Download PDF
Vet Comp Orthop Traumatol 2023; 36(02): 068-074
DOI: 10.1055/s-0042-1757592
Original Research

Ideal Anchor Points for Patellar Anti-rotational Sutures for Management of Medial Patellar Luxation in Dogs: A Radiographic Survey

Parisa Mazdarani 
1   College of Veterinary Medicine, University of Florida, Gainesville, Florida, United States
,
James Edward Miles 
2   Department of Veterinary Clinical Sciences, University of Copenhagen, Frederiksberg C, Denmark
› Author Affiliations Funding This study received financial aid from the Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen.
› Further Information
Also available at
    Permissions and Reprints

Abstract

Objective The aim of this study was to identify the ideal anchor point for patellar anti-rotational sutures for adjunctive stabilization of medial patellar luxation in both small and large breed dogs.

Study Design Retrospective radiographic survey was performed on 110 stifles from 101 dogs. Radiographs were grouped based on patient weight (≤15 kg; >15 kg) and diagnosis (medial patellar luxation, cranial cruciate ligament rupture, and normal joints). Radiographic measurements included: the proximal, middle, and distal points of the trochlear ridge, the caudal aspect of Blumensaat's line (roof of the intercondylar notch), the centre of the lateral fabella, as well as the “best-fit” centre of a circle overlying the trochlea. These landmark coordinates were used to calculate radii for comparison, and for scaling between joints.

Results Use of the fabellar centre resulted in larger radii (corrected p <0.001) than those from the best-fit circle centre for all but one combination of patient group and trochlear end point locations. Using the best-fit circle centre, radius variation was less marked than with the fabellar centre. Significant differences in location for centres of the best-fit circle and fabella were seen across all patient categories (Pillai's trace p <0.001).

Conclusion The fabella is unlikely to be the best choice for anchoring a patellar anti-rotational suture. Use of the best-fit circle centre to place a suture anchor should be preferred to maximise suture isometry during joint flexion and extension in large and small breed dogs.

Keywords

dogs - stifle joint - patellar luxation - patellar anti-rotational suture - radiography

Data Availability

Data related to this study are available at: https://doi.org/10.6084/m9.figshare.20080523.v1


Authors' Contributions

J.E.M. conceptualized the study, P.M. designed the study, P.M. acquired the data, J.E.M. and P.M. analysed and interpreted the data, drafted the manuscript and are accountable for the relevant content.


