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737C - Ortho sx > Exam 2: Lecture 8: Cranial Cruciate Ligament Injury Disease II > Flashcards

Exam 2: Lecture 8: Cranial Cruciate Ligament Injury Disease II Flashcards

(98 cards)

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1
Q

Why is surgical treatment recommended for CCLD?

A

slow down the progression of arthritis and eliminate / minimize lameness

  • always in large breeds
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2
Q

In dogs 20-25 pounds with CCLD, the condition may improve without surgery, but what is the outcome

A

progressive DJD occurs

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3
Q

Degenerative changes with CCLD include?

A
  • periarticular osteophytes
  • articular erosion
  • meniscal damage
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4
Q

Conservative therapy in animals with CCLD typically involves combination of what treatment plans?

A
  • medications
  • exercise modifications
  • joint supplements
  • possibly braces / orthotics (doesnt work well)
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5
Q

What is the effects of animals with CCLD when we restrict activity and give anti-inflammatories

A
  • lameness typically waxes and wanes
  • improves with pain medication and rest
  • small dogs and dogs with partial tears lameness completely disappear with treatment but usually some lameness in larger dogs
  • return to normal activity limited by progressive of arthritis
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6
Q

Return to normal activity is limited by which disease in animals with CCLD

A

limited by progression of arthritis

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7
Q

What type of therapy by trained practitioners can speed recovery from surgery
- but little evidence this is good alternative to surgical managment for most dogs

A

rehabilitation

  • may be alternative to surgery
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8
Q

Rehabilitation therapy may be an alternative option to surgery depending on what other factors?

A
  • concurrent injuries or disease
  • advanced age
  • patient size
  • financial limitations
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9
Q

Define the use of Custom Knee bracing / orthotics

A
  • relatively new to canine orthopedics
  • little sceintific evidence available
  • vluable for selected patients
  • temporary solution + not ideal for young active animals
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10
Q

Are custom knee braces / orthotics good for young active animals

A

no they are not ideal

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11
Q

Does surgery completly restore the normal joint anatomy and function in animals with CCLD

A

no it does not completely

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12
Q

What is the benefit of surgery in animals with CCLD

A

progression of arthritis - stabilization likely slows process

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13
Q

Is arthritis a reversible or non-reversible disease

A

non-reversible disease
- everything done to prevent development or progression of arthritis

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14
Q

When you stabilize the joint do you increase or decrease the progression of OA

A

decrease the progression of OA

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15
Q

During Cruciate ligament surgery, what should be done in all surgical cases?

A

arthrotomy / arthoscopy

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16
Q

what does the image show?

A

folded meniscus

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17
Q

Extra-articular techniques exert restrains on joint motion. This mimics the action of?

A

CCL

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18
Q

What type of surgical consideration does this image show?

A

extra-articular technique

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19
Q

What is the goal of cruciate surgery?

A

stabilize the stifle joint

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20
Q

What are the main clinical conclusions with cruciate surgery

A
  • use most comfortable technique for you
  • be prepared to alter procedure and be ready for changes
  • you are not repairing the cruciate = take it out
  • you are stabilizing the stifle
  • be familiar with advanced techniques
  • be able to discuss with clients and offer appropriate referral options
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21
Q

It is reported that any concurrent surgical methods (extracapsular or intracapsular) results in 90% subjective evaluation of what type of results?

A

good to excellent results

  • applies to newer osteotomy techniques
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22
Q

Does any technique prevent progressive DJD

A

no technique prevents

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23
Q

Are caudal cruciate injuries alone common or rare?

A

rare

  • cranial cruciate + collateral ligaments damage usually also occurs with CaCL injury
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24
Q

can clinical signs can be complicated by concomitant injuries when demonstrating caudal drawer movement

