Luxation Grade Research Articles

Medial patellar luxation induces cartilage erosion in dogs: a retrospective study of prevalence and risk factors.

To explain the relationship between cartilage erosion and medial patellar luxation (MPL) and to identify risk factors in dogs. A retrospective review was conducted on 90 dogs (103 stifles) surgically treated for MPL between January 2006 and March 2024. Data collected included signalment, side of operated stifle, patellar luxation grade, symptom duration, and lameness score. Cartilage erosion was evaluated for extent and location on the patella and femoral trochlea. Statistical analyses were conducted to identify risk factors. The prevalence of cartilage erosion of the patella and femoral trochlea was 47.6% (49/103) and 54.4% (56/103), respectively, increasing with a higher grade of patellar luxation. Lesions were most prevalent in the distolateral patella and proximomedial trochlea, with generalized lesions more prevalent in grade IV. The extent of both lesions was significantly associated with age, patellar luxation grade, and symptom duration, while body weight significantly correlated only with the cartilage erosion of the patella. No significant correlation was observed with sex, side of operated stifle, or lameness score. Many patients with MPL exhibited cartilage erosion in the patellofemoral joint, likely due to biomechanical mechanisms. Surgery can be indicated for patients with MPL, as it may prevent cartilage erosion while improving patellofemoral alignment and gait. When selecting surgical candidates, it is important to consider risk factors, such as patellar luxation grade, body weight, age, and symptom duration. Early surgical treatment is recommended, especially for dogs with higher body weight and higher grade of MPL, to prevent cartilage erosion and secondary osteoarthritis.

Medial patellar luxation grade IV according to the Singleton system can be classified into skeletally immature and skeletally matured types.

To determine the signalment and musculoskeletal morphology of small-breed dogs affected by medial patellar luxation (MPL) grade IV based on the age of the CT scan. 40 small-breed dogs (54 limbs) with MPL grade IV. Dogs that had undergone corrective surgery for MPL grade IV and had performed CT of the hind limb before surgery were included. Signalment (age, body weight, sex, laterality, and breed) and concomitant cranial cruciate ligament rupture (CrCLR) were recorded. Femoral inclination angle, anatomical lateral distal femoral angle (aLDFA), femoral torsion angle, quadriceps muscle length to femoral length ratio (QML/FL), and patellar ligament length to patellar length were obtained by CT images. The dogs were categorized into 2 groups based on their age at the time of the CT scan, the skeletally immature group and the skeletally matured group. Signalment and group were included in the multiple regression analysis to determine the factors associated with each measurement parameter. A logistic regression analysis was conducted to determine the risk of CrCL concomitant with age. The multiple regression model demonstrated that the group was associated with the value of aLDFA and QML/FL. aLDFA was higher, and QML/FL was lower in group SI than in group SM. CrCLR was present in 5/54 limbs (9.2%), with a mean age of 70.8 months and it was associated with increasing age. In Singleton's classification, dogs classified as grade IV can be categorized into 2 groups based on musculoskeletal morphology and pathophysiology: the skeletally immature and skeletally matured types.

Preoperative and postoperative stance analysis in dogs with patellar luxation confirms lameness improvement after surgery.

To document and compare preoperative and postoperative stance analysis measurements in animals with naturally occurring patellar luxation. 131 client-owned dogs surgically treated for naturally occurring unilateral or bilateral patella luxation between March 30, 2015, and February 12, 2020. Weight bearing as a percent body weight on each limb was recorded with the use of a platform device for analyzing stance (PetSafe Stance Analyzer; LiteCure LLC, Companion Animal Health) preoperatively and postoperatively for all dogs. Signalment, limb affected, lameness grade, luxation direction, luxation grade, and surgical procedure were collected from patient records and assessed for the effects of these variables on weight bearing preoperatively or at the first or second postoperative recheck examination. There were 61 males and 70 females, with a mean age and body weight of 4.62 years and 13.01 kg, included in the study. As age increased, body weight decreased in these dogs (P = .025). There was a statistically significant improvement in lameness after surgery (P = .008) at the second postoperative recheck examination. Lameness significantly decreased as postoperative time increased (P < .001, r = 0.503). As age increased, lameness at the initial visit decreased compared to younger dogs but not significantly (P = .062). There was no significant effect of preoperative luxation grade, luxation direction, surgical procedure, or sex when comparing initial lameness or lameness at recheck examination. Surgical correction of patella luxation improves lameness as measured by postoperative stance analysis. Preoperative luxation grade or direction, surgical procedure performed, and sex of the animal did not significantly affect outcome in this group of dogs.

