Stifle Luxation Research Articles

Surgical Repair of Psittacine Femorotibial Luxation: A Case Series.

Luxation of the psittacine femorotibial joint most commonly occurs following trauma or as a development abnormality. Historically, this injury is considered to have a poor prognosis in birds; however, surgical management may result in acceptable and functional outcomes. This case series describes the surgical techniques, complications, and outcomes of 7 cases of femorotibial luxation in psittacine birds. Of the 7 cases, 6 were chronic injuries. Surgical repair methods included conjoined intramedullary pinning, transarticular pinning with an external skeletal fixator (ESF), a combination of extracapsular stabilization and ESF, ESF alone, and a combination of conjoined intramedullary pins with an ESF. An acceptable outcome was achieved in 75% (6/8) of luxated femorotibial joints managed with surgical methods. All cases were female birds of various species, suggesting a possible sex predisposition for stifle luxation.

Surgical Repair of Psittacine Femorotibial Luxation: A Case Series.

Luxation of the psittacine femorotibial joint most commonly occurs following trauma or as a development abnormality. Historically, this injury is considered to have a poor prognosis in birds; however, surgical management may result in acceptable and functional outcomes. This case series describes the surgical techniques, complications, and outcomes of 7 cases of femorotibial luxation in psittacine birds. Of the 7 cases, 6 were chronic injuries. Surgical repair methods included conjoined intramedullary pinning, transarticular pinning with an external skeletal fixator (ESF), a combination of extracapsular stabilization and ESF, ESF alone, and a combination of conjoined intramedullary pins with an ESF. An acceptable outcome was achieved in 75% (6/8) of luxated femorotibial joints managed with surgical methods. All cases were female birds of various species, suggesting a possible sex predisposition for stifle luxation.

Surgical management of traumatic stifle luxation in cats with using fabelotibial and fibulopatellar sutures

Cats’ ligaments in the stifle joint may become damaged because of several accident kinds. Effective treatment of this condition requires surgical intervention. The objective of this article is to outline the most precise diagnostic process, surgical treatment, as well as investigate the outcomes and potential complications in the surgical treatment of stifle disruption in cats without a temporary transarticular pin. Five cats of various breeds, ranging in age from 1 to 5 years, were used in the study. Each animal has both cruciate ligaments damaged. As a therapeutic therapy, two stabilizing sutures (fabellotibial and fibulopatellar) were applied to the cats. At one, three, five, seven-, and nine-weeks following surgery, each patient underwent control and clinical gait evaluation. A phone call with the owners was conducted 4 months following the surgery to gauge their satisfaction with treatment results and find out whether the cat had fully recovered. After treatment, all patients regained their mobility. No one cat had major complications and required reoperation. Few patients were exposed to minor complications, including swelling, bacteril infection and rupture of sutures. Each owner was satisfied with the results of the therapy and their animal’s recovery. To preserve the entire functionality of the limb, the lateral fabellotibial and fibulopatellar suture technique can be effective in young animals. If the cruciate ligaments are the primary area of damage, the suture technique may be helpful.

Combination of TPLO, medial and lateral augmentation techniques for the treatment of traumatic stifle luxation in a cat

Case summary An 11-year-old female neutered domestic shorthair cat was referred for surgical management of a traumatic right stifle luxation. Orthopaedic examination of the affected stifle under general anaesthesia revealed joint effusion and craniocaudal and rotational instability. Cranial displacement of the tibia with respect to the femur and infrapatellar pad sign were identified on radiography. Intraoperatively, complete rupture of both cruciate ligaments and marked disruption of the mid and caudal poles of the medial and lateral menisci were observed. Both collateral ligaments appeared intact. The remnants of the injured cruciate ligaments were removed, and medial and lateral caudal hemimeniscectomies were performed. A tibial plateau levelling osteotomy (TPLO) was performed to address the craniocaudal stifle instability. Intraoperative assessment of the stifle revealed persistent instability with cranial tibial translation, internal and external rotation, and a positive caudal draw test. A lateral augmentation suture was employed to address the persistent cranial tibial translation and internal rotation. To successfully neutralise caudocranial and external rotational instability secondary to the caudal cruciate ligament deficiency, a medial augmentation suture was placed with the aid of three interference screws. Stifle stability was achieved. A modified Robert-Jones bandage was kept on for 24 h postoperatively. An excellent outcome was achieved, with successful limb function restoration. Relevance and novel information This case report represents the first documented instance of feline traumatic stifle luxation repair by combining a corrective tibial osteotomy and extra-articular augmentation. Notably, it introduces the novel technique of implementing a TPLO with medial and lateral augmentation sutures to address multidirectional stifle instability.

