Laurie's Blogs.

In today's blog, I wanted to share one of the research reviews from the latest edition of FourLeg News:

Apparently, cadaveric studies have shown arthroscopy to be more sensitive than arthrotomy in detecting meniscal tears.  This study compared detection rates in clinical cases. The authors hypothesizing that arthroscopy would detect more meniscal injuries than arthrotomy.

Methodology

This was a retrospective cohort study on 531 stifles (430 dogs) with naturally occurring cranial cruciate ligament ruptures.  Intra articular structures were examined by either arthroscopy or medial parapatellar arthrotomy.

What did they find?

Arthroscopic procedures were performed in 58.8% of cases and arthrotomy in 41.2%.  Of stifles examine, 44% were found to have meniscal tears.  Of those examined by arthrotomy, 38.8% had meniscal tears compared to 48.4% of those examined arthroscopically.

Results were analyzed, and there was a significant difference found between the two groups.  Meniscal tears were found more frequently by arthroscopy than arthrotomy.  The results suggest that arthroscopy may miss fewer meniscal tears than arthrotomy.

Relevance to Rehab

Well, this is rather interesting, because we know that a certain percentage of post-operative cruciate reconstructive cases go on to develop meniscal tears.  Perhaps a few of those are ‘missed’ meniscal tears from the time of surgery.  So clinically, if you have a case that seems to look like a meniscal tear (tippy-toe walking, failure to make timely significant improvements in use and muscle girth, then perhaps this study needs to be in the back of your mind.  And… If you suspect a meniscal tear, try conservative management first (modalities and manual therapy – distraction mobilization), but be prepared to refer back for a second surgical consult.

Plesman RL, Gilbert PJ, Campbell J.  Comparison of the detection of meniscal tears by arthroscopy and arthrotomy in dogs with cranial cruciate ligament ruptures: a retrospective, cohort study.  Proceeding of the European College of Veterinary Surgeons Annual Scientific Meeting. July 4–6, 2013.  Rome, Italy