Więzadło krzyżowe przednie u psów – dlaczego dochodzi do przerwania ciągłości i jak to naprawić?

Diagnosis

The typical anamnesis includes initial non-weight bearing lameness, clinical improvement after some weeks and clinical signs of degenerative joint disease. Stifle laxity is palpated in upright position and lateral recumbency. A positive cranial drawer sign (fig. 3, p. 42) or tibia compression test is diagnostic for CrCL rupture. Increased internal rotation and crepitus are the most common associated findings. Incomplete CrCL ruptures do not always lead to a positive drawer sign or tibia compression test. Eventually, pain in hyperextension or a slight drawer sign in flexion my be elicted. False negative joint laxity results are obtained in dogs with heavy muscle tone or severe degenerative joint disease with capsule fibrosis. In contrast, young dogs normally have some degree of stifle laxity.

Radiographs of the stifle are taken to rule other abnormalities than a CrCL rupture. Signs associated with CrCL may be joint effusion (fig. 4, p. 44), cranial displacement of the tibia, bulging of the joint capsule, calcification after meniscal or ligament injuries, and signs of degenerative joint disease. Radiographs of the entire tibia are taken to plan the surgery and to give a prognosis concerning long term outcome. Synovial fluid assessment, scintigraphy and positive contrast arthrography add little information to the diagnosis, whereas MRI is the method of choice in human knee disorders. Partial tears of the CrCL are best diagnosed with arthroscopy or explorative arthrotomy.

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