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

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 long-term 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.