Unlike radiography, MRI allows visualization of the cruciate ligaments and menisci, so it may be used to detect more subtle
pathology.18,19 However, because MRI accessibility is limited, it has not been an integral part of the diagnosis for most patients with cranial
cruciate ligament pathology.
Arthroscopic assessment and treatment of the intra-articular structures of the stifle are performed at many specialty practices.
The illumination and magnification allow direct visualization of the cranial cruciate ligament and surrounding structures.20 Arthroscopic techniques for cranial cruciate ligament and medial meniscal tear débridement, medial meniscal release, and
meniscectomy have been developed.
Surgically stabilizing the stifle is indicated in most patients with cranial cruciate ligament pathology. Combinations of
small patient size, adequate locomotor function and comfort, the presence of concurrent disease, and advanced age may preclude
surgical stabilization in isolated instances. Traditionally, surgical treatments have sought to passively constrain the stifle
joint by substituting the cranial cruciate ligament with autologous tissues or synthetic materials. These techniques have
been exhaustively described elsewhere. More recently, the tibial plateau leveling osteotomy (TPLO) and tibial tuberosity advancement
procedures have been described, which render the cranial cruciate ligament unnecessary by altering the mechanical forces acting
on the stifle. The TPLO procedure is described in the next article.
Ross H. Palmer, DVM, MS, DACVS
Department of Clinical Sciences
College of Veterinary Medicine and Biomedical Science
Colorado State University
Fort Collins, CO 80523
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