• Journal of Veterinary Science
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• 제21권4호
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• pp.67.1-67.11
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• 2020

Background: Tibial tuberosity transposition (TTT) causes caudalization of the patellar ligament insertion in canine medial patellar luxation, which can lead to increases in patellofemoral contact pressure. Objectives: The purpose of this study is to confirm the effect of patellofemoral contact mechanics after craniolateral and caudolateral transposition of tibial tuberosity in normal canine hindlimbs. Methods: Craniolateral and caudolateral transposition of tibial tuberosity was performed in 5 specimens, respectively. The pressure was measured in the specimen before TTT, and then in the same specimen after TTT. In this process, data was obtained in 10 specimens. The measurement results were output as visualization data through the manufacturer's software and numerical data through spreadsheet. Based on these 2 data and the anatomical structure of the patellofemoral joint (PFJ) surface, whole measurement area was analysed by dividing into medial, lateral and central area. Results: In craniolateralization of tibial tuberosity, total, medial, central contact pressure was decreased and lateral contact pressure was not statistically changed lateral contact pressure than normal PFJ. In caudolateralization of tibial tuberosity, total, lateral contact pressure was increased and medial contact pressure was not statistically changed than normal PFJ. Although not statistically significant changed, central contact pressure in caudolateralization of tibial tuberosity was increased in all 5 specimens. Conclusions: These results imply that traditional TTT, prone to caudal shift of patellar tendon, can increase retropatellar pressure may lead to various complications and diseases of the stifle joint.

• 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.

• 한국임상수의학회:학술대회논문집
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• 한국임상수의학회 2006년도 추계학술대회 및 정기총회
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• pp.83-83
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• 2006

• 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.

• 한국임상수의학회지
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• 제31권1호
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• pp.11-14
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• 2014

이 연구는 개에서 내측 슬개골 탈구 수술 후에 발생할 수 있는 합병증을 후향적으로 분석한 연구이다. 4년동안 내측 슬개골 탈구를 교정하기 위해 66마리의 개에서 77건의 수술이 시행되었다. 수술은 내측 연부 조직 이완, 외측 연부 조직 긴장, 활차구 사각 성형술, 경골 조면 이식술을 이용하여 실시되었다. 수술 후 6개월 동안 정기적으로 예후를 평가하였다. 실패율은 처음 수술을 한 경우보다 재수술을 한경우에 더 높았고, 가장 흔한 수술 후 합병증은 경골조면 조각의 변위였다. 경골 조면 변위는 핀이 아래쪽으로 삽입되거나, 핀이 경골 조면 조각의 가장자리에 삽입된 경우 혹은 경골 조면이 둔각인 경우에 발생했다. 따라서 경골 조면 이식술을 주의하여 실시하면 합병증을 최소화 할 수 있으며 좋은 예후를 기대할 수 있을 것으로 사료된다.

• 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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• 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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• 제31권2호
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• pp.133-136
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• 2014

8 kg, 9개월령 중성화 수컷 시바 이누견이 양측 후지의 간헐적인 파행 증상으로 내원하였다. 검사를 통해 3단계의 양측 슬개골 탈구가 진단되었다. 대퇴 사두근의 정상 배열을 회복하기 위해서 상대적으로 비침습적인 조면의 위치를 재배열하는 독특한 수술 방법을 적용하였다. 이 과정은 경골 능선을 따라 경골 조면의 내측 피질골을 절개하고, 경골 조면을 외측으로 변위시키기 위해 경골 능선의 내측에 피질골 나사못을 장착하는 방식으로 이루어졌다. 수술 후 3개월 검사에서 양측 후지의 파행과 슬개골 탈구가 개선된 것이 확인되었다. 이 수술 기법은 골격이 미성숙한 환자에서 내측 슬개골 탈구를 치료하기 위한 효과적인 방법으로 고려될 수 있다.

• 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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• 제31권4호
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• pp.263-266
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• 2014

내측 무릎골 탈구를 나타낸 개에서 경골결절 전위술 실시후 대퇴사두근각(QA)의 변화를 평가하였다. 내측 무릎골 탈구를 나타낸 전체 62 증례 중 실험조건에 맞는 37개의 다리를 조사대상으로 선정하였다. 술전 QA는 각각 grade 2에서 $24.02{\pm}4.02^{\circ}$, grade 3에서 $26.08{\pm}5.66^{\circ}$ 그리고 grade 4에서 $30.25{\pm}7.41^{\circ}$로 나타났다. 술후 QA는 grade 2에서 $21.25{\pm}3.24$, grade 3에서 $19.16{\pm}3.92$ 그리고 grade 4에서 $19.72{\pm}7.30$로 나타났으며, 모든 등급에서 술후 QA는 술전 QA에 비해 유의성 있게 감소되었다(P < 0.05). 4개월간 추적관찰한 결과 모든 증례는 술후 양호한 예후를 나타냈었으나, 술후 QA는 정상보다 높게 나타났다. 이러한 결과는 정상범위보다 큰 술후 QA는 임상적 예후와 관련성이 적을 것으로 생각된다.