Abstract
Measurement of fore and pelvic limb alignment in veterinary orthopedics is significant, as it is in human medicine. The establishment of reference ranges for alignments and comparing measured ranges in diseased animals to these reference values would allow veterinarians to specify the quantitative degree of an angular deformity, plan suitable treatments and evaluate treatment outcomes. Patellar luxation is a common orthopedic disease in small animal clinics. Severe grades of MPL may present with bone deformities or abnormal alignments; therefore, evaluation of the measurement methods of femoral and tibial alignment in dogs with different grades of patellar luxation to assess the accuracy and reliability of the measurements could be useful. In this retrospective study radiographs of 21 client-owned Chihuahuas that had been presented to the Small Animal Surgery of Vetmeduni Vienna from 2012–2016 with a diagnose of patellar luxation were selected. The measurements were performed on frontal, lateral and axial view radiographs to determine the femoral and tibial angles and to evaluate the intra- and inter-observer variabilities of the protocol. Radiographs of each dog were investigated by three observers. Intra-observer variability was based on measurements by each observer who repeated the protocol two times to evaluate repeatability. Inter-observer variability was based on the measurements between the three observers to evaluate the reproducibility of the protocol. The results of the study showed that 92.85% of inter-observer ICC (intra-class correlation coefficient) had high correlation, and the remaining 7.15% had good correlation. Intra-observer ICCs for measurements of the first observer were 28.57% high correlation and 50% good correlation. For the second observer, 100% high correlation was recorded, and for the third observer 71.42% high correlation and 14.28% good correlation was recorded. These results show that the selected methods have high correlation and could be used as a reliable method in veterinary orthopedics.
Highlights
Patellar luxation is one of the most prevalent orthopedic diseases in canines, with congenital pathogenesis that can develop at a young age and may be unilateral or bilateral [1,2,3]
The post-operative re-luxation rate for patellar luxation is reported to be from 8% to 48%, and the re-luxation rate is more frequent in large breed dogs than in small breeds [6,7,8]
In the present study our aims were (1) to evaluate the intra- and inter-observer variability of the protocols developed for measurement of femoral and tibial alignment in Chihuahuas with patellar luxation, (2) to report the measured values for different grades of MPL in Chihuahuas and (3) to investigate the proportion of variance of the observer and dog in this study
Summary
Patellar luxation is one of the most prevalent orthopedic diseases in canines, with congenital pathogenesis that can develop at a young age and may be unilateral or bilateral [1,2,3]. The main underlying cause of MPL is not completely clear, but derangement of the normal anatomic structure of the hindlimb, including coxa vara, genu varum, retroversion of the femoral head and neck, distal femoral varus, superficial trochlear groove, hypoplastic medial condyles, medial torsion of the tibia, proximal tibial valgus, and medial displacement of the tibial tuberosity, have been reported as the most important predisposing factors [1,2,5] These malalignments cause alteration of the normal function of the quadriceps muscle and increase the force on the patella in the medial direction. The post-operative re-luxation rate for patellar luxation is reported to be from 8% to 48%, and the re-luxation rate is more frequent in large breed dogs than in small breeds [6,7,8]
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