Hypothesis 2 Š Trauma

Possible trauma occurred to TitanÕs right stifle joint when she fell off the bed 
approximately one year ago.  At that time, the cranial cruciate ligament was ruptured, 
resulting in the weight-bearing lameness the owner noticed over the course of the 
following month.  This is evidenced by the medial buttressing found upon physical exam.  
(Medial buttressing is almost pathonomonic for the cranial drawer sign.)  Over time, the 
medial and lateral collateral ligaments hypertrophied and strengthened to support the 
joint, essentially taking over for the cranial cruciate ligament.  This resulted in the 
resolution of the right hind limb lameness.
During the past year, the left stifle joint has been compensating for the cranial cruciate 
rupture.  The pain associated with the left stifle joint found on physical exam suggests 
that the left cranial cruciate ligament might be ruptured as well.  This could be due to the 
compensation for the right stifle joint or another incident of trauma as Titan does play 
frequently with the other dog in the household.
At this point, both stifle joints are damaged.  Therefore, we see reoccurrence of the right 
hind leg lameness because the left hind leg is no longer able to compensate for the right 
leg.  This is evidenced by the grade III/IV intermittent non-weight bearing lameness 
found on physical exam.