Tendon and Ligament Disease Flashcards
What are common causes of muscular injuries?
Often similar to those causing tendon injuries but less commonly specifically diagnosed
What commonly causes tendon injuries?
Trauma such as lacerations
Strains = breaking or dehiscence of fibres mechanically induced or due to weakening by degeneration
How do muscle/tendon injuries often present?
Acute lameness if due to trauma otherwise chronic lameness
Diffuse, painful oedema in acute causes
Organised and established swelling in chronic cases
Specific functional disability
How is diagnosis of tendon/muscle injury made?
Dysfunction shown in clinical signs
Swelling or gap in radiographs
Gap or loss of linear orientation of fibres on ultrasound
How do tendons repair themselves?
Fibroblasts and collagen fibres lining up along the line of action
Sheathed tendons have poorer blood supply and heal slower
Takes 6 weeks to regain 50% normal strength and 1 year to regain an average of 80% normal strength
What is the treatment for tendon injuries?
Rest
Specific support such as dressings, casts or transarticular fixator to protect tendon from loading
Primary surgical repair using locking loop or 3 loop pulley
Ultrasound used to monitor repair
What is a sprain?
Ligamentous injury which varies from mild to severe and are graded as 1st/2nd/3rd degree with increasing levels of soft tissue damage, swelling, pain, lameness and instability
How do sprains present and how should they be examined?
Acute and chronic sprains have similar presentation to strains
Pay attention to range of movement on examination
What further diagnostic techniques can be used for strains?
Radiography including stressed views, ultrasound and manipulation under anaesthesia
What are the treatment options for sprains?
Dependent on degree of instability
Rest and reduce swelling, external coaptation, ligament repair, internal ligament splintage, attention to other structures, arthrodesis (salvage)
How long does treatment for sprains take?
Can be a very long time and won’t always get back to acceptable function so need to check use before treatment
What is cranial cruciate disease often caused by?
Degeneration but can be acute either due to trauma or the degenerative ligament giving way
Can be associated with MPL (medial patellar luxation)
What does cranial cruciate disease cause?
Debilitating cranio-caudal instability at the stifle with 60% cases involving the medial meniscus
What is the normal function of the cranial cruciate ligament? What impact does this have when the ligament becomes diseased?
Resists reactive force that acts caudally when a dog propels itself forwards so joint becomes unstable when loaded if ligament breaks allowing the femur to move across the tibia damaging the menisci
How do dogs with cranial cruciate disease typically present?
Middle aged (2-10 yrs), overweight, neutered dogs, medium to large breed Insidious onset pelvic limb lameness and can be bilateral or acute
