Stifle Arthroscopy
The stifle is by far the most common joint arthroscopically examined at GCVS, primarily due to the high prevalence of cranial cruciate ligament injury (CrCL). Arthroscopy allows all intraarticular work to be completed without a painful arthrotomy.
Meniscal tears can be more readily and reliably identified and treated with the arthroscope through two small punctures that usually require no sutures.
A. Normal meniscal edge with tiny radial tear B. Normal meniscotibial ligament C. Bucket-handle tear of medial meniscus D. Small oblique tear of lateral meniscus E. Complex degenerative tear of the lateralmeniscus
A. Normal meniscal edge with tiny radial tear B. Normal meniscotibial ligament C. Bucket-handle tear of medial meniscus D. Small oblique tear of lateral meniscus E. Complex degenerative tear of the lateralmeniscus
OCD lesions of the stifle can also be confirmed and treated through the scope without need for invasive arthrotomy.
Cranial Cruciate Injuries
Partial Cranial Cruciate Injuries
One of the most valuable roles of arthroscopy has been in the early detection of partial CrCL tears. Despite feeling stable during examination, osteoarthritis rapidly ensues and complete rupture occurs weeks to months later in almost all cases. Conservative treatment with rest and NSAIDs allows progression of osteoarthritis in almost all cases. However, studies indicate that early diagnosis and tibial plateau leveling osteotomy (TPLO) can prevent over 80% of partial tears from becoming complete tears and dramatically slow the progression of arthritis.
These cases present for low grade lameness but often have palpably stable knees. Hyperextension of the joint during examination is often uncomfortable and frequently exacerbates lameness, which is often intermittent. Careful radiographic evaluation usually reveals subtle joint capsule effusion (black arrow) and eventually early osteophyte formation, especially on the poles of the patella (white arrow).
These cases present for low grade lameness but often have palpably stable knees. Hyperextension of the joint during examination is often uncomfortable and frequently exacerbates lameness, which is often intermittent. Careful radiographic evaluation usually reveals subtle joint capsule effusion (black arrow) and eventually early osteophyte formation, especially on the poles of the patella (white arrow).
-
Subtle radiographic abnormalities caused by partial cranial cruciate rupture
Subtle joint capsule distention from stifle effusion (black arrow) and early osteophyte formation on the distal pole of the patella (white arrow).
Meniscal Tears
Osteochondrosis Dessicans (OCD)