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Second-look arthroscopic findings after CORA-based leveling osteotomy.

Barbara Vasquez¹, Don Hulse², Brian Beale³

¹Capital Area Veterinary Specialists, Austin, Texas.

Veterinary Surgery : VS

|September 9, 2017

Summary

Related Concept Videos

Knee Joint

Knee Joint

The knee joint is the most complicated joint in the body. It consists of three articulations– two tibiofemoral and one patellofemoral. As is characteristic of synovial joints, the knee joint has a thin articular capsule that partially surrounds this joint cavity. Additionally, several ligaments, muscles, and cartilaginous structures support the movement of the knee.
A total of seven ligaments support the knee joint. The patellar ligament, which is also attached to the quadriceps femoris...

Ankle Joint

Ankle Joint

The ankle is formed by the talocrural joint (crural = leg). It consists of the articulations between the talus bone of the foot and the distal ends of the tibia and fibula of the leg. The superior aspect of the talus bone is square-shaped and has three areas of articulation. The top of the talus articulates with the inferior tibia. This is the portion of the ankle joint that carries the body weight between the leg and foot. The sides of the talus are firmly held in position by the articulations...

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CORA-based leveling osteotomy (CBLO) shows minimal articular cartilage changes at mid-to-long term follow-up. Post-surgical lameness in dogs may stem from delayed meniscal issues.

Area of Science:

Veterinary Orthopedics
Surgical Outcomes
Canine Knee Surgery

Background:

Cranial cruciate ligament (CCL) deficiency is a common cause of stifle lameness in dogs.
CORA-based leveling osteotomy (CBLO) is a surgical technique used to treat CCL deficiency.
Assessing long-term intra-articular changes after CBLO is crucial for understanding surgical outcomes.

Purpose of the Study:

To evaluate the arthroscopic appearance of stifle intra-articular structures at mid-term (9 months) and long-term (>12 months) after CBLO.
To correlate arthroscopic findings with the type of CCL deficiency treated.

Main Methods:

A case series design was employed, reviewing medical records of 41 dogs (42 stifles) that underwent second-look arthroscopy post-CBLO.
Arthroscopic images and surgical reports were analyzed to assess the integrity of menisci and articular cartilage of the femoral condyles and tibial plateaus.

Related Experiment Videos

Dogs were categorized based on the preoperative CCL status: stable partial tears, complete tears, or incompetent partial tears.

Main Results:

In dogs with stable partial CCL tears, the median time to second-look arthroscopy was 16 months, with intact CCL in 6 stifles and minimal Outerbridge scores (0-1) for femoral condyle cartilage.
The articular cartilage of the tibial plateaus appeared normal in all stifles with stable partial tears.
In dogs with complete CCL tears, the median time to second-look arthroscopy was 12 months, with normal or mildly fibrillated caudal cruciate ligaments and near-normal articular cartilage (0-2) on femoral condyles, except for one dog with a grade 4 tibial plateau lesion.

Conclusions:

CBLO surgery results in minimal to no significant changes in articular cartilage at a median follow-up of 14 months.
Postoperative clinical lameness following CBLO is frequently associated with the development of late-onset meniscal pathology rather than cartilage degeneration.