Luxação patelar medial bilateral em cão, grau III: Relato de caso&#x0D;

Medial patellar luxation is an orthopedic problem commonly found in small breed dogs, whose treatment is surgical. This paper aims to report a case of grade 3 bilateral medial patellar luxation. A 5-year-old, uncastrated Maltese female dog was admitted to the Veterinary Hospital of the University of Sorocaba, diagnosed with a bilateral medial patellar luxation grade 3. The surgical procedure performed for patellar arthroplasty of the left pelvic limb, in this type of degree, has a favourable prognosis.

Treatment of cranial cruciate ligament insufficiency and medial patellar luxation in a small‐breed dog with a true spherical osteotomy

AbstractA 9‐year‐old, neutered, male, Cairn Terrier dog presented with a 3‐year history of progressive pain and lameness of the right hindlimb. After an acute episode of severe pain and non‐weight‐bearing lameness, the dog was referred to our clinic for evaluation. The physical examination was unremarkable; the orthopaedic examination revealed a positive cranial drawer sign and medial patellar luxation grade 3/4. Orthogonal radiographs were taken. Chronic degenerative changes consistent with cranial cruciate ligament insufficiency and medial patellar luxation were noted. Preoperative planning was performed using veterinary preoperative planning software. A spherical osteotomy was performed to level the tibial plateau, correct the medial patellar luxation and improve a valgus deformity. The osteotomy was stabilised using a polyaxial 2.0 tibial plateau levelling osteotomy plate. At the 8‐week postoperative follow‐up examination, the dog had normal weight‐bearing ability without evidence of lameness or pain.

Congenital elbow luxation grade I treated by radial head ostectomy in an English Bulldog

Congenital elbow luxation grade I treated by radial head ostectomy in an English Bulldog

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.

Risk factors and long-term surgical outcome of patellar luxation and concomitant cranial cruciate ligament rupture in small breed dogs

Concomitant cranial cruciate ligament rupture (CCLR) is a common complication in small breed dogs with patellar luxation (PL) with an elusive pathogenesis. Surgical treatment is available and commonly includes remodelling osteotomies. While these modern techniques have shown good functional results, access is limited due to the high costs for owners and the need for special surgical equipment. The objectives of the study were to evaluate the frequency and risk factors for concomitant CCLR in small breed dogs with PL. To study the outcome and complications of the combination of the Wedge recession osteotomy (WR) and Tibial tuberosity transposition (TT) with a Fascia over-the-top (OT) or a Capsular and fascial imbrication technique (CFI) for the simultaneous treatment of PL and concomitant CCLR. A retrospective study is presented here. The signalment, body weight, luxation grade and direction, affected side, bilateral or unilateral PL, CCLR and meniscal status were analysed. The surgical treatment for PL and concomitant CCLR, outcome and complications were investigated. Of 233 small breed dogs with PL, 52 (22.31%) had a concomitant CCLR. Maltese dogs were more likely to have concomitant CCLR. The mean age for the dogs with PL only was 5.32 years, which was significantly younger than the mean age of dogs with PL and concomitant CCLR (7.39 years). Overweight dogs with PL were prone to develop concomitant CCLR. Surgical stabilisation with a combination of WR, TT and OT or CFI had excellent or good results in 86.63% of the cases, while 16.67% of the cases developed complications. In conclusion, PL and concomitant CCL ruptures can be managed successfully by performing a combination of WR, TT and OT or CFI. The outcomes and complication rates are comparable to remodelling osteotomies. Moreover, these techniques are less expensive and can be performed with standard surgical equipment. These findings should be beneficial for clinical diagnosis, client education and treatment.

