Meniscal click in cranial cruciate deficient stifles as a predictor of specific meniscal pathology

Authors: 
Gleason HE, Hudson CC, Cerroni B.
Vet Surg. 2019 Jul 19. doi: 10.1111/vsu.13293.

OBJECTIVE: To determine the predictive value of meniscal click for specific meniscal tear morphology.

STUDY DESIGN: Prospective cohort.

ANIMALS: Client-owned dogs (104) with cranial cruciate ligament (CCL) deficiency treated with stifle arthroscopy (111).

METHODS: All stifles underwent a standardized examination for meniscal click before anesthesia (EBA) and during anesthesia (EDA). Presence or absence of a medial meniscal tear and diagnosis of tear morphology were confirmed with arthroscopic examination.

RESULTS: Complete CCL tears were noted in 93 dogs, and incompetent partial tears were noted in 18 dogs. Medial meniscal tears were noted in 40.5% (55/111) of dogs, including bucket handle tears (BHT) in 65.6% (36/55) of tears. Frays of the lateral meniscus were noted in 6.3% of dogs (7/111). Examination for meniscal click before anesthesia was 38% sensitive and 94.5% specific, and EDA was 38% sensitive and 98.2% specific for all meniscal tear morphologies. Positive meniscal click at EBA was associated with a meniscal BHT but not with a meniscal non-BHT (P < .0001 and P = .3515, respectively). Positive meniscal click at EDA was associated with a meniscal BHT but not with a meniscal non-BHT (P < .0001 and P = .1909, respectively).

CONCLUSION: A meniscal click is more commonly associated with a meniscal BHT than with a non-BHT.

CLINICAL SIGNIFICANCE: Meniscal tear morphology influences the presence or absence of meniscal click. Because of the high incidence of meniscal disease, this study provides evidence to support joint exploration in the treatment of CCL disease.