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Arthroscopic Articular Cartilage Scores of the Canine Stifle Joint with Naturally Occurring Cranial Cruciate Ligament Disease
Objective This study aimed to evaluate frequency, location and severity of cartilage pathology in dogs with naturally occurring cranial cruciate ligament (CCL) disease.
Study Design Stifle arthroscopic video recordings (n = 120) were reviewed. A modified Outerbridge classification system (MOCS) (0–4) was used to score cartilage at 10 locations in the femorotibial (medial and lateral femoral condyles and tibial plateaus) and patellofemoral compartments (proximal, middle and distal locations of the patella and femoral trochlear groove) of the stifle joint. Synovial pathology was scored and the presence of a medial meniscal tear was recorded. A Kruskal–Wallis test was used to evaluate association of location and synovitis with cartilage score; and presence of meniscal tear with cartilage and synovitis scores. Bonferroni correction was utilized and p < 0.05 was considered significant.
Results Cartilage pathology and synovitis were identified in all joints. Overall cartilage severity scores were low (median MOCS 1). The median MOCS of the proximal trochlear groove (2) was significantly higher than all other locations evaluated. Higher synovitis scores were significantly associated with higher cartilage severity scores and a medial meniscal tear had no association with cartilage severity scores or synovitis.
Conclusion Arthroscopic articular cartilage lesions are common in dogs with CCL disease at the time of surgical intervention, although the severity of cartilage damage is mild. The proximal trochlear groove of the femur had the most severe cartilage score in the stifle joint.
K.A. contributed to the conception of study, study design, acquisition of data and data analysis and interpretation. K.H. contributed to the conception of study, study design and data analysis and interpretation. D.B. contributed to conception of study, and data analysis and interpretation. All authors drafted, revised and approved the submitted. They are publically accountable for relevant content.
Received: 17 April 2020
Accepted: 14 September 2020
03 November 2020 (online)
© 2020. Thieme. All rights reserved.
Georg Thieme Verlag KG
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- 1 Johnson JA, Ausin C, Breur GJ. Incidence of canine appendicular musculoskeletal disorders in 16 veterinary teaching hospital from 1980 to 1989. Vet Comp Orthop Traumatol 1994; 7: 56-59
- 2 Innes JF, Bacon D, Lynch C, Pollard A. Long-term outcome of surgery for dogs with cranial cruciate ligament deficiency. Vet Rec 2000; 147 (12) 325-328
- 3 Elkins AD, Pechman R, Kearney MT. et al. A retrospective study evaluating the degree of degenerative joint disease in the stifle joints of dogs following surgical repair of anterior cruciate ligament. J Am Anim Hosp Assoc 1991; 27: 533-540
- 4 Halder N. Why does the patient with OA hurt?. In: Brandt KD, Doherty L, Lohmander S. eds. Osteoarthritis. 2nd edition. New York: Oxford University Press; 1998: 255-261
- 5 Au KK, Gordon-Evans WJ, Dunning D. et al. Comparison of short- and long-term function and radiographic osteoarthrosis in dogs after postoperative physical rehabilitation and tibial plateau leveling osteotomy or lateral fabellar suture stabilization. Vet Surg 2010; 39 (02) 173-180
- 6 Hulse D, Beale B, Kerwin S. Second look arthroscopic findings after tibial plateau leveling osteotomy. Vet Surg 2010; 39 (03) 350-354
- 7 Gong X, Jiang D, Wang YJ, Wang J, Ao YF, Yu JK. Second-look arthroscopic evaluation of chondral lesions after isolated anterior cruciate ligament reconstruction: single- versus double-bundle reconstruction. Am J Sports Med 2013; 41 (10) 2362-2367