Luxação lateral de patela em um Poodle toy

Background: Luxating patella is one of the most frequent conditions of the stifle joint in dogs and it can evolve into a degenerative joint disease. The occurrence of the condition can be medial or lateral, unilateral or bilateral. Its origin can be traumatic or congenital and, additionally, it may undergo genetic and environmental influence. Lateral luxation is more common in large breed dogs, and it can rarely affect medium and small breeds, whilst medial luxation is more common in small breed dogs. The classification of patellar luxation comprises four grades, according to the patellar position, clinical signs and seriousness of the bone deformities found. The diagnosis is made based on the clinical evaluation, associated with a radiographic evaluation. The present study aims at describing a case of bilateral grade 3 lateral luxating patella in a Toy Poodle dog. Case: A five-month-old female Toy Poodle dog was presented for difficulty standing and claudication of hind limbs. Orthopedic evaluation revealed internal rotation of the stifle, claudication of hind limbs during walking and “jumps” during trotting, in addition to a lateral grade 3 luxating patella and slight restriction of the joint motion upon extension of the right and left hind limbs. Radiographic evaluation of both stifles evidenced an ectopic (lateral) position of the right and left patellas. The animal was referred to the surgery department, where it was submitted to surgical intervention of both stifles. A reduction of luxation in both stifles was achieved through medial arthrotomy, wedge recession trochleoplasty, lateral desmotomy and medial imbrication of the articular capsule techniques. Tramadol hydrochloride, dipyrone and meloxicam were prescribed as postoperative medication. Daily wound care, resting and mild walks using a lead were recommended for the animal. On the tenth postoperative day, the stitches were removed from the skin and the animal seemed to be in a good general state, using adequately its hind limbs when walking and trotting. Discussion: The medial form of the congenital patellar luxation is common both in large and small breeds. However, the lateral form is more common in large or giant breeds, differently to the findings of the present case, in which luxation occurred in a Toy Poodle. Surgery is recommended in animals with a luxating patella grade starting from 2, as even the smallest luxation grades may evolve into higher grades, causing functional inability of the limb and degenerative joint disease. Surgery was justified in this case, because the animal presented a grade 3 luxating patella. The decision on which technique should be used will depend on the luxating patella grade and on soft tissue compromise. The most recommended procedure is a combination of various techniques in the same articulation. In this case, the use of wedge recession trochleoplasty and medial imbrication of the articular capsule techniques was successful, as a few days after surgery the animal was able to walk adequately without presenting any instability of the patellas, thus improving its quality of life. Moreover, upon reaching adulthood, the animal maintained an adequate gait, without excessive patellar motion.

Prevalence, treatment and outcome of patellar luxation in dogs in Italy. A retrospective multicentric study (2009-2014).

To determine the prevalence of patellar luxation in dogs in Italy and its relation to signalment, the frequency and the type of postoperative complications and the outcome of treatment, and to compare the findings with those of other studies. The medical records from four referral clinics were searched for dogs with orthopaedic disorders referred from 2009 to 2014. From these data, the records of dogs with patellar luxation were identified, and the signalment, age and body weight, grade, side and direction of patellar luxation, treatment, postoperative complications, and outcome were retrieved. Univariate and multivariate statistical analyses were used to evaluate the data. Of 8,694 canine orthopaedic cases, fractures not included, patellar luxation was diagnosed in 559 dogs (801 stifles). Mixed breed dogs were most commonly affected (18%), 85% of the luxations were medial, and 52% of the dogs were female. Of the 559 dogs examined, 400 (574 stifles) met the inclusion criteria for treatment evaluation. Minor complications occurred in five percent of the dogs, and major complications in 16%, including recurrence of patellar luxation in seven percent of the dogs. The outcome was good in 88% of stifles, fair in two percent, and poor in 10%. Although patellar luxation was more common in small breed dogs, it also was diagnosed in a significant number of large breed dogs, which included medial patellar luxation in 73% and lateral patellar luxation in 27% of stifles. Body weight and grade of luxation were the only variables statistically correlated with surgical complications.

Proximo-distal patellar position in three small dog breeds with medial patellar luxation.

Medial patellar luxation is thought to be associated with a high proximal position of the patella in the trochlear groove. To determine whether the ratio of patellar ligament length and patellar length (L:P) is influenced by the stifle angle (75°, 96°, 113°, 130°, and 148°) in small dog breeds and to compare the L:P ratio in dogs of three small dog breeds with and without medial patellar luxation. A mediolateral radiograph of the stifle joint was used to measure the L:P ratio in the stifle joints of dogs of three small breeds with and without medial patellar luxation. The L:P ratio was evaluated at five stifle angles (75°, 96°, 113°, 130°, and 148°) in 14 cadavers (26 stifle joints) of small dog breeds in order to identify the best stifle angle to measure the L:P ratio. Then the mean ± SD L:P ratio was calculated for normal stifles and stifles with medial patellar luxation grades 1, 2, and 3 in 194 Pomeranians, 74 Chihuahuas, and 41 Toy or Standard Poodles. The L:P ratio was the same for all five stifle angles in the cadavers (p = 0.195). It was also not significantly different in the three breeds (p = 0.135), in normal and medial patellar luxation-affected stifles overall (p = 0.354), and in normal and medial patellar luxation-affected joints within each breed (p = 0.19). We conclude that a proximo-distal patellar position is not associated with medial patellar luxation in Pomeranians, Chihuahuas, and Toy or Standard Poodles. Thus a longer patellar ligament length does not play a role in the pathophysiology of medial patellar luxation in these small dog breeds.

