Meniscus

Question 1

Imaging meniscus

Answer 1

Won VRU 2020
-rads: joint space width <3.4mm may indicate meniscal tear (high spec, low sens)

Knudsen VS 2024
-CT: contrast arthrogrphy
-sens 0.6-1.0, spc 0.7-0.96
-a/w experience and learning effect

Pye JSAP 2024
-hydrogen nuclear MR spectroscopy potential biomarker in synovial fluid (increased in dogs with CrCL rupture)

Question 2

Arthroscopy meniscus

Answer 2

Gleason VS 2020
-meniscal click more a/w bucket handle tear

Katz VS 2022
-meniscal flounce strongly indicates normal meniscus

Evers VS 2023
-needle arthroscopy 1.9mm
-rapid, low morbidity, high accuracy

Keider VS 2023
-caudal pole meniscectomy through caudomedial port feasible

Question 3

Meniscectomy

Answer 3

Saban AJVR 2023
-Arthroscopic partial meniscectomy for bucket handle tears
-sig improvement in lameness, postop 6m similar to dogs with intact meniscus
-OA progression similar to those with intact menisci

Question 4

Arthrotomy

Answer 4

Trebacz Animals 2024
-3D printed model
-Examining menisci via arthrotomy after TPLO allowed view of 50% (pre-TPLO 16% lateral menisci, 50% medial menisci)
(or do arthroscopy)

Question 5

Meniscus and surgeries

Answer 5

Jensen VCOT 2020
-medial meniscal release resulted in additional cranial tibial sublux (vs just CrCL transection)
-TTO restored joint stability up to 125deg

Laube VCOT 2021 (dogs undergoing TPLO)
-50% bilateral tears
-risk: rotties, older, small, complete tears

Mazdarani VS 2022
-CBLO target 10deg mostly eliminiated cranial tibial translation induced by CrCL transection and medial meniscal release
-stability post CBLO depends on: meniscus, joint angle, hamstring strength

Schmutterer VCOT 2022
-ex vivo TPLO postop TPA of 6deg and 1deg
-TPLO restored stifle kinematics and meniscal kinetics
-Constant force on both menisci reduced with TPA 1deg

Question 6

meniscal injuries in small vs med-large dogs

Answer 6

colthurst JSAP 2022
-40% small dogs, 40% med-large at sx
-1% small dogs, 8% med-large postlim tears
-no diff bwt small and med-large dogs at sx or subsequently
-deg of CrCL insufficiency sig a/w tears

Question 7

Rocheleau VS 2024

Meniscal suturing + TPLO +/- extracapsular suture

Criteria included an unstable medial meniscus without evidence of a tear, a caudal vertical longitudinal tear with or without displacement, or if a bucket-handle tear was debrided and the remaining rim was unstable

Answer 7

34% comp

TPLO 70% vs TPLO + extracap 93% success on meniscal repair