Radiographic and magnetic resonance imaging predicts severity of cruciate ligament fiber damage and synovitis in dogs with cranial cruciate ligament rupture.

Susannah J Sample,Peter Muir,Molly A Racette,Susan L Schaefer,Jason A Bleedorn,Eric C Hans,Kenneth R Waller,Gerianne Holzman,Nicola J Volstad,Zhengling Hao,Walter F Block,Douglas Thamm

doi:10.1371/journal.pone.0178086

Susannah J Sample, Peter Muir + Show 10 more

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https://doi.org/10.1371/journal.pone.0178086

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Abstract

Cruciate ligament rupture (CR) and associated osteoarthritis (OA) is a common condition in dogs. Dogs frequently develop a second contralateral CR. This study tested the hypothesis that the degree of stifle synovitis and cranial cruciate ligament (CrCL) matrix damage in dogs with CR is correlated with non-invasive diagnostic tests, including magnetic resonance (MR) imaging. We conducted a prospective cohort study of 29 client-owned dogs with an unstable stifle due to complete CR and stable contralateral stifle with partial CR. We evaluated correlation of stifle synovitis and CrCL fiber damage with diagnostic tests including bilateral stifle radiographs, 3.0 Tesla MR imaging, and bilateral stifle arthroscopy. Histologic grading and immunohistochemical staining for CD3+ T lymphocytes, TRAP+ activated macrophages and Factor VIII+ blood vessels in bilateral stifle synovial biopsies were also performed. Serum and synovial fluid concentrations of C-reactive protein (CRP) and carboxy-terminal telopeptide of type I collagen (ICTP), and synovial total nucleated cell count were determined. Synovitis was increased in complete CR stifles relative to partial CR stifles (P<0.0001), although total nucleated cell count in synovial fluid was increased in partial CR stifles (P<0.01). In partial CR stifles, we found that 3D Fast Spin Echo Cube CrCL signal intensity was correlated with histologic synovitis (SR = 0.50, P<0.01) and that radiographic OA was correlated with CrCL fiber damage assessed arthroscopically (SR = 0.61, P<0.001). Taken together, results of this study show that clinical diagnostic tests predict severity of stifle synovitis and cruciate ligament matrix damage in stable partial CR stifles. These data support use of client-owned dogs with unilateral complete CR and contralateral partial CR as a clinical trial model for investigation of disease-modifying therapy for partial CR.

Highlights

Cruciate ligament rupture (CR) is an important cause of stifle instability and pelvic limb lameness in dogs [1]
In partial CR stifles, we found that 3D Fast Spin Echo Cube cruciate ligament (CrCL) signal intensity was correlated with histologic synovitis (SR = 0.50, P
Two dogs had a subtle cranial drawer of the partial CR stifle with

Summary

Introduction

Cruciate ligament rupture (CR) is an important cause of stifle instability and pelvic limb lameness in dogs [1]. Bilateral CR identified at initial diagnosis or because of subsequent contralateral CR is common in affected dogs [1,5]. Rupture of both the CrCL and the CdCL is identified during surgical treatment of affected dogs. In dogs with unilateral CR, radiographic signs of synovial effusion and OA are often present in contralateral partial CR stifle joints [1]. Surgical stabilization of the stifle joint is a common treatment for dogs with CR. TPLO in partial CR stifles may help to better protect the CrCL from progressive fiber tearing and reduce disease progression [13]

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