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Pre- and Postoperative Radiographic and Computed Tomographic Evaluation of Dogs with Medial Patellar Luxation

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  • Presented at VOS in Big Sky, MT, February 2004, the American College of Veterinary Surgeons Annual Meeting, Denver, CO, October 2004, and the European College of Veterinary Surgeons Annual Meeting, Prague, Czeck Republic, July 2004.

Adrresss reprint requests to Dr. Heather A. Towle, DVM, School of Veterinary Medicine, Purdue University, 1248 Lynn Hall, West Lafayette, IN 47907-1248. E-mail: towle@purdue.edu.

Abstract

Objective— To quantify, using radiographic and computed tomographic (CT) techniques, the effects of surgical procedures most commonly combined to treat dogs with medial patellar luxation (MPL).

Study Design— Prospective study.

Methods— Six dogs with 8 MPL were studied. Radiographs and CT of the pelvic limbs were obtained before and immediately after soft-tissue reconstruction, trochlear wedge recession, and tibial crest transposition. Radiographic measurements included angle of inclination, Norberg angle, quadriceps angle (QA), anteversion angle, ratio of the length of the patellar tendon (PT) to the length of the patella, and change in patella tendon angle. CT measurements included angle of inclination, Norberg angle, QA, anteversion angle, depth of the femoral trochlear groove, ratio of the middle femoral trochlear groove depth to the patella thickness, and tibial crest alignment.

Results— Conformation of the coxofemoral joint was not affected by surgery. Surgical treatment corrected the QA by 33–58%. Trochlear wedge recession was most effective in deepening the proximal trochlea by 103.5%. The ratio of the middle femoral trochlear groove depth to the thickness of the patella postoperatively resulted in 50% coverage of the patella. Tibial crest transposition resulted in caudalization of the PT by 8.5±3.0°, with lateralization of the tibial tuberosity of 11.3°.

Conclusion— The effects of surgery for MPL can be quantified with radiographic and CT measurements. Surgical correction restored the alignment of the quadriceps and adequately deepened the femoral trochlear groove. Tibial crest transposition resulted in caudalization of the patella tendon and lateralization of the tibial tuberosity.

Clinical Relevance— These pilot data quantified the effects of surgical procedures most commonly combined to treat MPL. We hope to use these measurements to correlate surgical treatment with functional outcome and postoperative occurrence of luxation.

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