In cats with cranial cruciate rupture are better long-term outcomes achieved by surgical or conservative management?

Published:

2025-04-28

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DOI

https://doi.org/10.18849/ve.v10i2.696

Abstract

Question

In cats diagnosed with isolated rupture of the cranial cruciate ligament, does surgical intervention result in improved long-term function, when compared with conservative management?

 

Clinical bottom line

The category of research question was:

Treatment.

The number and type of study designs that were critically appraised were:

One retrospective cohort study comparing surgical management and conservative management.

Critical appraisal of the selected papers meeting the inclusion criteria collectively provide zero/weak/moderate/strong evidence in terms of their experimental design and implementation:

Weak.

The outcomes reported are summarised as follows…

This study evaluated and compared the long-term Feline Musculoskeletal Pain Index (FMPI) of patients with a cranial cruciate injury (39–87 months post injury). Patients that were managed conservatively showed statistically significant (P = 0.017) lower FMPI scores long term.

In view of the strength of evidence and the outcomes from the studies the following conclusion is made…

Conservative management can be considered in cats presenting with isolated cranial cruciate rupture; however, further research is required to establish the optimum treatment in these cases. Given the limitations of this study and the current lack of evidence, clinicians must rely on their clinical judgement at this point when managing this condition until further research is available.

References

Amimoto, H., Koreeda, T., Ochi Y., Kimura, R., Akiyoshi, H., Nishida, H., Miyabayashi, T., Beale, B.S., Hayashi, K. & Wada, N. (2020). Force Plate Gait Analysis and Clinical Results after Tibial Plateau Levelling Osteotomy for Cranial Cruciate Ligament Rupture in Small Breed Dogs. Veterinary Comparative Orthopaedics and Traumatology. 33(3), 183-188. DOI: https://doi.org/10.1055/s-0039-1700990

Bergh, M.S., Sullivan C., Ferrell, C.L., Troy, J. & Budsbery, S.C. (2014). Systematic Review of Surgical Treatments for Cranial Cruciate Ligament Disease in Dogs. Journal of the American Animal Hospital Association. 50(5), 315– DOI: https://doi.org/10.5326/JAAHA-MS-6356

Boge, G.S., Engdahl, K., Moldal, E.R. & Bergström, A. (2020). Cranial cruciate ligament disease in cats: an epidemiological retrospective study in 50 cats (2011–2016). Journal of Feline Medicine and Surgery. 22(4), 277– DOI: https://doi.org/10.1177/1098612X19837436

Brioschi, V. & Arthurs, G.I. (2021). Cranial cruciate ligament rupture in small dogs (<15kg): a narrative literature review. Journal of Small Animal Practice. 62(12), 1037– DOI: https://doi.org/10.1111/jsap.13404

Comerford, E., Forster, K., Gorton, K. & Maddox, T. (2013). Management of cranial cruciate ligament rupture in small dogs: a questionnaire study. Veterinary Comparative Orthopaedics and Traumatology. 26(6), 493– DOI: https://doi.org/10.3415/VCOT-12-06-0070

Coppola, M., Das, S., Matthews, M., Cantatore, M., Silva, L., Lafuente, P., Kulendra, E., Clarke, H., McCarthy, J, Fernadez-Salesa, N., Langley-Hobbs, S., Aisa, J., Parkin, T. & Addison, E.S. (2022). Traumatic stifle injury in 72 cats: a multicentre retrospective study. Journal of Feline Medicine and Surgery. 24(6), 587– DOI: https://doi.org/10.1177/1098612X211028834

Gordon-Evans, W.J., Griffon, D.J., Bubb, C., Knap, K.M., Sullivan, M. & Evans, R.B. (2013). Comparison of lateral fabellar suture and tibial plateau leveling osteotomy techniques for treatment of dogs with cranial cruciate ligament disease. Journal of the American Veterinary Medical Association. 243(5), 675– DOI: https://doi.org/10.2460/javma.243.5.675

Griffon, D.J. (2010). A Review of the Pathogenesis of Canine Cranial Cruciate Ligament Disease as a Basis for Future Preventive Strategies. Veterinary Surgery. 39(4), 399– DOI: https://doi.org/10.1111/j.1532-950X.2010.00654.x

