Long-term outcome of high tibial osteotomy for canine cranial cruciate ligament disease without stifle exploration: an observational study of 236 stifles

Abstract

Objective To report the long-term outcome of canine cranial cruciate ligament disease treated with high tibial osteotomy (HTO) without arthrotomy and meniscal evaluation with the use of validated owner-reported outcome measures, report postoperative clinical management of late lameness with a meniscal-sparing approach, and compare the outcome of dogs undergoing HTO without arthrotomy with that of dogs undergoing subsequent arthrotomy and meniscectomy for late lameness. Methods A retrospective review (March 2018 to March 2022) of preoperative clinical data and postoperative short- and longterm outcome data was conducted. Late lameness was defined as acute lameness occurring after the expected normal postoperative return to function, managed with a meniscal-sparing approach. Owner-reported outcome was compared between dogs that had undergone late meniscectomy and dogs that had not undergone stifle exploration. Results There were 191 dogs (236 stifles) undergoing HTO without concurrent stifle exploration. Late lameness was recorded in 37 stifles (15.7%) at a median of 141 days (IQR, 97 to 189 days) postoperatively. Resolution of lameness was achieved in 24 stifles with meniscal-sparing nonsurgical management. The remaining 13 stifles underwent stifle arthrotomy and meniscectomy. The overall meniscectomy rate was 13 of 236 (5.5%). There was no difference between Liverpool Osteoarthritis in Dogs and Canine Orthopedic Index scores of dogs undergoing late meniscectomy and those not undergoing stifle exploration. Conclusions Long-term owner-reported outcome after HTO with a meniscal-sparing approach was not different from that after HTO and meniscectomy. Some late meniscal injuries may experience clinical resolution with nonsurgical management. Clinical Relevance Some meniscal lesions may not be clinically significant. The need for routine stifle exploration is questionable.