Re: ?meniscal damage

Malcolm Ness — Mon, 08 Oct 2012 09:15:04 GMT

A failing cranial cruciate ligament with secondary OA remains the most likely cause of this dog's lameness. The cranial draw test is massively unreliable and cannot be used to rule out CCL failure.

Much has been written and said about the meniscus in these cases but evidence in the literature is lacking and what there is is often contradictory. Despite that, you will hear some very, very firmly held and loudly expressed opinions on various aspects of the subject. That said, meniscal abnormality in dogs is almost always associated with/secondary to a CCL failure. Diagnosis of a meniscal tear is adequately done by arthrotomy and probing of the meniscus. Treatment of meniscal injuries by partial meniscectomy is widely practised but there is remarkably little hard evidence to show a benefit to this intervention either therapeutically or prophylactically. Diagnosis by arthroscopy is currently fashionable (especially amongst those who have an arthroscope to pay for!) but evidence for a patient-end benefit to this is lacking. Similarly, though MRI is widely used in human knee investigation, it is not specific or sensitive enough in dogs to warrant the additional cost and time.

If your rads are not revealing any other cause then I would work on the assumption that a failing CCL is the cause of this dog's lameness. Options include persevering with conservative/medical treatment or considering an exploratory arthrotomy with possible surgical treatment of a failed CCL.

Re: ?meniscal damage

GUILHERME PIOCZCOVSKI — Sun, 07 Oct 2012 03:03:10 GMT

The presence of a "cleck" sound during the cranial drawer test can be listen in some cases of meniscal lesion.

The X-ray is not the better imaging test to confirm the suspect. For this, you should perform a MRI or arthroscopy.