Correction Of Medial Patellar Luxation Research Articles

Outcome of surgical correction of medial patellar luxation in dogs weighing less than 10 kg.

Varioustrochleoplasty techniques, including trochlear wedge recession (TWR) and trochlear block recession (TBR), are used to treat dogs with medial patellar luxation (MPL). However, the objective outcomes of these surgical proceduresare underreported. Medical records were obtained for dogs weighing less than 10kg that underwent either TWR or TBR and tibial tuberosity transposition to address grade I-III MPL. Long-term (at least 1 year after the last procedure) follow-up included orthopaedic and radiographic examinations, such as osteoarthritis score (OAS), ground reaction force (GRF) analysis and canine brief pain inventory (CBPI). Overall, 20 dogs (26 stifles) were followed up in the long term. Minor postoperative complications, medial patellar reluxation (MPR) and intermittent lameness occurred in 46.15%, 19.23% and 15% of the dogs, respectively. MPR occurred only in TWR-treated stifles, while mean OAS increased in all groups. Using the CBPI, the owners perceived an excellent or very good outcomein 95% of dogs. The limitations of the study include its retrospective observational nature, a lack of randomisation and a small sample size. Surgical treatment resulted in a favourable outcome. GRF analysis could detect subtle differences in weight bearing in dogs treated for MPL, which might not be apparent clinically. There might be a higher risk for reluxation for TWR. However, a larger-scale prospective study would be required to find which treatment is superior.

Post-operative radiographic measures of pelvic limb alignment in dogs with medial patellar luxation after trochlear wedge recession versus trochlear block recession surgery.

Background and Aim:Anatomical and mechanical femoral angles are quite different among dog breeds. Most published data are about large dog breeds, however, medial luxation of patella is more common in small breeds. Measures of pelvic limb alignment are important for outcome of patellar luxation surgery. Therefore, the aim of the present study was to compare the values of anatomical and mechanical femoral and tibial angles in dogs before, immediately after, and 1 month after surgery for correction of medial patellar luxation (MPL).Materials and Methods:The study was conducted with 54 dogs (67 stifle joints) from four small breeds that underwent surgery by either trochlear block recession (36 stifle joints) or trochlear wedge recession (31 stifle joints) techniques.Results:In both trochleoplasty techniques, statistically significant differences in the values of the anatomical medial proximal femoral angle (aMPFA), anatomical lateral distal femoral angle (aLDFA), and femoral varus angle (in MPL Grade II) and of aMPFA and Q-angle (in MPL Grade III) were found out.Conclusion:After block recession surgery, more angles were positively influenced and this effect was more pronounced in patients with MPL Grade II.

Radiographic evaluation of patellar tendon length following corrective surgical procedures for medial patellar luxation in dogs.

To quantify changes in the patellar tendon length following surgical correction of medial patellar luxation in dogs and evaluate potential risk factors associated with patellar tendon elongation. Retrospective case series (n = 50). Dogs that underwent surgery for medial patellar luxation correction and had 2-3 months follow up were included. Digital radiographs were utilized to quantify the patellar tendon length to patellar length ratio at various follow-up points. Odds ratio comparisons between potential risk factors associated with changes in patellar tendon length were performed. Post-operative patellar tendon lengthening of ≥ 5% was observed in 20% of stifles and post-operative patellar tendon shortening of ≥ 5% was observed in 22% of stifles at the 2-3 month follow up period. The risk factors including age, body weight, trochleoplasty and grade of medial patellar luxation were not significantly associated with risk of patellar tendon elongation. Patellar tendon lengthening was not associated with recurrence of luxation. Patellar tendon lengthening and shortening can be observed in dogs following common medial patellar luxation corrective procedures in the short term follow up period. Patellar tendon lengthening does not appear to be associated with age, weight, trochleoplasty, grade of luxation, or risk of luxation recurrence.

Complications Following Surgical Correction of Medial Patellar Luxation in Small-to-Medium-Size Dogs.

The main aim of this study was to describe complications in dogs weighing < 20 kg treated for medial patellar luxation and to determine risk factors associated with these complications. Medical records were reviewed and cases were grouped based on four techniques of stabilization for the tibial tuberosity transposition (TTT). Variables including animal signalment, clinical presentation, TTT technique, other concurrent surgical techniques and associated complications were investigated. Multiple logistic regression was used to determine the association of the same variables with specific complications such as tibial tuberosity fractures or avulsions, patellar reluxation and implant-related complications. Of the 100 procedures performed, 37 suffered a complication. There were no significant differences in the overall complication rate between TTT stabilization techniques. Preservation of the tibial tuberosity distal cortical attachment was associated with a reduced risk of implant-related complications, whereas adding a medial release to the surgical techniques was associated with an increased risk of medial patellar reluxation. The type of trochleoplasty performed did not affect the complication rate. In the current study, a high rate of complications was found in dogs < 20 kg undergoing medial patellar luxation surgery. Performing a medial release and preserving the distal cortical attachment of the tibial tuberosity were the only variables associated respectively with an increase and a reduction in the risk of postsurgical complications.

