Radiographic and ultrasonographic changes of the patellar ligament following tibial tuberosity advancement in 25 dogs

Abstract

Patellar ligament thickening is a recognized response following osteotomy of the proximal tibia as a treatment for cranial cruciate disease. In humans this is seen as a response to increased loading, but the reason for this thickening in dogs is unclear. A prospective study was undertaken to assess the degree and frequency of patellar ligament desmopathy in 25 consecutive cases undergoing tibial tuberosity advancement (TTA). To determine the incidence of patellar ligament thickening following TTA. Consecutive cases undergoing TTA had ultrasonographic and radiographic measurements performed of the patellar ligament, at multiple positions on the ligament. This was performed at the time of surgery, and at six weeks and six months (ultrasound only) following surgery. The radiographic measurements were performed by two reviewers who were blinded to the timeframe of each image. There was great variation in both the incidence and degree of thickening of the ligament. Fifty percent of the cases showed no changes in the thickness of the patellar ligament. A clinical pain response was not associated with patellar ligament thickening. No statistically significant variables which predicted the development of patellar ligament thickening were identified . The presence of signs of patellar ligament thickening is of questionable clinical significance and is probably an incidental finding.