans?

Answer 4

trauma

Question 5

what are factors that influence CCLD?

Answer 5

degeneration, obesity, poor physical condition, conformation and breed

Question 6

What % of dogs with cruciate ligament problem in one knee develop a similar problem in the other knee?

Answer 6

> 50%

Question 7

which CCL tear is more common? partial or full?

Answer 7

partial tearing is more common that typically progresses to full tear

Question 8

are CCL tears common in cats?

Answer 8

no, they are uncommon

Question 9

which dogs are at greater risk of CCLD?

Answer 9

female and neutered dogs are at greater risk

Question 10

which breeds have higher incidence of CCLD?

Answer 10

rottweiler, newfoundland, staffordshire terrier, mastiff, akita, st. bernard, chesapeake bay retriever, labrador retriever

Question 11

which breeds have a lower incidence of CCLD?

Answer 11

greyhound, dachshund, basset hound, old english sheepdog

Question 12

_____/______ deformities contribute to cruciate injuries

Answer 12

postural/anatomic

Question 13

Answer 13

1. patellar ligament
2. cranial tibial ligament of the medial meniscus
3. transverse ligament
4. cranial cuciate ligament
5. caudal ligament of the medial meniscus
6. medial meniscus
7. caudal cruciate ligament
8. caudal ligament of the lateral meniscus
9. meniscofemoral ligament
10. lateral meniscus
11. cranial tibial ligament of the lateral meniscus

Question 14

how are ligamentous support of the stifle named?

Answer 14

named for where they attach to tibia

Question 15

what do medial and lateral collateral ligaments do to the stifle?

Answer 15

limit medial and lateral movement of tibia

Question 16

What are the functions of the CCL?

Answer 16

restrains cranial translation of tibia on femur, restrains hyperextension of stifle joint, limits internal rotation, limits varus and valgus motion in flexed joint

Question 17

what are functions of CaCL?

Answer 17

restrains caudal translation of tibia on femur, helps restrains hyperextension of stifle joint, limits internal rotation of tibia on femur, limits varus and valgus motion in flexed joint

Question 18

what happens to the cruciate ligaments during flexion?

Answer 18

twist on each other

Question 19

what does the cruciate ligaments twisting on each other limit?

Answer 19

limits excessive internal rotation of tibia on femur

Question 20

Answer 20

purple: CCL
pink: meniscus
green: caudal cruciate
notice tibia is displaced forward and crushes meniscus when CCL ruptured

Question 21

the CCL prevents cranial translation of tibia

Answer 21

just know this

Question 22

what does a larger tibial plateau angle indicate?

Answer 22

greater cranial force on tibia at weight bearing

Question 23

what are the components of the CCL?

Answer 23

large caudolateral band, small craniomedial band

Question 24

what is 1b

Answer 24

craniomedial bundle of CrCL

Question 25

when are the craniomedial and caudolateral bands taut?

Answer 25

caudolateral band taut in extension craniomedial band taut all phases flexion and extension

Question 26

does involvement of the caudolateral band alone produce a drawer sign?

Answer 26

NO

Question 27

what does partial rupture of the craniomedial band produce?

Answer 27

small amount of drawer movement in flexion, NO drawer observed in extension

Question 28

How is CCL partial rupture diagnosed?

Answer 28

MRI, arthrotomy, Arthroscopy

Question 29

what is the end result of CCL deficiency

Answer 29

progressive DJD, loss of muscle mass, decreased limb use, decreased performance

Question 30

what are common complications of CCLD?

Answer 30

#1 - long term impairment due to OA #2 - tearing of meniscus

Question 31

How is CCLD diagnosed?

Answer 31

cranial drawer sign, tibial trust, radiographs, medial buttress

Question 32

what are some clinical signs of CCLD?

Answer 32

popping noise (mensical click), medial buttress - palpable thickening of medial aspect of stifle, non weight bearing lame when partially damaged ligament ruptures completely or meniscus is torn

Question 33

what are some ddx for CCLD?

Answer 33

hip dysplasia, ligament sprains, luxating patella, neurologic dz, bone cancer, fractures, joint luxation, tendon rupture, panosteitis, OCD

Question 34

which meniscus is frequently damaged?

Answer 34

medial

Question 35

describe repair of meniscal damage in dogs

Answer 35

too small to repair, excise damaged parts of meniscus = partial meniscectomy

Question 36

should PE of the stifle be performed with sedation?

Answer 36

more reliable results in painful patients with sedation due to increased pt comfort

Question 37

what is evaluated on ROM of the stifle?

Answer 37

creptius, meniscal click, pain on extension

Question 38

what does a negative cranial drawer test indicate?

Answer 38

periarticular fibrosis, meniscal entrapment

Question 39

what are the landmarks for cranial drawer test?

Answer 39

index on patella index on tibial tubercle thumb on lateral fabella thumb on fibular head

Question 40

what do radiographs NOT show for cranial cruciate diagnosis?

Answer 40

status (intact or damaged) of CCL or meniscus

Question 41

what is evaluated on radiographs of cranial cruciate diagnosis?

Answer 41

loss of fat pad definition and distention of caudal joint capsule, osteophyte formation and subchondral bone sclerosis