Surgical Correction of Medial Patellar Luxation including Release of Vastus Medialis without Trochleoplasty in Small Breed Dogs: A Retrospective Review of 22 Cases

Surgical Correction of Medial Patellar Luxation including Release of Vastus Medialis without Trochleoplasty in Small Breed Dogs: A Retrospective Review of 22 Cases

Effect of Physical Therapy Program After Surgical Correction of Medial Patellar Luxation in Small Breed Dogs

Effect of Physical Therapy Program After Surgical Correction of Medial Patellar Luxation in Small Breed Dogs

Medial Ridge Elevation Wedge Trochleoplasty for Medial Patellar Luxation: A Clinical Study in 5 Dogs

To develop a surgical technique to elevate the medial trochlear ridge for surgical correction of medial patellar luxation, and to evaluate clinical outcome. Case series. Dogs (n = 5) with Grade 3 medial patellar luxation. An asymmetrical wedge was removed from the trochlear groove, rotated 180°, and placed in the recess to create an elevated medial trochlear ridge. Postoperative radiography, CT scan, and subjective evaluation of clinical outcomes were performed. Surgical procedure and postoperative recovery were uncomplicated. There was no recurrence of spontaneous luxation and subjectively, gait improved in all dogs. Postoperative radiographs and CT images confirmed the elevated medial trochlear ridge, a significantly increased groove depth/patellar thickness ratio (P < .01), and seating of the patella in the trochlear groove. Elevating the medial trochlear ridge, instead of deepening the groove, can be considered a viable surgical technique to stabilize luxating patellae.

Evaluation of surgical treatment of medial patellar luxation in Pomeranian dogs

In a prospective study, the outcome of surgical correction of medial patellar luxation of 70 stifle joints in 55 Pomeranian dogs was evaluated. Trochlear block recession alone was performed in 46 stifle joints, or in combination with tibial tuberosity transposition in 24 stifle joints in cases with grade II, III or IV medial patellar luxation. Additional procedures were performed to restore lateral and medial retinacular function. The recurrence of patellar luxation and the degree of lameness were evaluated up to at least 16 weeks after surgery. The overall recurrence rate was 10%. The outcome of surgery was considered good for grade II luxation with a 100% success rate. Recurrent medial patellar luxation was diagnosed in approximately 11% of dogs with grade III and in 36% of dogs with grade IV luxation. The postoperative lameness score decreased significantly in comparison with the preoperative score at four weeks and thereafter until the end of the study.

Treatment of the lateral patellar luxation in toy poodles

The purpose of this retrospective study was to report the occurrence of lateral patellar luxation in poodles. The animals were referred to the Orthopedics Service of the Veterinary Hospital, Faculdade de Ciências Agrárias e Veterinárias, - Jaboticabal Campus, São Paulo, Brazil, twelve client-owned poodles, seven females and five males poodles ranging in age from three to nine months. Clinical examination showed lameness, pain and deformities of the affected limbs. Surgical trochleoplasties were performed with medial retinacular overlap and medial tibial tuberosity transposition. The animals recovered their normal activity within a period of one to two weeks after surgery. Although this was a rarely occurring pathological condition in poodles, surgical repair was easy to execute because of its similarity to correction of medial patellar luxation. Lateral patellar luxation in small dogs is rare and, when present, is of congenital origin, at times progressing to marked functional impotence of the affected limbs.

Clinical Results of Surgical Correction of Medial Luxation of the Patella in Dogs

Thirty-four dogs that had surgical correction of medial patellar luxation (MPL) in 52 stifle joints were examined after a minimum follow-up period of 1 year (median, 3.6 years). The dogs were divided into the following three groups depending on their age at the time of surgery: group 1, 3 to 6 months; group 2, 8 to 20 months; and group 3, 2.2 to 12 years. Two of the dogs in group 3 had ruptured their cranial cruciate ligament in addition to having MPL. The results were based on a clinical assessment of the animal's gait, and physical and radiographic examination of the stifle joints. Six of seven stifle joints evaluated in group 1 had radiographic evidence of moderate to severe degenerative joint disease of the patellofemoral joint, and in two of the joints recurrence of MPL was observed. Failure to maintain reduction of the patellofemoral joint was also observed in 11 of 22 (50%) and 12 of 23 (52%) of the stifle joints in groups 2 and 3, respectively. In the latter groups, mild degenerative joint disease was evident radiographically in stifle joint that had not maintained reduction. Four of the 34 dogs were consistently (n = 2) or intermittently (n = 2) lame; the two dogs that were consistently lame had cranial instability of the stifle consistent with rupture of the cranial cruciate ligament. In the latter two dogs, the cranial cruciate ligament had been intact at the time of surgery for correction of MPL.