• Journal of Veterinary Clinics
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• v.30 no.4
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• pp.278-282
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• 2013

This study was performed in 41 dogs with unilateral or bilateral medial patella luxation (MPL) and/or cranial cruciate ligament rupture (CCLR). These dogs were classified into 4 groups according to MPL grading system. Radiographic evaluation was performed for pelvis and stifle joint in the dogs. Norberg, inclination, quadriceps and femoral varus angle were measured and analyzed with MPL grading and the existence of cranial cruciate ligament rupture. The Norberg and inclination angle showed no differences between 4 grading groups and between CCLR and no CCLR groups. However, quadriceps and femoral varus angle were statistically different between grade 1, 2 and grade 3, 4 groups. They also have shown the statistical difference between CCLR and no CCLR group. Further studies for how these parameters affect the prognosis and the results of surgical treatment of MPL should be needed.

• Journal of Veterinary Clinics
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• v.33 no.6
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• pp.385-388
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• 2016

A 2-year-old, castrated male Chihuahua dog was referred for revision surgery for reluxation of the patella following surgery for medial patellar luxation (MPL) of the left stifle joint. On general inspection, the patient showed bilateral hindlimb weight-bearing lameness. On physical examination, bilateral non-reducible MPL was detected through palpation. Radiographs revealed bone deformities of both hindlimbs. Computed tomography (CT) was applied for a three-dimensional (3D) printing bone model to establish an accurate surgical plan. The bone plate was pre-contoured over the 3D-printing bone model after execution of corrective osteotomy and sterilized prior to use in surgery. Corrective osteotomy was performed through a staged, bilateral procedure. The patient showed improvement of limb function following surgery without reluxation of the patella. The use of 3D-printing bone model for accurate surgical planning of corrective osteotomy appears to be effective in increasing the accuracy of surgery. That may lead to successful surgical outcomes.

• Journal of Veterinary Clinics
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• v.37 no.3
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• pp.135-140
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• 2020

The purpose of this study was to determine the outcome of distal femoral osteotomy for distal femoral varus and medial patellar luxation (MPL) grade 4 in small-breed dogs. Radiographs and medical records were reviewed to collect data and plan the surgery in small-breed dogs with MPL grade 4. Computed tomography (CT) imaging was also performed in cases of severe bone deformities. Signalment, weight, medial patellar luxation and lameness grade, radiographic bone union, complications, pre- and postoperative femoral varus angle, passive range of motion, static weight bearing distribution and visual analogue scale scores were recorded. Thirteen corrective distal femoral osteotomies were performed with ancillary and additional procedures in 9 dogs; 4 dogs had staged bilateral procedures; and four stifles were suspected to have partial or complete rupture of the cranial cruciate ligament. One stifle underwent patellar groove replacement. The mean ± SD pre- and postoperative femoral varus angles were 109.15°± 3.71° and 96.30°± 2.97°, respectively. Significant improvements in passive range of motion, thigh circumference and visual analogue scale (VAS) scores were observed. There was no reluxation of the patella. This study suggests that distal femoral osteotomy with traditional and additional procedures provided satisfactory outcomes in patient healing and functional recovery in small-breed dogs with excessive femoral varus angles.

• Journal of Veterinary Clinics
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• v.34 no.6
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• pp.414-419
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• 2017

The present study aimed to document the biomechanical findings of soft tissue reconstruction surgeries for the treatment of medial patellar luxation in dogs. Stifle joints (n = 12) from dogs weighing 4.1-8.4 kg were used in this study. The following soft tissue reconstruction techniques used for the treatment of medial patellar luxation were selected for this study: vastus medialis release, medial retinacular release, and capsule release for medial realignment (n = 6), and retinacular imbrication and anti-rotational suture for lateral realignment (n = 6). A 5-kg traction using an electronic scale was applied at $45^{\circ}C$ laterally for medial realignment and medially for lateral realignment. Fluoroscopic imaging was used to measure the length of patellar displacement (LPD) in each technique. Among medial realignment techniques, capsule release had the highest horizontal LPD; vastus medialis release had significantly higher horizontal LPD than medial retinacular release. Vastus medialis release had the smallest increase statistically in vertical LPD, and vertical LPD did not differ significantly between medial retinacular and capsule release. Among lateral realignment techniques, the horizontal LPD was significantly higher in anti-rotational suture with retinacular imbrication than in retinacular imbrication alone, but the vertical LPD did not differ significantly between the two groups. Our findings indicated that vastus medialis release could decrease the medial tension on the patella without inducing patellar instability in dogs. Both medial retinacular and capsule release could increase patellar instability; moreover, medial retinacular release does not decrease the medial tension on the patella. Antirotational suture with retinacular imbrication provides more lateral tension than retinacular imbrication alone.