Harasen, G.L.G. (2005). Feline cranial cruciate rupture: 17 cases and a review of the literature. Veterinary and Comparative Orthopaedics and Traumatology. 18(4), 254– DOI: https://doi.org/10.1055/s-0038-1632963

Kwananocha, I., Akaraphutiporn, E., Upaiiputti, R., Lekchareonsuk, C. & Wangdee, C. (2024). Short-term outcomes of cranial cruciate ligament rupture treated surgically with tibial plateau leveling osteotomy or non-surgically in small-breed dogs weighing less than 10kg. The Journal of Veterinary Medical Science. 86(4), 428– DOI: https://doi.org/10.1292/jvms.23-0512

Minder, J.K., Bielecki, M.J., Scharvogel, S.S. & Meiler, D. (2016). Tibial plateau levelling osteotomy in eleven cats with cranial cruciate ligament rupture. Veterinary and Comparative Orthopaedics and Traumatology. 29(6), 528–535 DOI: https://doi.org./10.3415/VCOT-15-11-0184

Pond, M.J. & Campbell, J.R. (1972). The canine stifle joint I. Rupture of the anterior cruciate ligament. An assessment of conservative and surgical treatment. Journal of Small Animal Practice. 13(1), 1–10 DOI: https://doi.org/10.1111/j.1748-5827.1972.tb06791.x

Sen, I. (2019). Clinical and Radiological Evaluation of the Treatment of Cranial Cruciate Ligament Rupture in Cats with the Musculus Biceps Femoris Transposition Technique. Acta Veterinaria-Beograd. 69(3), 300– DOI: https://doi.org/10.2478/acve-2019-0025

Stadig, S., Lascelles, B.D.X. & Bergh, A. (2016). Do cats with a cranial cruciate ligament injury and osteoarthritis demonstrate a different gait pattern and behaviour compared to sound cats. Acta Veterinaria Scandinavica. 58(1). DOI: https://doi.org/10.1186/s13028-016-0248-x

Stadig, S., Lascelles, B.D.X., Nyman, G. & Bergh, A. (2019). Evaluation and comparison of pain questionnaires for clinical screening of osteoarthritis in cats. Veterinary Record. 185(24), 757. DOI: https://doi.org/10.1136/vr.105115

Stoneburner, R.M., Howard, J., Gurian, E.M., Jones, S.C., Karlin, W.M. & Kieves, N.R. (2022). Conservative nonsurgical treatment for cranial cruciate ligament disease can be an effective management strategy in cats based on validated owner-based subjective assessment in some cases. Journal of the American Veterinary Medical Association. 260(12), 1471– DOI: https://doi.org/10.2460/javma.22.01.0009

Taylor-Brown, F.E., Meeson, R.L., Brodbelt, D.C., Church, D.B., McGreevy, P.D., Thomson, P.C. & O’Neill, D.G. (2015). Epidemiology of Cranial Cruciate Ligament Disease Diagnosis in Dogs Attending Primary-Care Veterinary Practices in England. Veterinary Surgery. 44(6), 777–783 DOI: https://doi.org/10.1111/vsu.12349

Vasseur, P.B. (1984). Clinical Results Following Nonoperative Management for Rupture of the Cranial Cruciate Ligament in Dogs. Veterinary Surgery. 13(4), 243–246. DOI: https://doi.org/10.1111/j.1532-950X.1984.tb00801.x

Wessely, M., Reese, S. & Schnabl-Feichter, E. (2017). Aetiology and pathogenesis of cranial cruciate ligament rupture in cats by histological examination. Journal of Feline Medicine and Surgery.19(6), 631– DOI: https://doi.org/10.1177/1098612X16645142

Wucherer, K.L. Conzemius, M.G., Evans, R. & Wilke, V.L. (2013). Short-term and long-term outcomes for overweight dogs with cranial cruciate ligament rupture treated surgically or nonsurgically. Journal of the American Veterinary Medical Association. 242(10), 1364–1372. DOI: https://doi.org/10.2460/javma.242.10.1364