• 한국임상수의학회지
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• 제37권2호
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• pp.67-74
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• 2020

The purpose of this study is to identify clinical features of sound (non-lame) dogs with medial patellar luxation (MPL). Medical records of 72 dogs diagnosed with MPL were retrospectively reviewed. There were no significances in breed, sex, body weight, body condition score (BCS), osteoarthritis (OA) score, inclination of the femoral head angle (IFA), and mechanical medial proximal tibial angle (mMPTA) between sound and lame dogs, respectively. The mean age of sound dogs was significantly higher than that of lame dogs (P < 0.05), especially in MPL grade 3. The frequency of sound dogs with MPL grade 1 and 2 was 2.3 times higher than that of sound dogs with MPL grade 3 and 4 (P < 0.05). The anatomical lateral distal femoral angle (aLDFA) of sound dogs was significantly lower than that of lame dogs (P < 0.05). However, there were no statistical differences in aLDFA between sound and lame dogs in MPL grade 1, 2, and 4, except for MPL grade 3. This study suggests that in case of MPL grade 1 and 2, frequency of sound dogs is significantly high, and also that in MPL grade 3, if mean ± (standard deviation) age of the dogs is 7.4 ± 3.6 years old and the aLDFA is 105.6 ± 4.1 degrees, they are very highly possible to be sound dogs.

• 대한물리치료과학회지
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• 제31권1호
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• pp.46-52
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• 2024

Background: This study aims to investigate compensatory strategy in a dog with glenoid dysplasia using kinetic gait analysis before and after reconstruction of medial patellar luxation. Design: Case report Method: On the platform, gait analysis was evaluated for a dog with congenital luxation and bilateral medial patellar luxation (MPL). A dog was evaluated for maximal vertical force (MVF), body load distribution (BLD), and symmetry index (SI), including the left forelimb with congenital luxation before MPL surgery, 15 days of surgery, and 40 days of surgery. Result:: In the comparison between the preoperative and the 15 days of surgery, the MVF of the bilateral forelimbs, especially in the non-affected forelimbs, increased, and the SI also increased. For BLD, the maximum load distribution increased, but the total load distribution decreased. In the comparison of 15 days and 40 days of surgery, MVF and BLD increased, and SI decreased on 40days of surgery. Conclusions: In a dog, the shift in weight load to the non-affected side occurs all the limbs, affecting the peak vertical force, weight load distribution, and symmetry index.

• 한국임상수의학회지
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• 제34권5호
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• pp.366-369
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• 2017

A 30 kg, 6-year-old spayed female Samoyed dog was referred with a history of intermittent weight-bearing lameness in her right hindlimb for 3 weeks. The patient hadsurgery to correct a medial patellar luxation in the same limb 3 years prior. Based on the physical examination and radiographic findings, MPL and CCLR of the right hindlimb were diagnosed. Pre-surgical arthroscopy examination was performed, revealing a complete rupture of the cranial cruciate ligament, medial caudal meniscal tears and fibrotic cartilagechanges on the trochlear groove. An arthroscopy-assisted partial meniscectomy was used to repair themedial caudal meniscus. To correct the tibial plateau angle and medial patellar luxation, a tibial plateau leveling osteotomy (TPLO) was performed. A tibial tuberosity transposition (TTT) was performed to realignthe quadriceps mechanism with the trochlear block recession followed by soft tissue reconstruction. The post-surgical recovery was uneventful, and the patient was weight-bearing with normal ambulation on the repaired limb. There were no complications, and the implants were well positioned at the last follow-up. The clinical outcome of the caseindicates that combining TPLO with TTTis a good surgical option for treatingconcurrent CCLR and MPL.

