Comparative Orthopaedic Research Laboratory, and the Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, United States of America.
PLoS One. 2011;6(10):e25331. doi: 10.1371/journal.pone.0025331. Epub 2011 Oct 5.
Non-contact cranial cruciate ligament rupture (CrCLR) is an important cause of lameness in client-owned dogs and typically occurs without obvious injury. There is a high incidence of bilateral rupture at presentation or subsequent contralateral rupture in affected dogs. Although stifle synovitis increases risk of contralateral CrCLR, relatively little is known about risk factors for subsequent contralateral rupture, or whether therapeutic intervention may modify this risk.
METHODOLOGY/PRINCIPAL FINDINGS: We conducted a longitudinal study examining survival of the contralateral CrCL in client-owned dogs with unilateral CrCLR in a large baseline control population (n = 380), and a group of dogs that received disease-modifying therapy with arthroscopic lavage, intra-articular hyaluronic acid and oral doxycycline (n = 16), and were followed for one year. Follow-up in treated dogs included analysis of mobility, radiographic evaluation of stifle effusion and arthritis, and quantification of biomarkers of synovial inflammation. We found that median survival of the contralateral CrCL was 947 days. Increasing tibial plateau angle decreased contralateral ligament survival, whereas increasing age at diagnosis increased survival. Contralateral ligament survival was reduced in neutered dogs. Our disease-modifying therapy did not significantly influence contralateral ligament survival. Correlative analysis of clinical and biomarker variables with development of subsequent contralateral rupture revealed few significant results. However, increased expression of T lymphocyte-associated genes in the index unstable stifle at diagnosis was significantly related to development of subsequent non-contact contralateral CrCLR.
Subsequent contralateral CrCLR is common in client-owned dogs, with a median ligament survival time of 947 days. In this naturally occurring model of non-contact cruciate ligament rupture, cranial tibial translation is preceded by development of synovial inflammation. However, treatment with arthroscopic lavage, intra-articular hyaluronic acid and oral doxycycline does not significantly influence contralateral CrCL survival.
非接触性前十字韧带断裂（CrCLR）是导致患犬跛行的一个重要原因，通常无明显外伤。受影响的犬在就诊时或随后对侧出现双侧断裂的发生率较高。尽管膝关节滑膜炎会增加对侧 CrCLR 的风险，但对随后对侧断裂的风险因素或治疗干预是否可能改变这种风险知之甚少。
方法/主要发现：我们进行了一项纵向研究，检查了在基线对照人群（n = 380）中单侧 CrCLR 的患犬的对侧 CrCL 存活率，以及一组接受关节镜灌洗、关节内透明质酸和口服多西环素的疾病修饰治疗的犬（n = 16），并随访了一年。治疗犬的随访包括对移动性的分析、膝关节渗出液和关节炎的放射学评估以及滑膜炎症生物标志物的定量分析。我们发现对侧 CrCL 的中位存活时间为 947 天。胫骨平台角的增加降低了对侧韧带的存活，而诊断时年龄的增加则增加了存活。绝育犬的对侧韧带存活率降低。我们的疾病修饰疗法并没有显著影响对侧韧带的存活。与随后发生的非接触性对侧 CrCLR 相关的临床和生物标志物变量的相关性分析显示，很少有显著结果。然而，在诊断时不稳定膝关节中 T 淋巴细胞相关基因的表达增加与随后发生的非接触性对侧 CrCLR 显著相关。
在患犬中，随后发生的对侧 CrCLR 很常见，中位韧带存活时间为 947 天。在这种非接触性十字韧带断裂的自然发生模型中，前十字韧带的颅胫骨移位是由滑膜炎症的发展引起的。然而，关节镜灌洗、关节内透明质酸和口服多西环素的治疗并不能显著影响对侧 CrCL 的存活。