Supplementary Material



Publication History

Received: 28 January 2022

Accepted: 27 August 2022

Article published online:
31 December 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Johnson J, Austin C, Breur G. Incidence of canine appendicular musculoskeletal disorders in 16 veterinary teaching hospitals from 1980 through 1989. Vet Comp Orthop Traumatol 1994; 7: 56-69
    Thieme ConnectPubMedSearch in Google Scholar
  • 2 Bound N, Zakai D, Butterworth SJ, Pead M. The prevalence of canine patellar luxation in three centres. Clinical features and radiographic evidence of limb deviation. Vet Comp Orthop Traumatol 2009; 22 (01) 32-37
    Search in Google Scholar
  • 3 Ness MG, Abercromby RH, May C, Turner BM, Carmichael S. A survey of orthopaedic conditions in small animal veterinary practice in Britain. Vet Comp Orthop Traumatol 1996; 9: 43-52
    Thieme ConnectPubMedSearch in Google Scholar
  • 4 Engdahl K, Hanson J, Bergström A, Bonnett B, Höglund O, Emanuelson U. The epidemiology of stifle joint disease in an insured Swedish dog population. Vet Rec 2021; 189 (03) e197
    CrossrefPubMedSearch in Google Scholar
  • 5 Piermattei D, Flo G. The stifle joint. In: Piermattei D, Flo G, eds. Handbook of Small Animal Orthopedics and Fracture Repair. St Louis, Missouri: Elsevier; 2016: 597-669
    Search in Google Scholar
  • 6 Hayes AG, Boudrieau RJ, Hungerford LL. Frequency and distribution of medial and lateral patellar luxation in dogs: 124 cases (1982-1992). J Am Vet Med Assoc 1994; 205 (05) 716-720
    PubMedSearch in Google Scholar
  • 7 Priester WA. Sex, size, and breed as risk factors in canine patellar dislocation. J Am Vet Med Assoc 1972; 160 (05) 740-742
    PubMedSearch in Google Scholar
  • 8 Harasen G. Patellar luxation: pathogenesis and surgical correction. Can Vet J 2006; 47 (10) 1037-1039
    PubMedSearch in Google Scholar
  • 9 Kowaleski M, Boudrieau R, Pozzi A. Stifle joint. In: Tobias K, Johnston S, eds. Veterinary Surgery Small Animal. St Louis, Missouri: Elsevier; 2018: 1071-1167
    Search in Google Scholar
  • 10 Hulse DA. Pathophysiology and management of medial patellar luxation in the dog. Vet Med Small Anim Clin 1981; 76 (01) 43-51
    PubMedSearch in Google Scholar
  • 11 Towle HA, Griffon DJ, Thomas MW, Siegel AM, Dunning D, Johnson A. Pre- and postoperative radiographic and computed tomographic evaluation of dogs with medial patellar luxation. Vet Surg 2005; 34 (03) 265-272
    Search in Google Scholar
  • 12 Singleton WB. The diagnosis and surgical treatment of some abnormal stifle conditions in the dog. Vet Rec 1957; 69: 1387-1396
    PubMedSearch in Google Scholar
  • 13 Willauer CC, Vasseur PB. Clinical results of surgical correction of medial luxation of the patella in dogs. Vet Surg 1987; 16 (01) 31-36
    CrossrefPubMedSearch in Google Scholar
  • 14 Arthurs GI, Langley-Hobbs SJ. Complications associated with corrective surgery for patellar luxation in 109 dogs. Vet Surg 2006; 35 (06) 559-566
    Search in Google Scholar
  • 15 Gibbons SE, Macias C, Tonzing MA, Pinchbeck GL, McKee WM. Patellar luxation in 70 large breed dogs. J Small Anim Pract 2006; 47 (01) 3-9
    CrossrefPubMedSearch in Google Scholar
  • 16 Wangdee C, Theyse LFH, Techakumphu M, Soontornvipart K, Hazewinkel HAW. Evaluation of surgical treatment of medial patellar luxation in Pomeranian dogs. Vet Comp Orthop Traumatol 2013; 26 (06) 435-439
    Thieme ConnectPubMedSearch in Google Scholar
  • 17 Jensen TV, Kristiansen SS, Buelund LE, Miles JE. Modelling the effects of cranial cruciate ligament transection, medial meniscal release and triple tibial osteotomy on stability of the canine stifle joint. Vet Comp Orthop Traumatol 2020; 33 (03) 174-182
    Thieme ConnectPubMedSearch in Google Scholar
  • 18 Rueden CT, Schindelin J, Hiner MC. et al. ImageJ2: ImageJ for the next generation of scientific image data. BMC Bioinformatics 2017; 18 (01) 529
    CrossrefPubMedSearch in Google Scholar
  • 19 Blumensaat C. Die Lageabweichungen und Verrenkungen der Kniescheibe. Ergeb Chir Orthop 1938; 31: 149-223
    PubMedSearch in Google Scholar
  • 20 Mostafa AA, Griffon DJ, Thomas MW, Constable PD. Proximodistal alignment of the canine patella: radiographic evaluation and association with medial and lateral patellar luxation. Vet Surg 2008; 37 (03) 201-211
    Search in Google Scholar
  • 21 Johnson AL, Broaddus KD, Hauptman JG, Marsh S, Monsere J, Sepulveda G. Vertical patellar position in large-breed dogs with clinically normal stifles and large-breed dogs with medial patellar luxation. Vet Surg 2006; 35 (01) 78-81
    Search in Google Scholar
  • 22 Insall J, Salvati E. Patella position in the normal knee joint. Radiology 1971; 101 (01) 101-104
    CrossrefPubMedSearch in Google Scholar
  • 23 Murakami S, Shimada M, Harada Y, Hara Y. Examination of the proximodistal patellar position in small dogs in relation to anatomical features of the distal femur and medial patellar luxation. PLoS One 2021; 16 (05) e0252531
    Search in Google Scholar
  • 24 Casale SA, Mccarthy RJ. Complications associated with lateral fabellotibial suture surgery for cranial cruciate ligament injury in dogs: 363 cases (1997–2005). J Am Vet Med Assoc 2009; 234 (02) 229-235
    CrossrefPubMedSearch in Google Scholar
  • 25 Evans H, De Lahunta A. Arthrology. In: Evans H, De Lahunta A, eds. Miller's Anatomy of the Dog. St Louis, Missouri: Elsevier Saunders; 2013: 180
    Search in Google Scholar
  • 26 Ocal MK, Sevil-Kilimci F, Yildirim IG. Geometry of the femoral condyles in dogs. Vet Res Commun 2012; 36 (01) 1-6
    CrossrefPubMedSearch in Google Scholar
  • 27 Guerrero TG, Geyer H, Hässig M, Montavon PM. Effect of conformation of the distal portion of the femur and proximal portion of the tibia on the pathogenesis of cranial cruciate ligament disease in dogs. Am J Vet Res 2007; 68 (12) 1332-1337
    CrossrefPubMedSearch in Google Scholar
  • 28 Yasukawa S, Edamura K, Tanegashima K. et al. Morphological analysis of bone deformities of the distal femur in toy poodles with medial patellar luxation. Vet Comp Orthop Traumatol 2021; 34 (05) 303-311
    Thieme ConnectPubMedSearch in Google Scholar
  • 29 Yasukawa S, Edamura K, Tanegashima K. et al. Evaluation of bone deformities of the femur, tibia, and patella in Toy Poodles with medial patellar luxation using computed tomography. Vet Comp Orthop Traumatol 2016; 29 (01) 29-38
    Search in Google Scholar
  • 30 Campbell CA, Horstman CL, Mason DR, Evans RB. Severity of patellar luxation and frequency of concomitant cranial cruciate ligament rupture in dogs: 162 cases (2004-2007). J Am Vet Med Assoc 2010; 236 (08) 887-891
    CrossrefPubMedSearch in Google Scholar
  • 31 Arthurs GI, Langley-Hobbs SJ. Patellar luxation as a complication of surgical intervention for the management of cranial cruciate ligament rupture in dogs. A retrospective study of 32 cases. Vet Comp Orthop Traumatol 2007; 20 (03) 204-210
    Thieme ConnectPubMedSearch in Google Scholar
  • 32 Witte PG. Tibial anatomy in normal small breed dogs including anisometry of various extracapsular stabilizing suture attachment sites. Vet Comp Orthop Traumatol 2015; 28 (05) 331-338
    Thieme ConnectPubMedSearch in Google Scholar
  • 33 Brioschi V, Arthurs GI. Cranial cruciate ligament rupture in small dogs (<15 kg): a narrative literature review. J Small Anim Pract 2021; 62 (12) 1037-1050
    CrossrefPubMedSearch in Google Scholar