Ultrasound and Elastosonographic Features of the Patellar Ligament in Dogs Affected by Cranial Cruciate Ligament Disease

Simple Summary In patients suffering from cranial cruciate ligament disease, the patellar ligament is loaded aphysiologically, resulting in increased stress. To date, however, there have been no studies describing the establishment of anatomical or functional damage to this ligament after cranial cruciate ligament disease. This study aims to evaluate the appearance of the patellar ligament using ultrasound and elastosonography in dogs affected by disease of the cranial cruciate ligament but not yet treated in order to understand whether signs of thickening and a reduction in elasticity increase over time between the day of ligament disease onset and the day of diagnosis and therefore persist before being treated with the surgical procedure of tibial plateau leveling osteotomy or tibial tuberosity advancement. The results suggest that as the time increases between the onset of cranial cruciate ligament disease and diagnosis and treatment, the patellar ligament progressively thickens and has a tendency to lose its elasticity.Abstract This study aims to evaluate the morpho-functional change in the patellar ligament in dogs with cranial cruciate ligament disease. We hypothesized that it may show increased thickening and stiffness with increasing days from onset to diagnosis instead of trauma. Understanding this aspect has implications for the choice of timing for treating patients suffering from cranial cruciate ligament disease, as well as the contextualization of patellar ligament desmitis pictures after surgical treatment with tibial plateau leveling osteotomy or tibial tuberosity advancement. Thirty-three dogs affected by unilateral cranial cruciate disease were examined and divided into three groups based on the time elapsed from the onset of lameness to diagnosis: Group 1 (1-15 days), Group 2 (16-60 days), and Group 3 (over 60 days). Conventional B-mode ultrasonographic and elastosonographic examinations of the patellar ligament were performed without sedation for each dog. Upon ultrasonographic examination, all dogs showed modification in the echostructure of the patellar ligament. In addition, the patellar ligament tended to become harder with increasing days after disease, although there were no significant differences between groups. Our results show that as the time increases between the onset of cranial cruciate ligament disease and diagnosis and treatment, the patellar ligament progressively thickens and loses its elasticity.