Custom-built constrained uniaxial and rotating hinge total knee replacement in cats: Clinical application, design principles, surgical technique, and clinical outcome.

To describe the design principles and evolution, surgical technique, and outcome for custom constrained (uniaxial and rotating hinge) total knee replacement (TKR) in cats. Retrospective case series. Nine cats with traumatic stifle luxation (n=8) or severe distal femoral deformity (n=1) were considered suitable candidates. Cats that met eligibility criteria and received a custom TKR between 2009 and 2018 by a single surgeon were included in this case series. Three generations of implant were used. Implant positioning was assessed by postoperative orthogonal radiography. Functional outcome was determined by clinical assessment, owner interview, and a feline musculoskeletal pain index questionnaire. Median clinical follow-up time was 12 months (range, 4-41); follow-up time was increased to 29 months (range, 22-47) when results of functional questionnaires with owner were included. Median radiographic follow-up was 12 months (range, 4-25). One cat had a catastrophic outcome. Three cats had good outcomes, and five cats had excellent outcomes. Most cats treated with custom-built TKR achieved good to excellent outcomes. Custom TKR is a viable option for the treatment of severe pathologies of the feline stifle. Additional research is required to fully evaluate implant suitability.

Management of severe stifle trauma: 1. Stifle luxation.

Traumatic stifle joint luxation is an uncommon but severe injury. There is usually rupture of several stabilising structures of the joint including the cruciate ligaments, collateral ligaments, joint capsule and menisci. Successful management of this condition requires good anatomical knowledge and repair or replacement of all damaged structures to achieve adequate joint reduction and stability. Better understanding of the treatment options available will aid clinical decision-making. Due to the significant joint instability associated with these injuries, surgical repair is challenging. The use of a temporary transarticular pin to hold the stifle joint in anatomic reduction greatly aids ligament repair or replacement. Postoperative joint immobilisation has traditionally been recommended to protect the primary repair and aid periarticular fibrosis, but prolonged immobilisation can have deleterious long-term effects on the joint. Thus recommendations for the duration of postoperative immobilisation vary between 2 and 6 weeks. Also, due to their independent, outdoor lifestyle, affected cats may have been involved in a significant trauma with important concurrent injuries that need to be addressed prior to the orthopaedic repair. Published data is limited, with reports including only a small number of cats. The information and recommendations in this article have therefore been drawn from the available literature, the authors' experience and preliminary data from an ongoing multicentre retrospective study (unpublished). The aims of this article are to give the reader as thorough a summary as possible of the diagnosis, treatment, outcome and complications of traumatic stifle luxation.

Management of a complete stifle luxation with a hinged transarticular hybrid external fixator in a dog

A 2 years old, 15 kg, male, mix breed dog that was presented with a right open tibial fracture and left complete stifle luxation. Cranial and caudal cruciate ligaments with medial and lateral collateral ligaments were completely torn. Stabilization of the stifle was established with a hinged transarticular external fixator. After fixator removal, radiographic findings were normal besides some periarticular osteophyte formations. Physical therapy was initiated postoperatively. Now the dog can perform all daily activities with mild lameness

Correction of neonatal stifle luxation in a 35‐day‐old cockatiel (Nymphicus hollandicus)

