Advances in the Canine Cranial Cruciate Ligament, 2nd edition

Arthroscopic Follow-Up after Surgical Stabilization of the Stifle 287

lateral femoral condyle

lateral femoral condyle

femur

lateral meniscus

normal lateral meniscus

lateral

(A) (B) meniscus (C)

Figure 33.18 The cartilage of the femoral condyle and tibial plateau had an inconsistent appearance at the time of
follow-up arthroscopic examination after extracapsular stabilization amongst patients with cruciate ligament rupture.
The cartilage appeared to be normal (A), have mild wear (B), or have moderate wear (C).

smooth axial border, others healed with irregu-
lar fibrous tissue, and some showed no healing
response. The MR appears to remain functional
despite variation in healing patterns. Evidence
of continued function of the MR includes the
caudal position of the medial meniscus and a
dramatic reduction in the prevalence of postlim-
inary meniscal tears. The caudal horn of the
medial meniscus appeared to sit in a more cau-
dal position, and the meniscus did not appear to
shift forward during a tibial compression test or
cranial drawer test while viewing the meniscus
arthroscopically.

Follow-up arthroscopic examination

after extracapsular stabilization

Follow-up arthroscopy has also been used
to assess the stifle joint after extracapsular
stabilization of the CrCL-deficient stifle. Most
of the dogs examined in this group had under-
gone complete debridement of the CrCL at the

femur

*

shear lesion

tibial

spine

***

***

(A) (B)

Grade 4 cartilage lesion

medial femoral condyle

Figure 33.19 Some patients show
severe cartilage damage at
follow-up evaluation after
extracapsular stabilization. Erosion
of the lateral femoral condyle (∗∗∗)
in the region opposite the lateral
tibial eminence is seen in this
patient (A). This lesion is thought to
occur due to excessive shear force.
Full-thickness erosion (∗∗∗)of
weight-bearing regions of the
medial femoral condyle are
occasionally seen (B).

time of stabilization. Periarticular osteophytes

typically enlarge over time. Mild to moderate

synovitis is seen. Cartilage erosion is variable

(Figure 33.18). Some dogs show progressive

cartilage erosion of the medial and lateral

compartment (Figure 33.19). Erosion primarily

involves the articular cartilage of the weight-

bearing regions of the medial and lateral

femoral condyle and tibial plateau. Cartilage

damage is often more severe in the lateral

compartment. Increased cartilage damage in

the lateral compartment may be secondary to

increased forces generated by the placement of

a lateral extracapsular suture. Cartilage erosion

does not appear to commonly involve non

weight-bearing regions, unlike that seen after

TPLO. Some dogs show very little evidence of

articular cartilage damage. Meniscal tears are

also common at the time of follow-up arthro-

scopic examination in this group of patients

(Figure 33.20). Interestingly, many dogs identi-

fied as having bucket-handle tears of the medial

meniscus were not observed to have significant

lameness by the owners. However, physical