- 8 Struewer J, Frangen TM, Ishaque B. et al. Knee function and prevalence of osteoarthritis after isolated anterior cruciate ligament reconstruction using bone-patellar tendon-bone graft: long-term follow-up. Int Orthop 2012; 36 (01) 171-177
- 9 Innes JF, Costello M, Barr FJ, Rudorf H, Barr AR. Radiographic progression of osteoarthritis of the canine stifle joint: a prospective study. Vet Radiol Ultrasound 2004; 45 (02) 143-148
- 10 Vasquez B, Hulse D, Beale B, Kerwin S, Andrews C, Saunders BW. Second-look arthroscopic findings after CORA-based leveling osteotomy. Vet Surg 2018; 47 (02) 261-266
- 11 Kaufman K, Beale BS, Thames HD, Saunders WB. Articular cartilage scores in cranial cruciate ligament-deficient dogs with or without bucket handle tears of the medial meniscus. Vet Surg 2017; 46 (01) 120-129
- 12 Agnello KA, Holsworth IG, Caceres AV. et al. Articular cartilage lesions of the patellofemoral joint in dogs with naturally occurring cranial cruciate ligament disease. Vet Surg 2014; 43 (03) 308-315
- 13 Thompson J, Harris M, Grana WA. Patellofemoral pain and functional outcome after anterior cruciate ligament reconstruction: an analysis of the literature. Am J Orthop 2005; 34 (08) 396-399
- 14 Järvelä T, Paakkala T, Kannus P, Järvinen M. The incidence of patellofemoral osteoarthritis and associated findings 7 years after anterior cruciate ligament reconstruction with a bone-patellar tendon-bone autograft. Am J Sports Med 2001; 29 (01) 18-24
- 15 Nakamae A, Adachi N, Deie M. et al. Risk factors for progression of articular cartilage damage after anatomical anterior cruciate ligament reconstruction: a second-look arthroscopic evaluation. Bone Joint J 2018; 100-B (03) 285-293
- 16 Cohen M, Amaro JT, Ejnisman B. et al. Anterior cruciate ligament reconstruction after 10 to 15 years: association between meniscectomy and osteoarthrosis. Arthroscopy 2007; 23 (06) 629-634
- 17 Wang HJ, Ao YF, Chen LX. et al. Second-look arthroscopic evaluation of the articular cartilage after primary single-bundle and double-bundle anterior cruciate ligament reconstructions. Chin Med J (Engl) 2011; 124 (21) 3551-3555
- 18 Outerbridge RE. The etiology of chondromalacia patellae. J Bone Joint Surg Br 1961; 43-B: 752-757
- 19 Cook JL, Kuroki K, Visco D, Pelletier JP, Schulz L, Lafeber FP. The OARSI histopathology initiative - recommendations for histological assessments of osteoarthritis in the dog. Osteoarthritis Cartilage 2010; 18 (Suppl. 03) S66-S79
- 20 Deweese MD, Brown DC, Hayashi K. et al. Observer variability of arthroscopic cartilage grading using the modified Outerbridge classification system in the dog. Vet Comp Orthop Traumatol 2019; 32 (02) 126-132
- 21 Muir P, Kelly JL, Marvel SJ. et al. Lymphocyte populations in joint tissues from dogs with inflammatory stifle arthritis and associated degenerative cranial cruciate ligament rupture. Vet Surg 2011; 40 (06) 753-761
- 22 Griffin TM, Guilak F. The role of mechanical loading in the onset and progression of osteoarthritis. Exerc Sport Sci Rev 2005; 33 (04) 195-200
- 23 Andriacchi TP, Mündermann A, Smith RL, Alexander EJ, Dyrby CO, Koo S. A framework for the in vivo pathomechanics of osteoarthritis at the knee. Ann Biomed Eng 2004; 32 (03) 447-457
- 24 Kim SE, Pozzi A, Banks SA, Conrad BP, Lewis DD. Effect of tibial plateau leveling osteotomy on femorotibial contact mechanics and stifle kinematics. Vet Surg 2009; 38 (01) 23-32
- 25 Guerrero TG, Pozzi A, Dunbar N. et al. Effect of tibial tuberosity advancement on the contact mechanics and the alignment of the patellofemoral and femorotibial joints. Vet Surg 2011; 40 (07) 839-848
- 26 Pozzi A, Kim SE, Conrad BP, Horodyski M, Banks SA. Ex vivo pathomechanics of the canine Pond-Nuki model. PLoS One 2013; 8 (12) e81383 DOI: 10.1371/journal.pone.0081383.
