Slocum
Enterprises,
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Quality Veterinary Equipment,
Implants and Diagnostic Aids
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Meniscal Release By Theresa Devine Slocum, MS and Barclay Slocum, DVM Meniscal impingement and damage usually accompanies complete rupture of the cranial cruciate ligament in the dog. Methods of repair include partial and complete meniscectomies. A two part study of meniscal injuries was initiated. Part A In the first part of the study 300 menisci were evaluated from clinical cases for the location and amount of meniscal damage occurring from complete ruptures of the cranial cruciate ligament. The majority of the medial meniscal lesions were observed in the caudal horn of the medial meniscus, approximately 5 mm from the meniscal tibial attachment. Three discrete characteristics were found. The first was a bucket handle tear in which the cranial half of the caudal horn of the medial meniscus was cranial to the medial femoral condyle. These stifles characteristically lacked a drawer sign, and the lateral radiography usually showed a cranial translation of the tibia with respect to the femoral condyle. The second lesion identified was a repeated crush injury of the caudal horn in which fibers of the caudal horn were separated and flattened. These patients were reported to be chronically lame with a very swollen caudomedial joint capsule and resisted flexion or digital palpation directly over the injured site. Some cases had a small amount of cranial tibial translation on lateral radiographs. The third type of meniscal injury was a small cleavage located on the ventral caudal surface of the caudal horn of the medial meniscus. Part B Autopsy findings in dogs that lacked a meniscus for 5 years revealed eburnation of the cartilage in the medial compartment. A technique to prevent meniscal injury while leaving the meniscus intact in the stifle was devised. After initial study was completed on cadavers, a meniscal release of the caudal horn of the medial meniscus was performed on 100 stifles.
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With this technique the caudal horn of the medial meniscus was
incised at its lateral attachment. This procedure was performed through a
craniomedial arthrotomy, using #11 blade. The algorithm for usage of this
technique was very specific. In cases of complete rupture, a medial arthrotomy
was performed along with debridement of the CCL. If the caudal horn of the
medial meniscus projected forward due to a bucket handle tear, the bucket
portion of the meniscus was removed and the release performed. A blunt
instrument was used to push the caudal horn into the caudal joint capsule.
This
confirmed that the release was complete. Care was taken to avoid the PCL.
If the
caudal horn appeared to be intact, then a release was performed without removal
of the caudal horn. Results of a meniscal release on 100 cases demonstrated the
effectiveness of this procedure.