A

yes

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25
Caudal cruciate diagnosis due to muscle pull shows which bones appears to be subluxated caudally
tibia
26
How would you define the drawer movement of the tibia cranially in an animal with caudal cruciate diagnosis
actually is a reduction of subluxation
27
What type of diagnostic tools may be more important in assessing a CaCLD (caudal cruciate)
radiographs
28
What does the image on the left show?
caudal cruciate ligament rupture
29
What does the image on the right show?
CaCL rupture w/ medial collateral ligament tear
30
What does the image show?
caudal cruciate surgical technique - extracapsular imbrication technique utilized - surgically correct all injuries simultaneously
31
What is the 3 main functions of Meniscal functions?
- acts as a shock absorber - increases stability - aids in lubercation
32
What does the red area of the meniscus show?
peripheral 15% vascularized
33
What does the white area of the meniscus show?
Central 85% nourished by synovial diffusion
34
Are isolated meniscal lesions rare or common
rare - typically a secondary injury due to stifle instability
35
What is typically a secondary injury due to stifle instability
meniscal lesions
36
What is the shape / anatomy of meniscus
biconcave semilunar disc of fibrocartilage
37
Meniscus are attached to the tibia and femur by how many ligaments
6 ligaments
38
How is the lateral meniscus attached to the femur and allows for more movable-spares injury after CCL injury
Meniscofemoral ligament
39
Is the medial or lateral menicus firmly attached to joint capsule + medial collateral ligament (MCL)
medial meniscus
40
What is #1
cranial tibial ligament of the lateral meniscus
41
What is #2
lateral meniscus
42
What is #3
meniscofemoral ligament
43
What is #4
caudal ligament of the lateral meniscus
44
What is #5
caudal cruciate ligament
45
What is #6
medial meniscus
46
What is #7
caudal ligament of the medial meniscus
47
What is #8
cranial cruciate ligament
48
What is #9
transverse ligament
49
What is #10
cranial tibial ligament of the medial meniscus
50
What is #11
Patellar ligament
51
Is the most common injury occur to the medial or lateral meniscus during abnormal internal rotation
medial meniscus
52
Meniscal injuries are often associated with rupture of which ligament
CCL
53
Meniscal injuries occur when excessive crushing or shearing forces with stifle instability, resulting in?
- meniscocapsular detachment - seperation in substance of meniscus
54
What is #1
caudal cruciate ligament
55
What is #2
medial meniscus
56
What is #3
lateral meniscus
57
What is A
cranial cruciate ligament - ignore the star, not more important than anything else
58
What is #B*
tear to the medial meniscus - bucket hand tear
59
What is the most often damaged part to the medial meniscus
caudal horn - may be folded
60
What effects do the medial femoral and tibial condyles have on the meniscus during weight bearing in animals with disease/issues?
crushing shearing
61
What does the following define? - runs in an axial to abaxial direction
radial tears
62
What does the following define? - Follow the curvature of the meniscus - bucket handle tears
Circumferential tears - longitudinal
63
What does the following define? - circumferential tears with seperation of meniscus at site of tear
bucket handle tear - subtype of circumferential tears (longitudinal)
64
What does the following define? - midbody or meniscotibial incision of medial meniscus intended to prevent future meniscal impingment and damage
meniscal release
65
What does A show?
caudal bucket handle tear in medial meniscus
66
What does B show?
seperation of caudal section of medial meniscus
67
What does C show?
Isolated lateral meniscal tear
68
What does D show?
Cranial bucket handle tear in medial meniscus
69
What does A show
transverse radial tear
70
What does B show
Longitudinal or bucket handle tear
71
What does C show
medial peripheral detachment with shredding of cartilage
72
What does D show
folded cadual horn of the meniscus
73
What does the image show?
isolated lateral meniscal tear
74
Isolated lateral meniscal tears occurs in which area of the meniscus
cadual horn
75
Isolated lateral meniscal tears are RARE, they usually occur in conjunction with?
CCL tear
76
Why are isolated lateral meniscal tears rare? - very important to know
meniscofemoral ligament
77
Diagnosis of meniscal injuries have a clicking or snapping sound and can be hear on palpation or while the animal is weight bearing on that limb. What is the sound that can be heard?
Meniscal click
78
Sudden lameness in a dog with a chronic cruciate rupture may be an indication of what other type (concurrent) injury has occurred?
meniscal injury
79
A displaced meniscus may act as a wedge and prevent which movment in a acutely injured stifle
drawer movement
80
Are the following useful or useless in diagnosing meniscal injuries - radiology - arthroscopy - Surgical exploration
Radiology - ehhhh lets say no Arthroscopy - yes Surgical exploration - heck yeah
81
What is #1
medial femoral condyle
82
What is #2
medial meniscus
83
What is #3
tibial plateau
84
List 3 surgical treatment options for a ruptures CCL
- intracapsular + extracapsular reconstruction - corrective osteotomy (TPLO, TTA, TWO, CBLO) - primary repair with augmentation
85
What can we say for animals that have a cruciate ligament injury
injury of contralateral cruciate ligament occurs in more than 50% of patients
86
injury of contralateral cruciate ligament occurs in more than 50% of patients. When does the percentage increase by 60%
if radiographic changes are visible in "uninjured joint"
87
The surgical method for animals with ruptures CCL depends on which 3 factors?
- surgeon perference - patient size and function - cost of procedure
88
Most retrospective studies show success rates near _____% regardless of technique used to fix CCL rupture
90%
89
Intracapsular + extracapsular procedures focus on recreation of which movement constraints of the stifle joint - CCL - joint capsule fibrosis
passive contraints
90
What are the active restraints of the the stifle joint
muscles
91
Intracapsular reconstruction in CCL consist of?
passing autogenous tissue
92
Describe the method that consist of passing autogenous tissues during intracapsular reconstruction
- through joint using "over the top" method - passing tissue through predrilled holes in femur or tibia (or both)
93
What is the most common material for intracapsular material?
autogenous fascia lata
94
Why are synthetic materials rarely used during intracapsular reconstruction
eventually stretching or rupture - also common with fascia late risk of an inflammatory reaction or infection **because you cant keep the animal down long enough for healing**
95
What material type of not widespread instracapsular reconstruction technique for CCL reconstruction
alloggrafts with and without bone plugs
96
What is the advantages of intracapsular reconstruciton
most closely mimics origional position and biology of orgional CCL
97
What are the disadvatages of intracapsular reconstruction
- invasiveness - tendency of graft to stretch or fail
98

737C - Ortho sx (23 decks)

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