Gleason Hadley E, Hudson Caleb C, Cerroni Brittany
Department of Veterinary Clinical Medicine, University of Illinois, Urbana, Illinois.
Gulf Coast Veterinary Specialists, Houston, Texas.
Vet Surg. 2020 Jan;49(1):155-159. doi: 10.1111/vsu.13293. Epub 2019 Jul 19.
To determine the predictive value of meniscal click for specific meniscal tear morphology.
Prospective cohort.
Client-owned dogs (104) with cranial cruciate ligament (CCL) deficiency treated with stifle arthroscopy (111).
All stifles underwent a standardized examination for meniscal click before anesthesia (EBA) and during anesthesia (EDA). Presence or absence of a medial meniscal tear and diagnosis of tear morphology were confirmed with arthroscopic examination.
Complete CCL tears were noted in 93 dogs, and incompetent partial tears were noted in 18 dogs. Medial meniscal tears were noted in 40.5% (55/111) of dogs, including bucket handle tears (BHT) in 65.6% (36/55) of tears. Frays of the lateral meniscus were noted in 6.3% of dogs (7/111). Examination for meniscal click before anesthesia was 38% sensitive and 94.5% specific, and EDA was 38% sensitive and 98.2% specific for all meniscal tear morphologies. Positive meniscal click at EBA was associated with a meniscal BHT but not with a meniscal non-BHT (P < .0001 and P = .3515, respectively). Positive meniscal click at EDA was associated with a meniscal BHT but not with a meniscal non-BHT (P < .0001 and P = .1909, respectively).
A meniscal click is more commonly associated with a meniscal BHT than with a non-BHT.
Meniscal tear morphology influences the presence or absence of meniscal click. Because of the high incidence of meniscal disease, this study provides evidence to support joint exploration in the treatment of CCL disease.
确定半月板弹响对特定半月板撕裂形态的预测价值。
前瞻性队列研究。
104只客户拥有的患有前交叉韧带(CCL)损伤且接受膝关节镜检查(111个膝关节)的犬。
所有膝关节在麻醉前(EBA)和麻醉期间(EDA)均接受半月板弹响的标准化检查。通过关节镜检查确认内侧半月板撕裂的存在与否以及撕裂形态的诊断。
93只犬存在完全性CCL撕裂,18只犬存在不完全性部分撕裂。40.5%(55/111)的犬存在内侧半月板撕裂,其中65.6%(36/55)的撕裂为桶柄状撕裂(BHT)。6.3%(7/111)的犬存在外侧半月板磨损。麻醉前半月板弹响检查对所有半月板撕裂形态的敏感性为38%,特异性为94.5%;EDA的敏感性为38%,特异性为98.2%。EBA时半月板弹响阳性与半月板BHT相关,但与半月板非BHT无关(分别为P <.0001和P = 0.3515)。EDA时半月板弹响阳性与半月板BHT相关,但与半月板非BHT无关(分别为P <.0001和P = 0.1909)。
半月板弹响更常与半月板BHT相关,而非与非BHT相关。
半月板撕裂形态影响半月板弹响的存在与否。由于半月板疾病的高发病率,本研究提供了支持在CCL疾病治疗中进行关节探查的证据。