Lecture 7: Cranial Cruciate Ligament Injury/Dx I (Exam 2) Flashcards
What are some conditions of the stifle
- Arthritis
- Luxating patella
- Cruciate meniscal syndrome
- Inflammatory joint dx
- Neoplasia
- Injury
What is the most common canine orthopedic condition
Cranial cruciate lig injuries
What is a major cause of DJD in the canine stifle
Cruciate instability
What are some general considerations about cruciate ligs
- More complex in dogs
- Dogs sustain diff degrees of rupture (partial or complete)
- invariable causes arthritis (OA)
What is the most common cause in humans
Trauma
Describe “traumatic” rupture in dogs
- Rare
- Hyperextension
- Excessive internal rotation
- Applied load exceeds strength
What is cranial cruciate ligament disease in dogs (CCLD)
- A slow degenerative process
- Occurs over a few months to years
- Not the result of sudden trauma to a healthy lig
What factors influence CCLD
- Aging of the ligament
- Obesity
- Poor physical condition
- Conformation & breed
What are the two impt features of canine CCLD
- > 50% of dogs w/ cruciate lig probs in one knee dev similar probs in the other knee
- Partial tearing of CCL common & typically progresses to full tear
Describe the incidence & prevalence of CCLD
- Affects dogs of all sizes & ages
- Uncommon in cats
- Certain breed have higher incidence (some breeds less often affected)
- Female & neutered dogs & greater risk
List breed w/ higher incidence of CCLD
- Rottweiler
- Newfoundland
- Staffodshire terrier
- Mastiff
- Akita
- Saint bernard
- Chesapeake bay retriever
- Lab
- Greyhounds
- Dachshund
- Basset hound
- Old english sheepdog
Label the following
List the ligamentous support of the stifle
- Medial & lateral collateral ligs (limit medial & lateral movement of the tibia)
- Cranial cruciate lig
- Caudal cruciate lig
What are the functions of CCL
- Restrains cranial translation of the tibia on the femur
- Restrains hyperextension of the stifle joint
- Limits internal rotation of the tibia on the femur
- Limits varus & valgus motion in flexed joint
- Restrains caudal translation of tibia on femur
What happens to the cruciate ligs during flexion
- They twist on each other
- Limit excessive internal rotation of the tibia on the femur
Label the key structures in cruciate dx
What does CCL prevent
- Cranial translation of the tibia
- larger tibial plateau angle leads to greater cranial force on the tibia @ wt bearing
What are the components of the CCL
- Large caudolateral band
- Small craniomedial band
Describe a partial rupture of the CCL
- Caudolateral band is taut in extension & laxity in flexion
- Craniomedial band is taut in all phases of flexion & extension
- Involvement of the caudaolateral band alone produces no draw sign
What happens if there is a partial rupture of the craniomedial band
- Produces small amount of drawer movement in flexion
- No drawer observed in extension
How are CCL partial ruptures Dxed
- MRI
- Surgical exploration (arthrotomy & arthroscopy)
What results in stifle instability w/ CCL deficiency
- Joint capsule inflammation
- Synovial membrane inflammation
- Degeneration of the articular cartilage
- Production of osteophytes
- Meniscal damage
What is the end result of CCL Deficiency
Progressive DJD, loss of muscle mass, decreased limb use, & decreased performance
What are the common complications of CCLD
- Long term impairment due to OA
- Tearing of meniscus