Complications after corrective surgery for lateral patellar luxation in dogs: 36 cases (2000–2011)

To determine the frequency and severity of complications after corrective surgery in dogs with lateral patellar luxation (LPL) and identify risk factors for reluxation. Retrospective case series. 36 client-owned dogs with 47 affected stifle joints. Medical records of dogs that underwent surgical correction of LPL at 1 of 2 veterinary teaching hospitals between 2000 and 2011 were reviewed. Data analyzed included signalment, grade of luxation, orthopedic comorbidities, surgical procedures performed, frequency and type of complications, and whether a second surgery was performed. A total of 36 dogs with 47 affected stifle joints met the inclusion criteria. Complications were recorded for 24 of 47 (51.1%) stifle joints; there were major complications for 18 of 47 (38.3%) stifle joints. All complications were confirmed through examination by a veterinarian. The most frequent complication was reluxation, which was detected in 10 of 47 (21.3%) stifle joints. Dogs that underwent bilateral surgical repair during a single anesthetic episode had odds of reluxation that were 12.5 times the odds of reluxation for dogs that underwent unilateral surgical repair. Complication rate after corrective surgery for LPL was high, with reluxation being the most common complication in this population of dogs. Performing staged bilateral surgeries may decrease the risk of reluxation.

Major complications and risk factors associated with surgical correction of congenital medial patellar luxation in 124 dogs.

Dogs treated for congenital medial patellar luxation were reviewed for the purpose of determining the incidence of postoperative major complications requiring surgical revision and the risk factors for their occurrence. Major complications occurred in 18.5% of the patellar luxation stabilization procedures with implant associated complications being the most frequent, patellar reluxation the second, and tibial tuberosity avulsion the third most common major complication. Other complications included patellar ligament rupture and trochlear wedge displacement. When recession trochleoplasty was performed in addition to tibial tuberosity transposition, a 5.1-fold reduction in the rate of patellar reluxation was observed. Release of the cranial belly of the sartorius muscle further reduced the incidence of patellar reluxation, while patella alta (pre- or postoperative) and patellar luxation grade were not found to influence the rate of reluxation. Tibial tuberosity avulsion was 11.1-times more likely when using a single Kirschner wire to stabilize a transposition, compared with two Kirschner wires. Independent to the number of Kirschner wires used, the more caudodistally the Kirschner wires were directed, the higher the risk for tibial tuberosity avulsion. Tension bands were used in 24.4% of the transpositions with no tuberosity avulsion occurring in stifles stabilized with a tension band. Overall, grade 1 luxations had a significantly lower incidence of major complications than other grades, while body weight, age, sex, and bilateral patellar stabilization were not associated with risk of major complication development.

Aspectos clínicos, cirúrgicos e epidemiológicos da luxação de patela em cães atendidos no Hospital Veterinário, no período de janeiro de 2000 a julho de 2010: estudo retrospectivo

Avaliaram-se, por meio de estudo retrospectivo, o perfil epidemiológico, os sinais clínicos, as técnicas cirúrgicas utilizadas e a recuperação de cães apresentados para tratamento de luxação de patela no Hospital Veterinário da UFMG, no período de 2000 a 2010. Utilizaram-se as fichas clínico-cirúrgicas dos cães e registraram-se os dados referentes a cada animal. Foram estudadas 342 articulações nos registros de 210 animais. A luxação medial congênita bilateral foi a apresentação mais frequente, e as fêmeas foram mais acometidas. A idade dos animais variou de 32 dias a 16 anos, com maior ocorrência da luxação nos animais com até um ano de idade e massa corporal inferior a 9,1kg. Em 11,7% dos membros, a luxação era de grau I, em 39,8% grau II, em 20,5% grau III e em 28% grau IV. A frequência de claudicação pré-operatória foi maior nos cães com luxações graus III e IV. Das 342 articulações, 218 foram submetidas à cirurgia. Na avaliação pós-operatória, os animais com luxação grau IV mostraram maior frequência de claudicação. A luxação patelar acomete principalmente fêmeas, sendo a luxação congênita bilateral a apresentação mais comum, e animais jovens e de pequeno porte são mais susceptíveis. A recuperação funcional pós-operatória nas luxações grau IV é lenta e parcial.