• 한국임상수의학회지
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• 제36권6호
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• pp.301-305
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• 2019

Wii^® balance board (WBB, Nintendo, Japan) is a device that can measure and record the center of pressure path length (CPPL) and 95% confidence ellipse area (Area 95) in relation to body sway. For evaluating measure of improvement after reconstruction of medial patellar luxation (MPL) in small sized dogs, A total of 6 dogs with limping and lameness gait attributed to Grade II, III or IV MPL were evaluated. Dogs were measured for difference of extension and flexion range of motion in the stifle (dROM), muscle mass, lameness, willingness to bear weight on the affected limb while standing, and willingness to lift the contralateral limb scores, CPPL and Area 95 of WBB on pre-surgery, post-surgery 4, 8 weeks. CPPL was significantly different on pre-surgery compared with post-surgery 8 weeks (p < 0.05). Except for CPPL, measured variables were significantly different on pre-surgery compared with post-surgery 4 and post-surgery 8 weeks (p < 0.01).

• 한국임상수의학회지
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• 제35권5호
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• pp.200-205
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• 2018

This retrospective study is designed to compare the clinical results of tibial tuberosity transposition (TTT) and anti-rotation suture (ARS) treatments for medial patellar luxation (MPL). Medical records of 133 dogs were reviewed that had undergone surgical correction of MPL between January 2013 and May 2017. MPL correction was performed on 182 stifles, with TTT and ARS being performed on 101 stifles and 81 stifles. The common dog breeds receiving surgical treatment for MPL were Maltese, Pomeranian, Chihuahua and Poodle. Mean age of dogs with MPL was 32.6 months, and their mean body weight was 4.26 kg. Seventy dogs (52.6%) were male and 63 (47.4%) were female. Of the 182 stifles with MPL, grade II, III and IV were 18.7%, 72.0% and 9.3%. Total complications after TTT and ARS were recorded in 16.8% and 29.6%. Major complications after TTT and ARS were recorded in 5.9% and 12.3%, minor complications after TTT and ARS were recorded in 10.9% and 17.3%. The risk of complication and reluxation rate after TTT were significantly lower than that for ARS (p < 0.05). However, the rate of reluxation among dogs treated by ARS (1.2%) for grade II MPL was significantly lower than that for dogs treated by ARS (8.6%) for grade III MPL (p < 0.05). The TTT group had a shorter recovery period after surgical intervention than that in the ARS group (p < 0.001). In conclusion, TTT had a significantly lower incidence of complication and a shorter recovery period than ARS. However, ARS for grade II MPL appears to be a good surgical option for reducing the rate of reluxation after surgery. These results of this study could be used to provide therapeutic guidelines for surgical MPL correction in small-breed dogs.

• 한국임상수의학회지
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• 제33권6호
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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.

• 한국임상수의학회지
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• 제37권3호
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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.

• 한국임상수의학회지
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• 제41권4호
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• pp.228-233
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• 2024

A 7-month-old, 5.2 kg spayed female Norwegian Forest cat was referred for chronic, non-weight-bearing lameness in the left pelvic limb that has been present since 3 months old and has not responded to medical conservative therapy. Based on orthopedic and radiographic examination, concomitant cranial cruciate ligament rupture (CCLR) and medial patellar luxation (MPL) of the left hind limb were diagnosed. In this case, cranial tibial wedge osteotomy (CTWO) was adopted to overcome side effect of performing other osteotomy techniques such as impairing the growth plates in the proximal tibia. Additionally, patient-specific surgical guides were applied to improve surgical accuracy. The patient showed an improvement in weight-bearing scores and gait condition during follow-up periods without complications. In our case, CTWO combined with corrective surgery for MPL can be used to treat concomitant CCLR and MPL without damaged on the growth plates and shows good clinical outcomes in an immature cat. Furthermore, the use of a surgical guide facilitates surgical procedures that minimize surgical error and increase surgical precision. This case study suggests that CTWO assisted by patient-specific surgical guides may be a viable surgical option for treating an immature cat with concomitant CCLR and MPL.

• 한국임상수의학회지
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• 제33권5호
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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.

• 한국임상수의학회지
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• 제35권3호
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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.