• Journal of Veterinary Clinics
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• v.33 no.5
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• pp.295-299
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• 2016

A 2-year-old, 1.94 kg spayed female Toy Poodle was referred for revision surgery for patellar reluxation following surgery for bilateral medial patellar luxation (MPL). Intermittent non-weight-bearing lameness of the right hindlimb and weight-bearing lameness of the left hindlimb were evident on general inspection. A physical examination revealed that there was a bilateral grade 4 MPL. On radiographs, the medial and lateral trochlear ridge was bilaterally worn out. Patellar groove replacement (PGR) was performed in two stages to replace the bilateral femoral trochlea that had a severely worn out groove. Corrective femoral osteotomy with increasing anteversion angle, tibial tuberosity transposition, medial releasing, lateral imbrications and PGR were performed on the right hindlimb. Six months after surgery on the right hindlimb, a PGR prosthesis was positioned medially on the frontal plane and tibial tuberosity transposition and lateral imbrications were performed on the left hindlimb. Two weeks after surgery, reluxation of the patella occurred on the left hindlimb. The tibial tuberosity transposition was performed to realign the patella more laterally than the previous surgery, and a patellar sling was applied. Two years after the last surgery, the patient showed no pain on the stifle joint and satisfactory weight-bearing ambulation. Reluxation did not recur. PGR maybe a successful treatment for dogs with iatrogenically damaged and/or worn out patellar grooves.

• Journal of Veterinary Clinics
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• v.35 no.3
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• pp.71-76
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• 2018

In 22 dogs with medial patellar luxation (MPL) of grade 3 or lower, resection of the vastus medialis oblique muscle, patellar anti-rotational suture, fascia lata overlap, and tibial tuberosity transposition (TTT) were undertaken to stabilize the patella without trochleoplasty. Data including signalment, clinical symptoms, details of the affected hindlimb, preoperative and postoperative patellar luxation grades, postoperative recovery time, and postoperative complications were obtained from medical records. The grade of lameness was evaluated preoperatively and postoperatively. Mean (${\pm}SEM$) grade of medial patellar luxation was $2.64{\pm}0.11$ preoperatively and $0.2{\pm}0.27$ postoperatively. Mean (${\pm}SEM$) grade of lameness was $1.73{\pm}0.27$ preoperatively and $0.18{\pm}0.15$ postoperatively. Patellar reluxation occurred in 1 of 22 (4.5%) cases requiring additional surgery. At final follow-up, 2 of the 22 (9.0%) dogs, including one with reluxation, had occasional lameness. Client-based questionnaire results demonstrated significant improvements in all parameters. Surgical treatment of MPL that included resection of the vastus medialis oblique without femoral trochlear groove deepening improved surgical outcomes in dogs with up to grade 3 MPL.

• Journal of Veterinary Clinics
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• v.16 no.2
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• pp.497-500
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• 1999

A 4 years old male mixed breed dog, which weighed 25.5 kg, referred to Veterinary Teaching Hospital at College of Veterinary Medicine in Chonnam National University, because of chronic hindleg lameness. Click sound by flexion and extension of stifle joint, positive reaction by cranial drawer movement, fat pad sign and tibial position in cranial drawer position on the lateral radiographic view, medial patellar luxation (grade II), and lameness score 2.5 at standing and 2 at walking in right hindleg were showed. Under general anesthesia with enflurane, after medial arthrotomy, it was performed to remove remnants of cranial cruciate ligament and torn medial menisci and joint closed. In modified retinacular imbrication technique, one lateral fabellar/tuberosity suture, one medial fabellar/tuberosity suture, and one imbrication suture adjacent to the patella were placed. At 9 days after operation, lameness score 0 was observed and general condition was excellent.

• Journal of Veterinary Clinics
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• v.26 no.6
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• pp.655-658
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• 2009

An 11-year-old, female, Maltese dog was presented with abdominal distension and intermittent slight lameness on left hindlimb. Palpable abdominal pain and purulent vaginal discharge were observed on physical examination. Severe leukopenia with toxic change, and azotemia, hyperphosphatemia, and hyponatremia were identified on blood profile. On radiographs and abdominal sonograms, remarkable soft tissue mass containing echogenic material deviating intestines craniodorsally compatible with pyometra. On stifle radiographs, 4-5 fragmented sesamoid bone (fabella) was identified on both stifle joint with medial patella luxation. Immediate ovariohysterectomy was performed and the patient was recovered well with normal blood work. No specific treatment was attempted to the left hindlimb showing minimal and intermittent lameness. No remarkable abnormal gait was reported for 3-month follow-up period. The fragmented lateral fabella is considered congenital multipartite of lateral fabella not related to the lameness.