In cases of stifle luxation in birds, surgical repair of the damaged soft tissues may be attempted in larger species and internal fixation is the technique of choice (Bennet 1997, Bowles & Zantop 2002). A 35-day-old Nimphycus hollandicus was presented because of inability to stand (Fig 1A). Medio-cranial luxation of the femoro-tibiotarsal joint was apparent on radiographs (Fig 1B). As the young age of the patient increased the chances of good healing, we decided to correct the problem by immobilising the legs with a semi-rigid foam splint (Fig 2A, B), that was more rigid than the devices used to treat splay-legs (Parrot Parrot 1997), after the luxation had been repositioned under general anaesthesia. Immobilisation of the legs aimed to achieve periarticular fibrosis and stabilise the stifle joint. Weekly physiotherapy under general anaesthesia was performed to avoid ankylosis of the unaffected joints and leg. After 20 days the bird was able to stand with the legs in normal position. With daily physiotherapy, the condition of the bird improved, although walking ability never became fully normal because of ankylosis of the stifle joint (Fig 3A, B). The bird also developed a moderate left pododermatitis that healed in 2 months with topical therapy. No sign of pododermatitis appeared on the right foot despite ankylosis at the stifle joint. This use of semi-rigid foam rubber devices is an effective method to maintain the legs in normal position after stifle luxation reduction, allowing stabilisation of the joint in growing birds belonging to smaller species in which surgical repair of the ligaments tends to be difficult. Marco Luparello Centro Veterinario per Animali Esotici 426 Palermo, Italy Laura Faraci Centro Veterinario per Animali Esotici 426 Palermo, Italy Marco Di Giuseppe Centro Veterinario per Animali Esotici 426 Palermo, Italy Lorenzo Crosta Veterinari Montevecchia 23874 Montevecchia (LC), Italy

Evaluation of short-term outcomes of experimental stifle luxation in feral pigeons (Columba livia domestica) treated with a hinged transarticular external skeletal fixator and physical therapy

To evaluate the use of the FESSA hinged linear transarticular external fixator (HLTEF) and the effect of early physical therapy after experimental stifle luxation in pigeons, eight feral pigeons (Columba livia domestica) underwent surgery and afterwards one group started physical therapy on day 1 post surgery, while the other after HLTEF removal on day 21. Healing was evaluated with clinical, radiographic, patho

Use of an Extracapsular Stabilization Technique to Repair Cruciate Ligament Ruptures in Two Avian Species

An extracapsular stabilization technique was used to repair cruciate ligament ruptures in a trumpeter hornbill (Bycanistes bucinator) and an African grey parrot (Psittacus erithacus). The hornbill demonstrated cranial drawer motion and severe rotational instability of the stifle from ruptures of the cranial and caudal cruciate ligaments and stifle joint capsule. The luxation was reduced, and the fibula was cranially transposed, in relation to the tibiotarsus, and anchored with 2 positive profile threaded acrylic pins. A lateral extracapsular stabilization was then performed. The African grey parrot had a traumatic stifle luxation, and an open reduction and a lateral extracapsular stabilization were performed. Both birds regained function of the affected leg by 1 month after surgery. Extracapsular stabilization allows motion of the stifle joint to be maintained during the postoperative recovery period, an advantage over rigid stabilization. Maintaining motion in the stifle joint facilitates physical therapy and can aid in full recovery after avian stifle injuries.

Stifle Luxation Repair by Articular Stabilization Technique with Non-Absorbable Suture in a White-Fronted Goose and Therapeutical Trial in a Domestic Pigeon

Stifle Luxation Repair by Articular Stabilization Technique with Non-Absorbable Suture in a White-Fronted Goose and Therapeutical Trial in a Domestic Pigeon

Stifle Luxation Repair in a Moluccan Cockatoo and a Barn Owl

New York, New York 10021 An eight-year-oldMoluccan Cockatoo developed a severe stifle luxation after a traumatic event. Due to the severity of the injury, the decision was made to arthrodese the stifle. In order to fuse the stifle in a functional position, multiple K-wires were placed in the lateral aspect of the femur and tibiotarsus, and a type-1 external fixator with a connecting bar composed of an acrylic polymer was used. The bird was weight bearing by day 4 after surgery, and 7 months after surgery the stifle was stable with no detectable movement. A seven-month-old Barn Owl was examined because of a closed stfle luxation. The stifle luxation was reduced and stabilized by an externalfixation method similar to the one used for the cockatoo. External fixation for stifle repair in birds offers the advantages of no permanent implant, use of the limb during convalescence, and early return to function.

Collateral Ligament Injury and Stifle Luxation

Isolated collateral ligament injury is uncommon in dogs and cats and often occurs concurrently with injuries to other stifle ligaments. These injuries are either treated with primary reconstruction of the individual ligaments or with transarticular pin or splint stabilization of the joint until adequate periatricular fibrosis is achieved. Prognosis is generally good if adequate joint stability has been achieved.

Stifle Luxation Repair in a Moluccan Cockatoo and a Barn Owl

Stifle Luxation Repair in a Moluccan Cockatoo and a Barn Owl