Tibial tuberosity transposition-advancement for treatment of medial patellar luxation and concomitant cranial cruciate ligament disease in the dog

To report surgical technique, morphometric effects and clinical outcomes for tibial tuberosity transposition-advancement (TTTA), sulcoplasty and para-patellar fascial imbrication for management of concomitant medial patellar luxation (MPL) and cranial cruciate ligament (CCL) disease in 32 dogs. Case series. A previous technique for tibial tuberosity advancement was modified to incorporate lateral and distal tibial tuberosity transposition. Preoperative, immediate, and six to eight week postoperative radiographs were reviewed with morphometry of a range of tibial and stifle anatomic parameters. Findings of sequential clinical examinations to six to 20 months postoperatively were recorded. Thirty-nine stifles were treated by surgery. Medial patellar luxation grade ranged from II to IV/IV. The CCL rupture was complete in 17/39 stifles, and incomplete in 22/39. Complications occurred in 11/39 stifles including MPL recurrence (n=4). Resolution of subjectively-assessed lameness occurred in 29/39 stifles at the six to eight week assessment. Resolution of lameness was eventually documented in 35/39 stifles (4/39 lost to follow-up), and was maintained at the six to 20 month reassessment where available. The TTTA induced relative patella baja in 31/39 stifles. Magnitude of actual tibial tuberosity advancement was lower than that predicted by cage size. Tibial tuberosity transposition-advancement is a potential treatment modality for concomitant CCL disease and MPL in the dog, but refinement of planning is required, while biomechanical and kinematic effects remain unknown.

Severity of patellar luxation and frequency of concomitant cranial cruciate ligament rupture in dogs: 162 cases (2004–2007)

To evaluate severity of medial patellar luxation (MPL) and frequency of concomitant cranial cruciate ligament rupture (CCLR) in dogs. Retrospective case series. 162 dogs (266 stifle joints). Medical records of 162 small-breed dogs with MPL were reviewed. Signalment, body weight, luxation grade, bilateral or unilateral MPL, CCLR, and difference in luxation grades between stifle joints were evaluated. Association between severity of MPL and CCLR was investigated. 58 dogs had unilateral MPL, and 104 dogs had bilateral MPL. Dogs ranged from 8.4 months to 16.7 years of age (mean, 5.7 years), and mean body weight was 5.45 kg (12 lb). Forty-one percent of all dogs had concomitant CCLR. Mean age for dogs with MPL alone was 3.0 years, which differed significantly from mean age of dogs with MPL and concomitant CCLR (7.8 years). Dogs with grade IV MPL were significantly more likely to have concomitant CCLR than were dogs with any other grade of MPL. In dogs with bilateral MPL and unilateral CCLR, there was a significantly higher grade of luxation in the stifle joint with CCLR. Small-breed dogs with MPL and concomitant CCLR were older than were dogs with only MPL. Dogs with grade IV MPL were more likely to have CCLR than were dogs with other grades of MPL. Most dogs with concomitant CCLR had a higher MPL grade in the affected stifle joint than in the intact joint. These findings should be beneficial in client education and clinical diagnosis.

A Surgical Technique of Medial Patellar Luxation in Dogs

Medial patellar luxation is a displacement of the patella from the trochlear sulcus, a common cause of lameness in small-breed dogs, but also occurs in large-breed dogs . Without an adequate treatment, medial displacement of the quadriceps muscle group, lateral torsion of the distal femur, a lateral bowing of the distal one third of the femur, femoral epiphyseal dysplasia, rotational instability of the stifle joint, or tibial deformity can occur. The grades of luxation (4 grades) and the best therapeutic management can be established after the signalment, history, diagnostic imaging and physical examination findings. A 9-month-old female was presented for an intermittent weight-bearing lameness at left hindleg. The leg holded in a flexed position at steps, patella luxated medially most of the time and medial displacement of the quadriceps muscle group were the physical examination which included the disease in grade 3 of medial patellar luxation . Under general inhalatory anaesthesia, the method performed was trochlear resection. After a lateral parapatellar arthrotomy, the technique consisted in removing of the articular cartilage and bone from femoral trochlea with a rongeur. Medial and lateral trochlear ridges were made parallel to each other and the base of the groove perpendicular to each trochlear ridge, so the new groove could accommodate 50% of the height of patella. After trochlear resection, two layers of interrupted mayo matress sutures (polyester 1-0) were done for a lateral capsular imbrication. No major intraoperative and postoperative complications were noted. The local swelling of stifle decreased progressively in the first days postoperative due to anti-inflamatory drugs (carprofen). A long-term sample protocol of physical rehabilitation consisting in exercises (massage, passive range of motion, swimming, criotherapy) was recommended. The normal function of the leg was observed after 12 weeks postoperative. Our case confirm that the trochlear resection is a simple surgical procedure which can reestablish the normal alignment of the patellar complex mechanism, but it should only be performed when a recession procedure or a lateral imbrication are impossible, because removing the articular cartilage of the trochlea allows articulation of the patella on the rough cancellous surface, which results in wearing of patellar articular cartilage in time.

