CCL II

Question 1

what is the recommended treatment for CCL repair?

Answer 1

surgery recommended to slow down progression of arthritis and eliminate lameness

Question 2

which breeds should always be recommended for surgery?

Answer 2

always in large breeds, small breeds - conservative treatment

Question 3

when can conservative therapy for CCL ruptures be considered?

Answer 3

dogs <20-25 lbs but progressive DJD occurs

Question 4

what are degenerative changes associated with conservative therapy for CCL repairs?

Answer 4

periarticular osteophytes, articular erosions, meniscal damage

Question 5

describe rehabilitation therapy

Answer 5

when performed by trained rehab practitioner can speed recovery from surgery, but little evidence that this is good alternative to surgical management

Question 6

what does conservative therapy of CCL repairs typically involve?

Answer 6

medications, exercise modification, joint supplements, braces

Question 7

does surgery completely restore normal joint anatomy and function?

Answer 7

no

Question 8

despite surgical correction of CCLD, what still occurs?

Answer 8

progression of arthritis - stabilization likely slows the process

Question 9

is arthritis reversible?

Answer 9

no

Question 10

what should be performed on all surgical cases of CCL repair?

Answer 10

arthrotomy/arthroscopy

Question 11

what do extra-articular techniques do to joint motion?

Answer 11

exert restraints on joint motion, mimic action of CCL

Question 12

what is being done when performing cruciate surgery?

Answer 12

you are not repairing the cruciate, you are stabilizing the stifle

Question 13

what should be offered to clients when discussing CCL surgery?

Answer 13

offer appropriate referral options

Question 14

it is reported that any current surgical method results in what kind of evaluation of results?

Answer 14

90% subjective evaluation of good to excellent results

Question 15

which technique prevents progressive DJD?

Answer 15

no technique

Question 16

is caudal cruciate injury alone rare?

Answer 16

yes, cranial cruciate and collateral ligament damage usually also occurs with CaCL injury

Question 17

when are radiographs more important for diagnosis? CaCL or CCL?

Answer 17

caudal cruciate

Question 18

which techniques are utilized to repair caudal cruciate?

Answer 18

extracapsular imbrication techniques utilized

Question 19

what percent of the peripheral meniscus is vascularized?

Answer 19

15%

Question 20

what percent of the meniscus is nourished by synovial diffusion?

Answer 20

central 85%

Question 21

are isolated meniscal lesions rare?

Answer 21

yes - typically a secondary injury due to stifle injury

Question 22

how is the lateral meniscus attached to the femur?

Answer 22

meniscofemoral ligament

Question 23

how is the medial meniscus attached?

Answer 23

firmly attached to joint capsule and medial collateral ligament

Question 24

when does the most common injury occur to the medial meniscus?

Answer 24

during abnormal internal rotation

Question 25

what are meniscal injuries often associated with?

Answer 25

rupture of CCL

Question 26

excessive crushing or shearing forces with stifle instability result in

Answer 26

meniscocapsular detachment, separation in substance of meniscus

Question 27

which part of the medial meniscus is most often damaged?

Answer 27

caudal horn of medial meniscus, can be folded

Question 28

what happens to meniscus by medial femoral and tibial condyles during weight bearing?

Answer 28

medial femoral and tibial condyles crush and shear meniscus

Question 29

what direction do radial tears run?

Answer 29

run in axial to abaxial direction

Question 30

how do circumferential tears run?

Answer 30

aka longitudinal, follow the curve of meniscus

Question 31

what are bucket handle tears?

Answer 31

circumferential tears with separation of meniscus at site of tear

Question 32

what is meniscal release?

Answer 32

midbody or meniscotibial incision of medial meniscus intended to prevent future meniscal damage

Question 33

Answer 33

caudal bucket handle tear in medial meniscus

Question 34

Answer 34

isolated lateral meniscal tear

Question 35

Answer 35

separation of caudal section of medial meniscus

Question 36

Answer 36

cranial bucket handle tear in medial meniscus

Question 37

Answer 37

transverse radial tear

Question 38

Answer 38

longitudinal or bucket handle tear

Question 39

Answer 39

medial peripheral detachment with shredding of cartilage

Question 40

Answer 40

folded caudal horn

Question 41

when do isolated lateral meniscal tears occur?

Answer 41

usually occur in conjunction with CCL tear *RARE*

Question 42

why are isolated lateral meniscal tears rare?

Answer 42

meniscofemoral ligament

Question 43

what is the clicking sound heard upon palpation during weight bearing called?

Answer 43

meniscal click

Question 44

sudden lameness in a dog with chronic cruciate rupture possibly indicate?

Answer 44

meniscal injury occured

Question 45

how are meniscal injuries diagnosed?

Answer 45

radiology? arthroscopy! surgical exploration!

Question 46

injury of contralateral cruciate ligament occurs in what percentage of patients?

Answer 46

>50%

Question 47

percentage of contralateral CCL injury increases (60%) if what?

Answer 47

if radiographic changes are visible in uninjured joint

Question 48

what does the surgical method used depend on for ruptured CCL?

Answer 48

surgeon preference, patient size and function, cost of procedure

Question 49

most retrospective studies show a success rate of what in terms of CCL surgical repairs?

Answer 49

90%

Question 50

what is intracapsular reconstruction?

Answer 50

passing autogenous tissue through the joint, passing tissue through predrilled holes in femur or tibia

Question 51

what is the most common material used for intracapsular reconstruction?

Answer 51

autogenous fascia lata

Question 52

what is an advantage of intracapsular reconstruction?

Answer 52

most closely mimic original position and biology of original CCL

Question 53

what are disadvantages of intracapsular reconstruction?

Answer 53

invasiveness, tendency of graft to stretch or fail