Canine Distal Hindlimb

What is another word for the knee joint?

stifle joint

What is the stifle (knee) joint between?

femur & tibia

What does the stifle (knee) joint primarily move in?

flexion & extension

What is the most commonly affected joint for lameness in dogs?

stifle (knee) joint

Give 4 examples of problems you can see in the stifle (knee) joint in dogs

• lameness

• cranial cruciate disease

• meniscal injury

• patella luxation

1

femur

2

femoral condyles

3

lateral meniscus

4

medial meniscus

5

tibial plateau

6

tibia

What are menisci?

crescent shaped fibrocartilage pads

What is the role of menisci?

• provide shock absorption

• reduce friction

What is the medial meniscus anchored to?

tibia

What is the lateral meniscus anchored to?

tibia and femur

Which meniscus is less likely to be damaged?

lateral meniscus

Why is the lateral meniscus less likely to be damaged?

has extra attachment (to femur)

1

cranial tibial ligaments of the medial and lateral menisci

2

cranial cruciate 

3

medial meniscus

4

medial collateral

5

caudal cruciate 

6

meniscotibial ligament

7

meniscofemoral ligament

8

lateral collateral

9

lateral meniscus 

What are the names for the 2 cruciate ligaments?

cranial and caudal cruciate ligament

Where does the cranial cruciate ligament insert?

cranial tibia

Where does the caudal cruciate ligament insert?

caudal tibia

What is the role of the cruciate ligaments?

prevent cranial and caudal translation of the tibia relative to the femur

15

caudal cruciate ligament 

16

cranial cruciate ligament 

What’s the most common cause of stifle lameness?

cranial cruciate ligament rupture

What is the cause of cranial cruciate ligament rupture?

• degenerative changes to ligament

• genetic causes (rarely purely traumatic)

What does cranial cruciate ligament rupture allow?

cranial translation of tibia across femur

Why is medial meniscal injury associated with CrCL rupture?

MM closely attached to tibia & doesn’t move with femur - damaged

Which meniscus injury is associated with CrCL ligament?

medial meniscus

What do these images show?

proximal tibial articular surface has backward slope

What are 1,2,3 & 4 showing?

1. weight-bearing force

2. caudally sloping tibial plateau

3. cranial tibial translation force

4. intact CrCL resists tibial translation

What does this image show?

cranial drawer test

What structures support the knee cranially?

patellar tendon & ligament

Which structures support either side of the knee joint?

medial and lateral collateral ligaments

11

medial collateral ligament

13

lateral collateral ligament 

1

quadriceps femoris muscles

2

femoropatellar ligament 

3

patellar tendon/ligament 

4

tibial tuberosity

What type of patellar ligament does the horse have?

tripartite patellar ligament

What does the patella do to limit stifle flexion while resting?

locks

What is the patella part of in horses?

passive stay apparatus

What can the patella cause in horses if ‘stuck’ in upward fixation?

lameness

1

quadriceps femoris

2

medial patellar ligament

3

intermediate patellar ligament

4

lateral patellar ligament

1

lateral, intermediate & medial patellar ligaments

2

cranial & caudal cruciate ligaments

3

medial meniscus

1

patella articular surface 

2

patella fibrocartilage

3

medial patella ligament 

4

lateral & intermediate patella ligament

What do the red X show?

injection point 

What are the 3 articulation points between the bones in the stifle?

• femoropatellar (FP)

• lateral femorotibial (LFT)

• medial femorotibial (MFT)

What do the 3 articulation points between bones in the stifle joint each have?

synovial capsule

Are all the stifle synovial capsules continuous in the dog?

YES

Are all the stifle synovial capsules continuous in the horse?

FT & MFT usually communicate, LFT separate

In dogs, why would you palpate the long digital extensor tendon?

effusion & joint puncture lateral or medial to patellar tendon

What is the main effect of biceps femoris on the stifle?

flexion

What does biceps femoris have insertion with?

calcaneal tendon

Where is the origin of semitendinosus?

between biceps femoris and semimembranosus

What does semitendinosus have a second smaller insertion with?

calcaneal tendon

Which hamstring muscle is the largest and most lateral muscle?

biceps femoris

Which hamstring is most medial?

semimembranosus

Which hamstring doesn’t have an insertion on calcaneus?

semimembranosus

What nerve innervates the hamstrings?

sciatic nerve

1

biceps femoris

2

semitendinosus

3

semimembranosus

4

calcaneal tendon insertion

What do equine hamstrings have additional of?

vertebral heads

Can you palpate the tuber ischii in the horse?

NO

Can you palpate the tuber ischii in the cow?

YES

1

tensor fascia lata

2

superficial gluteal

3

semimembranosus

4

semitendinosus

5

biceps femoris

6

vastus lateralis

1

gastrocnemius

2

superficial digital flexor (SDF)

3

popliteus

What nerve innervates the minor stifle flexors (gastrocnemius, SDF & popliteus)?

tibial nerve

What are the roles of gastrocnemius?

• primarily hock extensor

• minor stifle flexor 

What are the roles of the superficial digital flexor (SDF)?

• primary hock extensor/digit flexor

• minor stifle flexor 

What are the roles of popliteus?

• stifle flexor

• internal rotator of lower limb

• internally rotates/pronates tibia

Name the 4 bellies of the quadriceps

• rectus femoris

• vastus lateralis

• vastus intermedius

• vastus medialis 

Where does rectus femoris originate?

ventral ilium

Where do vastus lateralis, intermedius & medialis originate?

cranioproximal femur