The treatment of hip dysplasia or dislocation with Fettweis' immobilization cast

To verify the success of the cast immobilisation in a squatting position in the treatment of dysplasia and dislocation of the hip 41 children were reviewed whereby lapses up to 13 years had to be considered. In 9 hips the cast immobilisation leaded to an unsatisfactory result so that the joints had to be revised operatively. In the remaining 48 hips 31 (65%) were cured, 15 (31%) showed a light, 2 (4%) a grave remaining dysplasia. One hip joint showed an ischemic necrosis of the femoral head which corresponds to a rate of necrosis of 2.1%. As the concerned patient was treated with spreader pants in spite of the high grade of luxation of her hip it more likely that this avascular necrosis is caused by the preceding treatment and not by the cast immobilisation itself. Factors with negative effects on the result or bad prognostic signs respectively, were poor initial findings and reluxation during cast immobilization. The start of therapy had no noticeable influence on the result. On the other hand this factor was very important for the permanence of treatment. In hips with remaining dysplasia very often a clinical hypermobility was found. A positive Trendelenburg-sign was seen in the hip with defect-healed avascular necrosis of the femoral head and furthermore in 2 other hips with evident remaining dysplasia of the acetabulum. In comparison to other methods, the cast immobilisation according to Fettweis shows a low rate of avascular necrosis of the femoral head and a forced supplementary development of the dysplastic acetabulum. Because of its wide range of indication and its small rate of complications the Fettweis plaster cast is a very reliable method for the treatment of dysplasia and dislocation of the hip in infancy and early childhood.

Die Tendenzen der Pfannenentwicklung von konservativ behandelten Luxationshüften bei Femurkopfnekrose - 1. Mitteilung

The late results of 101 cases of avascular necrosis in congenital dislocation of the hip are reported, which occurred after closed reduction between 1954 and 1960. A good development of hips was observed in 24 cases (23,8%). A severe deformity took place in 33 hips (32.7%), which mostly had total femoral head necrosis. In the groups with partial necrosis a good development was occurred only in the half of all cases. Early treatment led to better results. Besides the necrosis the grade of luxation plays an important role for the development of the hips.

Clinical signs and results of treatment in cats with patellar luxation: 42 cases (1992–2002)

To describe clinical signs and results of treatment in cats with patellar luxation. Retrospective case series. 42 cats in which patellar luxation had been diagnosed on the basis of results of palpation of the stifle joints. Degree of luxation was graded on a scale from 1 to 4, and severity of lameness was graded on a scale from 0 to 5. Radiographs of stifle joints were evaluated for signs of osteoarthritis. Long-term function was classified as poor, fair, good, or excellent. 34 cats had bilateral luxation and 8 had unilateral luxation. Only 7 (17%) cats had a history of trauma. Mean age of the cats was 3.3 years, and mean weight was 4.26 kg (9.4 lb); 26 (62%) were domestic shorthairs. Seventy-three of the 76 (95%) affected joints had medial patellar luxation. Luxation grades could be assigned to 65 joints, with grade 2 (30 joints) and 3 (22 joints) luxation being most common. Lameness grades could be assigned to 73 joints, with grade 1 lameness (27 joints) most common. Outcome was excellent for 8 of 17 joints treated without surgery and for 23 of 35 joints treated surgically. Complications attributable to surgery were reported in 8 cats. Patellar luxation should be considered as a cause of hind limb lameness in cats. Low-grade luxation can be associated with lameness of the same severity as high-grade luxation. Surgical correction of patellar luxation in cats with grade 2 or 3 lameness can result in a favorable outcome.