• 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.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.

• 대한관절경학회:학술대회논문집
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• 2007.10a
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• pp.15-15
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• 2007

• Journal of Veterinary Clinics
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• v.20 no.1
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• pp.96-103
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• 2003

The purpose of this study is to evaluate the results obtained from three surgical techniques (retinacular imbrication, trochleoplasty and tibia tuberosity transposition), which were simultaneously applied for correction of patellar luxation. Eleven, (6 to 108 months) old dogs were presented. The dogs showed, medial patellar luxation (17 stifle joint) and lateral patellar luxation (2 stifle joint) ranging from grade 1 to 4. By palpation and radiographic view, all 11 dogs were diagnosed as patellar luxation. Bilateral patellar luxation was diagnosed in 8 dogs. After operation, the dogs were monitored daily for 7 days and on the 10th, 15th, 20th, 25th and 30th days. Lameness progressively decreased in all dogs around 30 days after surgery, and the patients were showed normal walking. Normal walking was possible in 2 dogs after 4 days, in a dog after 5 days, a dog after 7 days, 3 dogs after 10 days,2 dogs after 15 days, a dog after 25 days and a dog after 30 days (Mean$\pm$S.E: 12.27$\pm$2.57). The recovery took 14 days in dogs with bilateral patellar luxation, and 9 days in dogs with unilateral patellar luxation. Trend of decrease of lameness grade in bilateral patellar corrected dogs were similar to that in unilateral patellar corrected dogs. Swelling, pain and fever disappeared on 7 days. In conclusion, combination of tibial tuberosity transposition, retinacular imbrication and trochleoplasty is appropriate for dogs with patellar luxation.

• Journal of Veterinary Clinics
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• v.24 no.3
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• pp.342-344
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• 2007

This study was performed to report the signalment, history, and outcome of modified retinacular imbrication technique (MRIT) for treatment of cranial cruciate ligament rupture (CCLR) in dogs. Nine dogs (12 stifles) presented with chronic hindlimb lameness associated with CCLR. They were 7 males and 2 females. Six were Yorkshire terriers. Mean age was 8 years (range,2 to 14 years), and mean weight was 5.6kg (range, $1.8{\sim}19kg$). Three dogs had bilateral CCLR and six dogs had unilateral CCLR (2 left stifles and 4 right stifles). Nine stifles (8 dogs) had concomitant patellar medial luxation. Surgery was performed in eight stifles (5 dogs) and recovery rate of 100%. Three stifles (2 dogs) were underwent simultaneously femoral trochleoplasty. Mean time to the normal gait after surgery was 30 days. There were not postoperative complications.

• Journal of Korean Foot and Ankle Society
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• v.12 no.1
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• pp.9-13
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• 2008

Purpose: Medial capsulorrhaphy is additional hallux reduction method following various hallux reduction procedures and we are going to report author's opinion about several methods of medial capsulorrhaphy. Materials and Methods: We performed three kinds of medial capsulotomy and imbricatory capsulorrhaphy in hallux valgus surgery. Through 8 cadavar study, we compared the easiness of sesamoid reduction and hallux valgus angle reduction. Also, we measured thickness of capsule in various portions. Results: Longitudinal capsule incision and imbrication was useful in sesamoid reduction and vertical procedures was useful in hallux valgus angle reduction. The capsule thickness was measured thickest in dorsal and distal portioin. Conclusion: The methods of medial capsulorrhaphy should be planned preoperatively considering individual hallux deformities. These selected medial capsulorrhaphy can help the reduction of hallux valgus deformity correction and its maintenance.

• Journal of Veterinary Clinics
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• v.36 no.5
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• pp.285-288
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• 2019

A 5-year-old 6 kg male mongrel (case 1) and a 7-year-old 4.3 kg male yorkshire terrier (case 2) were presented to Chonbuk animal medical center (CAMC). Both animals had non-weight bearing hind limb lameness. Case 1 had complete rupture of cranial cruciate ligament with grade 3 medial patellar luxation. Case 2 had complete cranial cruciate ligament rupture with grade 4 medial patellar luxation. During surgery, in both cases, trochlear block recession was performed followed by CORA based leveling osteotomy (CBLO) and tibial tuberosity transposition (TTT). General soft tissue reconstructions for medial patellar luxation including medial releasing and lateral imbrication were also performed. Postoperatively, both animals demonstrated excellent recovery and regained normal weight bearing of the affected hind limb without any recognizable complication. CBLO followed by TTT can be a curative surgical option without complications in cases of cranial cruciate ligament rupture with high-grade medial patellar luxation in small breed dogs.

