Vet Comp Orthop Traumatol 2022; 35(04): 263-269
DOI: 10.1055/s-0042-1748858
Original Research

Arthroscopic Caudal Cruciate Ligament Damage in Canine Stifles with Cranial Cruciate Ligament Disease

Kimberly A. Agnello
1   Department of Clinical Sciences and Advanced Medicine, University of Pennsylvania, School of Veterinary Medicine, Philadelphia, Pennsylvania, United States
Dorothy Cimino Brown
2   Elanco Animal Health, Greenfield, Indiana, United States
Samuel G. Zyla
3   Department of Biological Sciences, The State University of New York at Buffalo, Buffalo, New York, United States
Kei Hayashi
4   Department of Clinical Sciences, Cornell University, College of Veterinary Medicine, Ithaca, New York, United States
› Author Affiliations
Funding None.


Objective The aim of this study was to describe the arthroscopic changes to the caudal cruciate ligament (CdCL) in dogs with cranial cruciate ligament disease.

Study Design Arthroscopic video recordings (n = 117) of the stifle with cranial cruciate ligament disease were reviewed. The extent of CdCL tearing was described. Signalment, palpable stifle stability and the presence of a meniscal tear were recorded. Pathology of the synovial joint and the synovium overlying the CdCL were scored at two time points.

Two-way interactions were investigated (p < 0.05). Univariate analysis and a Wald test (p < 0.20) were performed. Factors were retained with a Wald test p < 0.05 or if a confounder, then a changing model coefficient >15%. A weighted kappa statistic was used to evaluate intraobserver agreement.

Results Caudal cruciate ligament tearing was identified in 94% of stifles. Longitudinal tearing (76%) was the most common type of damage (45% partial, 31% full thickness). Synovitis was present in all joints and changes to the synovium overlying the CdCL were less frequently identified (67%).

Synovitis was associated with the degree to CdCL tearing. Synovitis overlying the CdCL was associated with lower body weight and lower CdCL damage.

Conclusion Caudal cruciate ligament damage is common in dogs with cranial cruciate ligament disease and longitudinal tearing was the most common injury identified. Severity of joint pouch synovitis was positively correlated with the degree of CdCL damage and the portion of the CdCL not exposed to the synovium was unaffected. These findings suggest synovitis is likely a contributor to CdCL injury.

Authors' Contributions

K.A.A. contributed to the conception of study, study design, and data acquisition, analysis and interpretation. D.C.B. contributed to conception of study, and data analysis and interpretation. S.G.Z. contributed to the data acquisition. K.H. contributed to the conception of study, study design and data interpretation. All authors drafted, revised and approved the submitted manuscript; and are publicly accountable for relevant content.

Publication History

Received: 27 May 2021

Accepted: 04 May 2022

Article published online:
22 June 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

  • References

  • 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 Moore EV, Weeren R, Paek M. Extended long-term radiographic and functional comparison of tibial plateau leveling osteotomy vs tibial tuberosity advancement for cranial cruciate ligament rupture in the dog. Vet Surg 2020; 49 (01) 146-154
  • 3 Agnello KA, Hayashi K, Brown DC. Arthroscopic articular cartilage scores of the canine stifle joint with naturally occurring cranial cruciate ligament disease. Vet Comp Orthop Traumatol 2021; 34 (03) 153-160
  • 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 Sumner JP, Markel MD, Muir P. Caudal cruciate ligament damage in dogs with cranial cruciate ligament rupture. Vet Surg 2010; 39 (08) 936-941
  • 6 Zachos TA, Arnoczky SP, Lavagnino M, Tashman S. The effect of cranial cruciate ligament insufficiency on caudal cruciate ligament morphology: an experimental study in dogs. Vet Surg 2002; 31 (06) 596-603
  • 7 Whitney WO. Arthroscopy assisted surgery of the stifle joint. In: Beale BS, Hulse DA, Schulz KS, Whitney WO. eds. Small Animal Arthroscopy. Philadelphia: WB Saunders; 2003: 117-157
  • 8 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
  • 9 Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977; 33 (01) 159-174
  • 10 Pozzi A, Hildreth III BE, Rajala-Schultz PJ. Comparison of arthroscopy and arthrotomy for diagnosis of medial meniscal pathology: an ex vivo study. Vet Surg 2008; 37 (08) 749-755
  • 11 Plesman R, Gilbert P, Campbell J. Detection of meniscal tears by arthroscopy and arthrotomy in dogs with cranial cruciate ligament rupture: a retrospective, cohort study. Vet Comp Orthop Traumatol 2013; 26 (01) 42-46
  • 12 Forterre S, Zurbriggen A, Spreng D. In vitro effect of different mediators of apoptosis on canine cranial and caudal cruciate ligament fibroblasts and its reversibility by pancaspase inhibitor zVAD.fmk. Vet Immunol Immunopathol 2011; 139 (2-4): 264-270
  • 13 Arnoczky SP, Rubin RM, Marshall JL. Microvasculature of the cruciate ligaments and its response to injury. An experimental study in dogs. J Bone Joint Surg Am 1979; 61 (08) 1221-1229
  • 14 Heffron LE, Campbell JR. Morphology, histology and functional anatomy of the canine cranial cruciate ligament. Vet Rec 1978; 102 (13) 280-283
  • 15 Vasseur PB, Pool RR, Arnoczky SP, Lau RE. Correlative biomechanical and histologic study of the cranial cruciate ligament in dogs. Am J Vet Res 1985; 46 (09) 1842-1854
  • 16 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
  • 17 Tanegashima K, Edamura K, Ogawa T. et al. Functional anatomy of the craniolateral and caudomedial bundles of the caudal cruciate ligament in Beagle dogs. Vet Comp Orthop Traumatol 2021; 34 (05) 312-320