DOI
https://doi.org/10.18849/ve.v5i4.339Abstract
PICO question
In adult dogs with naturally occurring medial meniscal tears concurrent to cranial cruciate ligament disease does meniscal release confer the same benefits in lameness resolution as meniscectomy?
Clinical bottom line
Category of research question
Treatment
The number and type of study designs reviewed
A single prospective cross-sectional study was reviewed, that fulfilled the criteria
Strength of evidence
None
Outcomes reported
Meniscal release, meniscectomy (partial, hemi- or complete), or the two combined performed for concurrent medial meniscal pathology at time of surgery for naturally occurring cranial cruciate ligament (CCL) rupture resulted in an acceptable long-term outcome. Difference in outcome between the techniques was not reported
Conclusion
There is no evidence that meniscal release provides an equal or superior treatment option for medial meniscal injury treated at the time of surgery for CCL rupture when compared to meniscectomy. The study critically reviewed performed meniscal release via radial transection through the meniscotibial ligament, and therefore does not represent mid-body abaxial radial release. Neither is this summary appropriate for considering prophylactic meniscal release of the normal meniscus. In addition, the surgical treatments for cranial cruciate ligament rupture were either ‘Tightrope’ or tibial plateau levelling osteotomy (TPLO) procedures. Further studies are required to compare clinical outcome between meniscal release or meniscectomy for treatment of concurrent meniscal tears
How to apply this evidence in practice
The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.
Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.
References
Aragon, C. and Budsberg, S. (2005). Applications of evidence-based medicine: cranial cruciate ligament injury repair in the dog. Veterinary Surgery. 34, 93–8. DOI: http://dx.doi.org/10.1111/j.1532-950X.2005.00016.x
Austin, B., Montgomery, R.D., Wright, J., Bellah, J.R. and Tonks, C. (2007). Evaluation of three approaches to meniscal release. Veterinary and Comparative Orthopaedics and Traumatology. 20(2), 92–97. DOI: http://dx.doi.org/10.1160/vcot-06-04-0033
Cook, J.L., Evans, R., Conzemius, M.G., Lascelles, B.D.X., McIlwraith, C.W., Pozzi, A., Clegg, P., Innes, J., Schulz, K., Houlton, J., Fortier, L., Cross, A.R., Hayashi, K., Kapatkin, A., Brown, D.C. and Stewart, A. (2010). Proposed Definitions and Criteria for Reporting Time Frame, Outcome, and Complications For Clinical Orthopedic Studies in Veterinary Medicine. Veterinary Surgery. 39, 905–908. DOI: https://doi.org/10.1111/j.1532-950X.2010.00763.x
Cook, J.L. and Pozzi, A. (2010). Surgical treatment of concurrent meniscal injury. In: Muir, P. ed., Advances in The Canine Cranial Cruciate Ligament 1st Edition. Wiley-Blackwell, 217–222.