- 27 Smith GN, Mickler EA, Albrecht ME, Myers SL, Brandt KD. Severity of medial meniscus damage in the canine knee after anterior cruciate ligament transection. Osteoarthritis Cartilage 2002; 10 (04) 321-326
- 28 Kim SE, Zann GJ, Tinga S, Moore EJ, Pozzi A, Banks SA. Patellofemoral kinematics in dogs with cranial cruciate ligament insufficiency: an in-vivo fluoroscopic analysis during walking. BMC Vet Res 2017; 13 (01) 250 DOI: 10.1186/s12917-017-1186-1.
- 29 Moore EJ, Kim SE, Banks SA, Pozzi A, Coggeshall JD, Jones SC. Normal patellofemoral kinematic patterns during daily activities in dogs. BMC Vet Res 2016; 12 (01) 262 DOI: 10.1186/s12917-016-0889-z.
- 30 Neuman P, Kostogiannis I, Fridén T, Roos H, Dahlberg LE, Englund M. Patellofemoral osteoarthritis 15 years after anterior cruciate ligament injury--a prospective cohort study. Osteoarthritis Cartilage 2009; 17 (03) 284-290
- 31 Culvenor AG, Crossley KM. Patellofemoral osteoarthritis: are we missing an important source of symptoms after anterior cruciate ligament reconstruction?. J Orthop Sports Phys Ther 2016; 46 (04) 232-234
- 32 Culvenor AG, Cook JL, Collins NJ, Crossley KM. Is patellofemoral joint osteoarthritis an under-recognised outcome of anterior cruciate ligament reconstruction? A narrative literature review. Br J Sports Med 2013; 47 (02) 66-70
- 33 Culvenor AG, Lai CC, Gabbe BJ. et al. Patellofemoral osteoarthritis is prevalent and associated with worse symptoms and function after hamstring tendon autograft ACL reconstruction. Br J Sports Med 2014; 48 (06) 435-439
- 34 Voss K, Damur DM, Guerrero T, Haessig M, Montavon PM. Force plate gait analysis to assess limb function after tibial tuberosity advancement in dogs with cranial cruciate ligament disease. Vet Comp Orthop Traumatol 2008; 21 (03) 243-249
- 35 Pozzi A, Dunbar NJ, Kim SE. Effect of tibial plateau leveling osteotomy on patellofemoral alignment: a study using canine cadavers. Vet J 2013; 198 (01) 98-102
- 36 Zann GJ, Kim SE, Tinga S, Pozzi A, Banks SA. The effect of tibial plateau leveling osteotomy on patellofemoral kinematics in dogs: an in vivo study. Vet Surg 2020; 49 (01) 207-213
- 37 Bleedorn JA, Greuel EN, Manley PA. et al. Synovitis in dogs with stable stifle joints and incipient cranial cruciate ligament rupture: a cross-sectional study. Vet Surg 2011; 40 (05) 531-543
- 38 Hill CL, Hunter DJ, Niu J. et al. Synovitis detected on magnetic resonance imaging and its relation to pain and cartilage loss in knee osteoarthritis. Ann Rheum Dis 2007; 66 (12) 1599-1603
- 39 Scanzello CR, Goldring SR. The role of synovitis in osteoarthritis pathogenesis. Bone 2012; 51 (02) 249-257
- 40 Ayral X, Pickering EH, Woodworth TG, Mackillop N, Dougados M. Synovitis: a potential predictive factor of structural progression of medial tibiofemoral knee osteoarthritis -- results of a 1 year longitudinal arthroscopic study in 422 patients. Osteoarthritis Cartilage 2005; 13 (05) 361-367