• Journal of the Korean Arthroscopy Society
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• v.10 no.1
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• pp.118-122
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• 2006

Purpose: We introduce a technique of all inside arthroscopic capsular imbrication and lateral release used to treat patellofemoral instability. Methods: With the arthroscope in the anteromedial portal for best viewing, the arthroscopic scissor is placed through superolateral portal for proximal to distal release. The release performed 5mm to 1cm from the edge of the patella. After completion of the procedure, with the arthroscope in anterolateral portal, we inserted 5mm cannula in superolateral portal and made working portal from superomedial portal. Medial reefing was performed with all inside technique by using curved needle of the spectrum suturing system and No. 1 monofilament PDS suture is passed through the superomedial portal percutaneously and retrieved through a superolateral portal. Conclusion: Several methods for arthroscopic patella realignment have been proposed, but they have consisted primarily of arthroscopically assisted techniques using a medial incision. We believe that our procedure is preferable to arthroscopically assisted methods commonly used, in that an incision is avoided and the vastus medialis obliqqus is not violated. Our technique is minimally invasive and is easy to control the tightness of the medial patellofemoral ligament (MPFL) under direct vision.

• Journal of Korean Orthopaedic Sports Medicine
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• v.9 no.2
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• pp.98-103
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• 2010

Purpose: We reported the results of arthroscopically assisted lateral release and medial imbrication for the recurrent patella dislocation. Materials and Methods: Twenty patients (20 knees) underwent arthroscopically assisted surgery for the recurrent patella dislocation. There were 4 males and 16 female. The average age was 20.2 years. All patients had definite trauma history and average follow-up period was 19 months. The surgical results were evaluated according to the Lysholm knee score and the Kujala score. The congruence angle and lateral patellofemoral angle were measured on plain radiograph and the tibial tubercle-trochlear groove distance was calculated on computerized tomography. Results: The median value of preoperative congruence angle was $16.5^{\circ}$ (range, $0.0{\sim}+34^{\circ}$) and the average final follow-up was $-6.4^{\circ}$ (range, $-19{\sim}10^{\circ}$) with statistically significant improvement (p=0.025). The median value of preoperative Lysholm knee score was 70 (range, 63~81) and the final follow-up score had changed to 88 (range, 80~95) with statistically significant improvement (p=0.0341). The median value of preoperative Kujala score was 72 (range, 65~80) and the average final follow-up score showed 87 (range, 80~92) with statistically significant improvement (p=0.024). Recurrent dislocations after surgery occurred in 2 cases, one case which showed positive "thumb to forearm test" had been treated with medial patellofemoral ligament reconstruction. Conclusion: Arthroscopically assisted lateral release and medial imbrication for recurrent patella dislocation without bony malaligmenent showed the effective treatment, but would be inappropriate for the patients with the generalized joint laxity.

• Journal of Veterinary Clinics
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• v.16 no.2
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• pp.309-320
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• 1999

Medial patellar luxation in dogs is one of the most common patellar problems presented to the veterinary practitioner. It is observed in toy and miniature breed and the majority of cases is a congenital form. Because of extensor mechanism's instability, it causes deformity and disorder in the growth of the affected limb when the luxation is left without treatment As lameness is not easily detectable in puppies, early diagnosis and correction are essential for therapy. Up to now, there has not been any reports refering to the diagnostic methods and the optimal age for correction in young dogs. Thirteen 45-90 days old puppies, have grade I and/or II medial patellar luxation. Only by palpation, all 13 dogs were diagnosed of patelar luxation. Skyline radiographic view was useful to interpret patellar morphology and depth of trochlear groove only above 60 days old. However, it was difficult to make definite diagnosis patellar luxation. The caudocranial and lateral radiographic view as well as ultrasonographic skyline view were not showed of patellar luxation. 2 puppies had unilateral patellar luxation and 11 puppies had bilateral patellar luxation which more serious on the left than on the right. Only 3 puppies among 11 puppies with bilateral patellar luxation were observed of lameness degree 1. Regardless of grade of patellar luxation and lameness, we performed trochlear chondroplasty using a U-shape sculpture blade to minimize cartilage injury, transposition of tibia tuberosity with No. 1 Supramid to align extensor mechanism and lateral imbrication. After surgery, we examined the operated animal daily for 10 days and on 15, 30 and 60 days after surgery respectively. After operation, pain and fever became normal on 7 days, swelling on 10 days, respectively. On 10 days after surgery, dogs showed normal standing position, and normal walking was observed in 15 days after surgery. In force plate analysis, the operated legs were normal weight bearing at 30 days after operation. After surgery, not only patellar luxation and clinical signs have been gradually reduced but also bone growth have become normal without showing growth physeal plate injury. The survival rate of puppies over 62 days old was 100%, while 42-45 days old 37.5%. The above results suggest that optimal age for surgical correction of congenital medial patellar luxation is recommended over 60 days old. In conclusion, combination of trochlear chondroplasty, transposition of tibia tuberosity, and lateral retinacular imbrication is appropriate for over 60 days old puppies to efficiently correct patellar luxation.