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Resumen: Objetivo: Presentar los diferentes procedimientos quirúrgicos en el tratamiento de las inestabilidades femoropatelares objetivas, incluyendo la osteotomía de la tuberosidad tibial anterior y la trocleoplastía femoral. Material y métodos: Con un diseño prospectivo con seguimiento a cinco años que incluyó a 21 pacientes (21 rodillas) tratados por luxación rotuliana recidivante entre Marzo de 2010 y Agosto de 2014, tratándose de forma quirúrgica mediante dos técnicas diferentes según el tipo de inestabilidad estructural de base. Para determinarlo, se analizó el índice radiográfico de Caton-Deschamps (para la evaluación de la altura rotuliana) y parámetros tomográficos para valorar el configuración troclear y distancia desde la tuberosidad tibial anterior hasta la tróclea femoral (TT-TG) en la superposición de imágenes en el plano axial. Resultados: Hemos tenido resultados satisfactorios tanto con la transferencia de la tuberosidad tibial anterior como con la trocleoplastía. En ambos procedimientos se realizó una reconstrucción del ligamento patelofemoral medial (LPFM). Conclusiones: La recurrencia de inestabilidad es muy rara después de estos procedimientos y es más probable que ésta resulte de anomalías asociadas no diagnosticadas o subestimadas. Se requiere una planificación precisa preoperatoria para determinar la altura rotuliana, la ubicación de la tuberosidad tibial anterior y la configuración troclear para obtener resultados satisfactorios.

Abstract: Objective: To present the different surgical procedures in the treatment of objective femoropateral instability, including osteotomy of anterior tibial tuberosity and femoral trocleoplasty. Material and methods: With a prospective 5-year follow-up design that included 21 patients (21 knees) treated for relapsing patellar dislocation between March 2010 and August 2014, treated surgically using 2 different techniques depending on the type of basic structural instability. To determine this, the Caton-Deschamps X-Ray Index (for the evaluation of the patellar height) and tomographic parameters were analyzed to assess the troclear configuration and distance from the anterior tibial tuberosity to the femoral trochlea (TT-TG) in the overlapping of images in the axial plane. Results: We have had satisfactory results both with the transfer of the anterior tibial tuberosity and with the trocleoplasty. In both procedures, a reconstruction of the medial patelo-femoral ligament (LPFM) was performed. Conclusion: Recurrence of instability is very rare after these procedures and is more likely to result from undiagnosed or underestimated associated abnormalities. Precise preoperative planning is required to determine the patellar height, location of the anterior tibial tuberosity, and troclear configuration for satisfactory results.

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A luxação patelar é uma das condições mais comuns da articulação do joelho em cães e pode evoluir para doença articular degenerativa. A luxação pode ocorrer medial ou lateralmente, sendo unilateral ou bilateral, onde a ocorrência medial é mais frequente em animais de raças pequenas e a lateral é mais comum em animais de raças grandes. A classificação da luxação patelar compreende quatro graus, de acordo com a posição patelar, sinais clínicos e gravidade das deformidades ósseas encontradas. O diagnóstico é feito com base na avaliação clínica, associada a uma radiografia. O presente estudo apresenta uma fêmea de 10 meses de idade, na qual o tutor relatou que o animal já havia sido submetido à cirurgia para corrigir o deslocamento medular da patela e ainda apresentava claudicação e dor. Após a radiografia, foi encontrado o diagnóstico de luxação patelar medial do membro em que a cirurgia havia sido realizada.(AU)

Patellar dislocation is one of the most common knee joint conditions in dogs and may progress to degenerative joint disease. The dislocation can run medially or laterally, being unilateral or bilateral, where the medial occurrence is more frequent in small breed animals and the lateral one is more common in large breed animals. 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 radiograph. The present study presents a 10-month-oldfemale canine in which the tutor reported that the animal had already undergone surgery to correct medial patellar dislocation and still had lameness and pain. After x-ray the diagnosis of medial patellar dislocation of the limb in which surgery had been performed was found.(AU)

