Meniscal click in cranial cruciate deficient stifles as a predictor of specific meniscal pathology

Abstract

ObjectiveTo determine the predictive value of meniscal click for specific meniscal tear morphology.Study designProspective cohort.AnimalsClient‐owned dogs (104) with cranial cruciate ligament (CCL) deficiency treated with stifle arthroscopy (111).MethodsAll stifles underwent a standardized examination for meniscal click before anesthesia (EBA) and during anesthesia (EDA). Presence or absence of a medial meniscal tear and diagnosis of tear morphology were confirmed with arthroscopic examination.ResultsComplete CCL tears were noted in 93 dogs, and incompetent partial tears were noted in 18 dogs. Medial meniscal tears were noted in 40.5% (55/111) of dogs, including bucket handle tears (BHT) in 65.6% (36/55) of tears. Frays of the lateral meniscus were noted in 6.3% of dogs (7/111). Examination for meniscal click before anesthesia was 38% sensitive and 94.5% specific, and EDA was 38% sensitive and 98.2% specific for all meniscal tear morphologies. Positive meniscal click at EBA was associated with a meniscal BHT but not with a meniscal non‐BHT (P < .0001 and P = .3515, respectively). Positive meniscal click at EDA was associated with a meniscal BHT but not with a meniscal non‐BHT (P < .0001 and P = .1909, respectively).ConclusionA meniscal click is more commonly associated with a meniscal BHT than with a non‐BHT.Clinical significanceMeniscal tear morphology influences the presence or absence of meniscal click. Because of the high incidence of meniscal disease, this study provides evidence to support joint exploration in the treatment of CCL disease.

Subsequent meniscal tears following tibial tuberosity advancement and tibial plateau leveling osteotomy in dogs with cranial cruciate ligament deficiency: An in vivo experimental study

“…One of the interesting findings in our study was that an audible or palpable meniscal click was only elucidated in 4 of 15 stifles (27%) following TTA, which had two bucket handle tears and two flap tears of medial meniscus, and only one of these stifles with a flap tear was associated with visible lameness. Although the type of tear or involvement of the peripheral one‐third rim of the medial meniscus might impact meniscal click or lameness level, 4,34 these findings may challenge the dogma that meniscal tears are painful and help explain a potential underestimation of subsequent meniscal tears after TTA or TPLO in clinical cases. In a previous clinical study, all dogs with subsequent meniscal tears detected on second‐look arthroscopy had periodic soreness and lameness 35 .…”

Update on the management of canine cruciate disease

“…Medial meniscal injuries (Fig 3) have been reported in 33.2 to 48 per cent of stifles with CCL rupture, and lateral meniscal tears in 6.3 per cent (Fitzpatrick and Solano 2010, Gleason and others 2020, Laube and Kerstetter 2020). Meniscal tears are 9.6 to 12.9 times more common in stifles with complete v partial CCL rupture, and risk also increases with duration of lameness, bodyweight, being older, being a smaller dog, or a rottweiler (Hayes and others 2010, Laube and Kerstetter 2020).…”

The significance of the meniscal flounce sign in canine stifle arthroscopy

“…Medial meniscal pathology is a common finding in dogs with cranial cruciate ligament disease. The reported incidence of meniscal injuries ranges from 20% to 77% in dogs with concurrent cranial cruciate ligament injuries 1–6 . Postliminary meniscal tears following stifle stabilization have been reported in up to 37% of cases, depending on surgical technique 7–9 .…”