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

Vet Surg. 2006 Dec;35(8):705-10. doi: 10.1111/j.1532-950X.2006.00214.x.

Abstract

Objective: To determine and compare rates of meniscal tears after tibial plateau leveling osteotomy (TPLO) among 3 groups of dogs based on treatment method: arthrotomy with meniscal release (openR), arthrotomy without meniscal release (openNR), arthroscopy without meniscal release (scopeNR), and compare long term owner-assessed outcomes for the same groups.

Study design: Retrospective cohort study.

Sample population: Stifles (n=254) of dogs that had TPLO.

Methods: The three groups were compared for significant (P<.05) differences in rate of subsequent tears using a chi(2) test. Odds ratios for likelihood of subsequent meniscal tears were determined. Data for signalment, outcome, time to peak function, and time to subsequent tear were compared for significant differences using ANOVA, t-test, or rank sum test.

Results: Subsequent meniscal tears were diagnosed in 16 cases (6.3%). Of dogs with subsequent meniscal tears, 9 had openNR, 4 had openR, and 3 had scopeNR; the proportion of subsequent meniscal tears was significantly different (P=.035) among groups. Odds ratio indicated that subsequent meniscal tear was 3.8 times more likely to occur for openNR than openR or scopeNR. No significant differences among groups were noted for measures of outcome.

Conclusions: Meniscal release did not reduce the rate of subsequent meniscal tears when compared with cases treated arthroscopically or when compared with all cases combined, but may be advantageous when meniscal pathology cannot be comprehensively assessed in the cranial cruciate deficient stifle. Meniscal release had no effects on owner-assessed outcome as determined in this study.

Clinical relevance: The low rates of subsequent meniscal tears in conjunction with the relatively high and equivocal levels of owner-assessed outcome and time to peak function for all 3 treatment groups suggest that any of these surgical management strategies can be considered acceptable. We suggest that a meniscal release be performed when complete and thorough exploration of the joint and meniscus cannot be, or are not, performed.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Analysis of Variance
  • Animals
  • Anterior Cruciate Ligament / surgery
  • Anterior Cruciate Ligament Injuries*
  • Arthroscopy / veterinary
  • Chi-Square Distribution
  • Cohort Studies
  • Dogs
  • Female
  • Fracture Fixation, Internal / methods
  • Fracture Fixation, Internal / veterinary*
  • Likelihood Functions
  • Male
  • Menisci, Tibial / surgery*
  • Odds Ratio
  • Osteotomy / methods
  • Osteotomy / veterinary*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / veterinary
  • Retrospective Studies
  • Rupture / veterinary
  • Tibia / surgery*
  • Treatment Outcome