Dean, R. (2013). How to read a paper and appraise the evidence. In Practice. 35, 282–285. DOI: http://dx.doi.org/10.1136/inp.f1760
Fitzpatrick, N. and Solano, M.A. (2010). Predictive Variables for Complications after TPLO with Stifle Inspection by Arthrotomy in 1000 Consecutive Dogs. Veterinary Surgery. 39, 460–474. DOI: https://doi.org/10.1111/j.1532-950X.2010.00663.x
McColl, E., Jacoby, A., Thomas, L., Soutter, J., Bamford, C., Steen, N., Thomas, R., Harvey, E., Garratt, A. and Bond, J. (2002). Design and use of questionnaires: a review of best practice applicable to surveys of health service staff and patients. Health Technology Assessment. 5(31). DOI: https://doi.org/10.3310/hta5310
McCready, D.J. and Ness, M.G. (2016a). Diagnosis and management of meniscal injury in dogs with cranial cruciate ligament rupture: a systematic literature review. Journal of Small Animal Practice. 57(2), 59–66. DOI: https://doi.org/10.1111/jsap.12433
McCready, D.J. and Ness, M.G. (2016b). Systematic review of the prevalence, risk factors, diagnosis and management of meniscal injury in dogs: Part 2. Journal of Small Animal Practice. 57(4), 194–204. DOI: https://doi.org/10.1111/jsap.12462
Muller, C., Gaines, B., Gruen, M., Case, B., Arrufat, K., Innes, J. and Lascelles, B.D.X. (2016). Evaluation of Clinical Metrology Instrument in Dogs with Osteoarthritis. Journal of Veterinary Internal Medicine. 30(3), 836–846. DOI: https://doi.org/10.1111/jvim.13923
Plesman, R., Gilbert, P. and Campbell, J. (2013). Detection of meniscal tears by arthroscopy and arthrotomy in dogs with cranial cruciate ligament rupture: a retrospective, cohort study. Veterinary and Comparative Orthopaedics and Traumatology. 26(1), 42–46. DOI: http://dx.doi.org/10.3415/VCOT-11-10-0153
Pozzi, A., Hildreth, B.E. and Rajala‐Schultz, P.J. (2008a). Comparison of Arthroscopy and Arthrotomy for Diagnosis of Medial Meniscal Pathology: An Ex Vivo Study. Veterinary Surgery. 37, 749–755. DOI: https://dx.doi.org/10.1111/j.1532-950x.2008.00442.x
Pozzi, A., Litsky, A.S., Field, J., Apelt, D., Meadows, C. and Johnson, K.A. (2008b). Pressure distributions on the medial tibial plateau after medial meniscal surgery and tibial plateau levelling osteotomy in dogs. Veterinary and Comparative Orthopaedics and Traumatology. 21, 8–14. DOI: https://doi.org/10.3415/VCOT-06-12-0099
Pozzi, A., Kim, S. E. and Lewis, D.D. (2010a). Effect of transection of the caudal menisco-tibial ligament on medial femorotibial contact mechanics. Veterinary Surgery. 39, 489–495. DOI: https://doi.org/10.1111/j.1532-950X.2010.00662.x
Pozzi, A., Tonks, C.A. and Ling, H.Y. (2010b). Femorotibial contact mechanics and meniscal strain after serial meniscectomy. Veterinary Surgery. 39, 482–488. DOI: https://doi.org/10.1111/j.1532-950X.2010.00668.x
Rovesti, G.L., Devesa, V., Bertorelli, L. and Rodriguez-Quiros, J. (2018). Facilitation of arthroscopic visualization and treatment of meniscal tears using a stifle joint distractor in the dog. BMC Veterinary Research. 14(1), 212. DOI: https://doi.org/10.1186/s12917-018-1534-9
Ritzo, M.E., Ritzo, B.A., Siddens, A.D., Summerlott, S. and Cook, J.L. (2014). Incidence and type of meniscal injury and associated long‐term clinical outcomes in dogs treated surgically for cranial cruciate ligament disease. Veterinary Surgery. 43(8), 952–958. DOI: https://doi.org/10.1111/j.1532-950X.2014.12220.x
Thieman, K.M., Tomlinson, J.L., Fox, D.B., Cook, C. and Cook, J.L. (2006). Effect of Meniscal Release on Rate of Subsequent Meniscal Tears and Owner‐Assessed Outcome in Dogs with Cruciate Disease Treated with Tibial Plateau Leveling Osteotomy. Veterinary Surgery. 35, 705–710. DOI: https://doi.org/10.1111/j.1532-950X.2006.00214.x
Thieman, K.M., Pozzi, A., Ling, H.‐Y. and Lewis, D. (2010). Comparison of Contact Mechanics of Three Meniscal Repair Techniques and Partial Meniscectomy in Cadaveric Dog Stifles. Veterinary Surgery. 39, 355–362. DOI: https://doi.org/10.1111/j.1532-950X.2010.00661.x
Wilke, V.L, Robinson, D.A., Evans, R.B., Rothschild, M.F. and Conzemius, M.G. (2005). Estimate of the annual economic impact of treatment of cranial cruciate ligament injury in dogs in the United States. Journal of the American Veterinary Medication Association. 227, 1604–1607. DOI: https://doi.org/10.2460/javma.2005.227.1604
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