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RESUMO

A luxação patelar é uma das condições mais comuns da articulação do joelho em cães e pode evoluir para doença articular degenerativa. A luxação pode ocorrer medial ou lateralmente, sendo unilateral ou bilateral, onde a ocorrência medial é mais frequente em animais de raças pequenas e a lateral é mais comum em animais de raças grandes. A classificação da luxação patelar compreende quatro graus, de acordo com a posição patelar, sinais clínicos e gravidade das deformidades ósseas encontradas. O diagnóstico é feito com base na avaliação clínica, associada a uma radiografia. O presente estudo apresenta uma fêmea de 10 meses de idade, na qual o tutor relatou que o animal já havia sido submetido à cirurgia para corrigir o deslocamento medular da patela e ainda apresentava claudicação e dor. Após a radiografia, foi encontrado o diagnóstico de luxação patelar medial do membro em que a cirurgia havia sido realizada.

Patellar dislocation is one of the most common knee joint conditions in dogs and may progress to degenerative joint disease. The dislocation can run medially or laterally, being unilateral or bilateral, where the medial occurrence is more frequent in small breed animals and the lateral one is more common in large breed animals. 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 radiograph. The present study presents a 10-month-old female canine in which the tutor reported that the animal had already undergone surgery to correct medial patellar dislocation and still had lameness and pain. After x-ray the diagnosis of medial patellar dislocation of the limb in which surgery had been performed was found.

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Introducción: El objetivo de este estudio es presentar los diferentes procedimientos quirúrgicos en el tratamiento de las inestabilidades femoropatelares objetivas, como la osteotomía de la tuberosidad tibial anterior y la trocleoplastia femoral. Materiales y Métodos: Se analizó el Índice de Caton-Deschamps para evaluar la altura rotuliana, la distancia desde la tuberosidad tibial anterior hasta la tróclea femoral en la tomografía computarizada, en el plano axial, y los morfotipos troclear y rotuliano. Se incluyeron 11 pacientes (11 rodillas) tratados por inestabilidad femoropatelar objetiva y documentada. Resultados: Los resultados fueron satisfactorios tanto con la transferencia de la tuberosidad tibial anterior como con la trocleoplastia. En ambos procedimientos, se realizó una reconstrucción del ligamento femoropatelar medial. La recurrencia de la inestabilidad es muy rara después de estos procedimientos y es más probable que sea secundaria a anomalías asociadas no diagnosticadas. Conclusión: Se requiere una planificación preoperatoria precisa para determinar la altura rotuliana, la ubicación de la tuberosidad tibial anterior, y los morfotipos troclear y rotuliano para lograr resultados satisfactorios. De todas formas y, como cualquier procedimiento quirúrgico, tanto las osteotomías de la tuberosidad tibial anterior, como la trocleoplastia pueden causar complicaciones.

Introduction: The aim of this study is to show the different surgical procedures for treating the objective patellar instability, including the different tibial tubercle osteotomies and the sulcus deepening trochleoplasty. Methods: This study analyzed the Caton-Deschamps index used for assessment of patellar height, the distance from the tibial tubercle to the troclear groove on CT scan in the axial view, and the different trochlear and patellar morphotypes. We included 11 knees (11 patients) treated due to an objective and documented patellofemoral instability. Results: We obtained good results with both the transfer of the tibial tuberosity and the trochleoplasty. A reconstruction of the medial patellofemoral ligament was performed in both procedures.Recurrence of instability is very rare after these procedures and this is more likely to result from missed associated abnormalities. Conclusion: Accurate preoperative planning of the patellar height and determining the location of the tibial tubercle and the trochlear and patellar morphotypes for satisfactory results are required. How ever, as with any surgical procedure, both tibial tubercle osteotomy and the sulcus deepening trochleoplasty are susceptible of complications.

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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 anima

RESUMO

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 anima

RESUMO

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.

Assuntos

RESUMO

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.(AU)

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