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To inspect or not inspect the meniscus: doest it make a difference for the outcome ?
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Meniscal injuries are a common concurrent finding in canine stifles with CCL disease. These injuries are a common cause of pain and joint dysfunction in dogs and have been reported to cause osteoarthritis and lameness. Undiagnosed meniscal damage during initial CCL repair has been published as a cause for persistent lameness and revision surgery. Diagnosing and treating meniscal lesion has been found to lower the incidence of postliminary meniscal tears and improve the rate of successful long-term clinical outcome.
Historically all meniscal tears have been assumed to be clinically significant in the dog. Nevertheless, the relative contribution of meniscal damage to the lameness of dogs with CCL rupture and the way in which lesion evolves have never been studied in dogs (McCready and Ness JSAP 2016). Whether certain meniscal tears conserve a level of function or directly impact a patient’s symptom is largely unknown.
Medial meniscal lesions were simulated in a cadaveric study (Thieman and coll Vet Surg 2009) performed on normal stable stifles. The results suggest that radial and vertical longitudinal tears of the medial meniscus had a minimal impact of the contact pressures of the medial compartment of the stifle allowing consideration of non surgical treatment. Conversely, non-reducible bucket handle, flap and complex medial meniscal tears cause a significant increase in peak contact pressure. The presence of a bucket handle tear of the medial meniscus was not associated with more severe arthroscopic articular cartilage lesions in the medial joint compartment at the time of surgery (Kaufman et al Vet Surg 2017). It is possible that a non displaced bucket handle tear provides some degree of mechanical support to the medial femorotibial joint. [...]
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