• 한국임상수의학회지
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• 제16권2호
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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.

• 한국임상수의학회지
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• 제34권6호
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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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• 대한관절경학회 2007년도 제17차 추계학술대회 심포지움
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• pp.15-15
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• 2007

• 한국임상수의학회지
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• 제20권1호
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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.

• 한국임상수의학회지
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• 제24권3호
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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.

• 대한족부족관절학회지
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• 제12권1호
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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.

• 한국임상수의학회지
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• 제36권5호
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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.

• 대한관절경학회지
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• 제10권1호
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• pp.118-122
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• 2006

목적: 슬개대퇴관절 불안정성에 대한 치료 방법 중 하나인 관절경적 all inside 관절막 중첩술 및 외측 지대 유리술을 소개하고자 한다. 방법: 슬관절의 관절경적 기본 검사 후, 관절경을 전내측 도달법을 개설하여 위치한 후, 외측 지대의 근위부에서 원위부까지 유리술을 시행하기 위하여 상외측 도달법을 개설하여 관절경 scissor를 위치한다. 슬개골의 가장자리부터 5 mm에서 1 cm정도에서 외측 지대 유리술을 시행한다. 외측 지대 유리술 후, 관절경을 전외측 도달법을 개설하여 위치한 후, 상외측 도달법을 개설하여 5 mm 배관을 삽입하고, 조작용 상내측 삽입구를 개설한다. 경피적으로 만곡 침을 상내측 삽입구를 통해 통과시킨 후 봉합사를 상외측 삽입구를 통해 회수하는, all inside 수기로 시행된다. 결론: 근위부 재정렬을 위한 여러 가지 관절경적 방법이 제시되었지만, 대부분이 내측 절개를 이용한 관절경 보조수기 방법들이었다. 관절경적 all inside 관절막 중첩술 및 외측 지대 유리술은 기존의 관절경 보조 수기 방법들에 비해 내측 절개를 피함으로써 내측 광사근에 손상을 주지 않는 점에서 장점을 가진다. 이 수기는 최소 침습적이면서 직접 관찰하면서 내측 슬개대퇴 인대의 긴장의 정도를 조절하기가 쉬운 수술 수기로 사료된다.

• 대한정형외과스포츠의학회지
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• 제9권2호
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• pp.98-103
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• 2010

목적: 슬개골 재발성 탈구 환자에 있어 관절경 보조하의 외측 유리술 및 내측부 중첩술의 결과를 보고하고자 한다. 대상 및 방법: 재발성 슬개골 탈구로 수술적 치료를 받은 20 명의 환자, 21례를 대상으로 하였다. 남자가 4 명, 여자가 16명이고 평균연령 20.2세였다. 모든 환자가 외상의 병력이 있었고 평균 추시 기간은 19개월이었다. 수술 결과의 평가는 Lysholm점수와 Kujala슬관절 점수를 이용하였고, 방사선 사진상 congruence angle, lateral patellofemoral angle을 측정하였고, 전산화 단층촬영에서 tibial tuberosity-trochlear groove distance를 측정하였다. 결과: 단순 방사선 사진상 congruence angle은 술전 중위값 $16.5^{\circ}$ (범위, $0.0{\sim}+34^{\circ}$) 에서 추시 시 $-6.4^{\circ}$ (범위, $-19{\sim}10^{\circ}$), lateral patellofemoral angle은 술전 중간값 -4.5도(범위, $-8{\sim}+6^{\circ}$)에서 $4.0^{\circ}$ (범위, $2.0{\sim}10^{\circ}$)로 호전되었다(p=0.034). Lysholm 점수는 수술 전 중위값 70점(범위, 63~81점)에서 최종 추시 시 중위값 88점(범위, 80~95점)이었다(p=0.341). Kujala 슬관절 점수는 수술 전 중위값 72점(범위,65~80점)에서 수술 후 중위값 87점(범위, 80~92점)으로 호전되었다. (p=0.024). 재발성 탈구는 총 2례에서 발생하였으며 1례는 thumb to forearm검사 양성이었던 경우로 재탈구 되어 내측 슬개대퇴인대 재건술을 시행하였다. 결론: 관절경적 외측 유리술 및 내측부 중첩술은 대퇴슬개관절의 골성 부정정렬이 없는 경우에서 시행하여 좋은 결과를 얻을 수 있었지만, 관절 이완이 심한 환자에서는 좀 더 주의가 필요하다고 사료된다.

• 한국임상수의학회지
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• 제16권2호
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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.