Advances in the Canine Cranial Cruciate Ligament, 2nd edition

Risk Prediction of Cruciate Ligament Rupture using Stifle Diagnostic Imaging 167

(A)

40

Frequency

Effusio

indexn grade

stifle

Effusion grade

contralateral stifle

35

30

25

20

15

10

5

2

1

0

(B)

0

1

2

22

Frequency

Osteophytosis g

rade

index

stifle

Osteophytosis gradecontralateral stifle

20

14

16

18

12

10

8

6

2

4

2

3

1

(^00)
1
2
3
Figure 22.1 Relationship of osteoarthritic changes in the index and contralateral stifles in dogs with unilateral complete
cruciate ligament rupture (CR) and contralateral partial CR. (A) Bivariate histogram of radiographic synovial effusion
grade in index and contralateral stifles. (B) Bivariate histogram of osteophytosis grade in index and contralateral stifles.
Severity of osteophytosis (SR=0.39,P<0.0005), but not synovial effusion (SR=0.17,P=0.13) in the index and
contralateral stifles were correlated (n=85 dogs). Source: Chuanget al. 2014,http://journals.plos.org/plosone/
article?id=10.1371/journal.pone.0106389#. Used under CC BY 4.0,https://creativecommons.org/licenses/by/4.0/.
Conclusions
If there is any uncertainty about the diag-
nosis of CR, bilateral orthogonal stifle radio-
graphs should be made in dogs with pelvic
limb lameness and carefully examined for effu-
sion and osteophyte formation. In dogs with
unilateral CR, bilateral films are important to
fully determine the clinical status of the dog,
particularly with regard to the risk of subse-
quent contralateral rupture (Chuanget al. 2014;
Fulleret al. 2014). In stifles with partial CR,
including palpably normal stifles on clinical
examination, if moderate to severe radiographic
(A) Index effusion
Days
Percent survival
100
50
0 1000 2000 3000
Grade 0
Grade 1
Grade 2
0
(B) Index osteophytosis
Days
Percent survival
100
50
0 1000 2000 3000
Grade 0
Grade 1
Grade 2
Grade 3
0
Figure 22.2 Time to contralateral cranial cruciate ligament rupture (CR) stratified by severity of synovial effusion and
osteoarthritis in the unstable index stifle with complete CR. Kaplan-Meier plots for a population of 85 client-owned dogs
with unilateral complete CR and contralateral partial CR. Time to contralateral complete CR was not significantly
influenced by severity of synovial effusion (A) or osteophytosis (B) in the index stifle. Source: Chuanget al. 2014,
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0106389#. Used under CC BY 4.0,https://creative
commons.org/licenses/by/4.0/.