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DOI: 10.1160/VCOT-06-10-0074
Patellar luxation as a complication of surgical intervention for the management of cranial cruciate ligament rupture in dogs
A retrospective study of 32 casesPublikationsverlauf
Received
05. Oktober 2006
Accepted
22. Januar 2007
Publikationsdatum:
21. Dezember 2017 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00035023/200703/lookinside/thumbnails/10-1160-vcot-06-10-0074-1.jpg)
Summary
This retrospective study identified 32 cases of patellar luxation which occurred as a complication of surgical intervention for cranial cruciate ligament rupture (CCLR). The complication was recorded mostly in larger (≥20 kg) dogs with the Labrador Retriever being the most common breed. The complication followed extracapsular, intra-capsular and tibial plateau levelling surgery. The mean time from CCLR surgery to the diagnosis of patellar luxation was 14 weeks. The incidence of patellar luxation occurring as a complication of surgical intervention for CCLR was 0.18% of all CCLR corrective procedures. Corrective surgery for patellar luxation was successful in 79% of stifles. The patellar reluxation rate was significantly lower (p=0.0007) when at least one corrective osteotomy (tibial tuberosity transposition, femoral trochlear sulcoplasty or tibial plateau levelling osteotomy with tibial axial re-alignment) was performed (35%), compared to when corrective osteotomy was not performed (100% patellar reluxation rate). When performing corrective surgery for patellar luxation following CCLR surgery, at least one corrective osteotomy should be performed in order to reduce the patellar reluxation rate. The correction of patellar luxation following surgery for CCLR is challenging and carries a significant rate of failure.
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References
- 1 Conzemius MG, Evans RB, Besancon MF. et al. Effect of surgical technique on limb function after surgery for rupture of the cranial cruciate ligament in dogs. J Am Vet Med Assoc 2005; 226: 232-236.
- 2 Johnson JA, Austin C, Breur GJ. Incidence of canine appendicularmusculoskeletal disorders in 16 veterinary teaching hospitals from 1980 through 1989. VetComp Orthop Traumatol 1994; 7: 56-69.
- 3 Aragon Aragon, Budsberg SC. Applications of Evidence-Based Medicine: Cranial Cruciate Ligament Injury Repair in the Dog. Vet Surg 2005; 34: 93-98.
- 4 Innes JF, Bacon D, Lynch C. Long term outcome of surgery for dogs with cranial cruciate ligament deficiency. Vet Rec 2000; 147: 325-328.
- 5 Moore Moore, Read RA. Rupture of the cranial cruciate ligament in dogs -part2. Com Cont Ed Pract Vet 1996; 18: 381-391.
- 6 Vasseur PB. Stifle Joint. In: Textbook of Small Animal Surgery. Slatter D. (ed). Philadelphia: WB. Saunders Company; 2003: 2091-2133.
- 7 Ness MG, Abercromby RH, May C. et al. A Survey of Orthopaedic Conditions in Small Animal Practice in Britain. Vet Comp Orthop Traumatol 1996; 9: 43-52.
- 8 Arnoczky SP, Tarvin GB, Marshall JL. et al. The over-the-top procedure: A technique for anterior cruciate ligament substitution in the dog. J Am Anim Hosp Assoc 1979; 15: 283-290.
- 9 Childers HE. New methods of cruciate ligament repair: II. Repair by sutures technique. Mod Vet Pract. 1966 47. 59.
- 10 DeAngelis DeAngelis, Lau RE. A lateral retinacular imbrication technique for the surgical correction of anterior cruciate ligament rupture in the dog. J Am VetMed Assoc 1970; 157: 79-84.
- 11 DeJardin LM. Tibial Plateau Levelling Osteotomy. In: Textbook of Small Animal Surgery, Slatter D (ed). Philadelphia: WB. Saunders Company; 2003: 2133-2143.
- 12 Flo G. Modification of the lateral retinacular imbrication technique for stabilizing cruciate ligament injuries. JAmAnim Hosp Assoc 1975; 11: 570-576.
- 13 Hulse DA. A technique for reconstruction of the anterior cruciate ligament in the dog: Preliminary report. Vet Surg 1980; 9: 135-140.
- 14 Lopez MJ, Markel MD, Kalscheur V. et al. Hamstring Graft Technique for Stabilisation of Canine Cranial Cruciate Ligament Deficient Stifles. Vet Surg 2003; 32: 390-401.
- 15 Matthiesen DT. Fibular Head Transposition. Vet Clin North Am Small Anim Pract 1993; 23: 755-760.
- 16 Mullen Mullen, Matthiesen DT. Complications of transposition of the fibular head for stabilization of the cranial cruciate deficient stifle in dogs: 80 cases (1982-1986). J Am Vet Med Assoc 1989; 195: 1267-1271.
- 17 Piermattei Piermattei, Flo GL. The Stifle Joint. In: Handbook of Small Animal Orthopaedics and Fracture Repair. Brinker WO, Piermattei DL, Flo GL. (eds). Philadelphia: W.B. Saunders; 1997: 516-580.
- 18 Pond Pond, Campbell JR. The canine stifle joint. I. Rupture of the anterior cruciate ligament. An assessment of conservative and surgical treatment. J SmallAnim Pract 1972; 13: 1-10.
- 19 Roush JC, Hohn RB, DeAngelis M. Evaluation of Transplantation of the Long Digital Extensor Tendon for Correction of Anterior Cruciate Ligament Rupture in Dogs. JAmVet MedAssoc 1970; 156: 309-312.
- 20 Smith Smith, Torg JS. Fibular head transposition for repair of cruciate deficient stifle in the dog. J Am VetMed Assoc 1985; 187: 375.
- 21 Slocum Slocum, Slocum TD. Tibial Plateau Leveling Osteotomy for repair of cranial cruciate ligament rupture in the canine. Vet Clin North Am Small AnimPract 1993; 23: 777-795.
- 22 Vasseur PB. Clinical Results Following Nonoper- ative Management for Rupture of the Cranial Cruciate Ligament in Dogs. Vet Surg 1984; 13: 243-246.
- 23 Pacchiana PD, Morris E, Gillings SL. et al. Surgical and postoperative complications associated with tibial plateau levelling osteotomy in dogs with cranial cruciate ligament rupture: 397 cases (1998-2001). J Am Vet Med Assoc 2003; 222: 184-193.
- 24 Dupuis J, Harari J, Papageorges M. et al. Evaluation of Fibular Head Transposition for Repair of Experimental Cranial Cruciate Ligament Injury in Dogs. Vet Surg 1994; 23: 1-12.
- 25 Priddy NH, Tomlinson RJ, Dodam JR. et al. Complications with and owner assessment of the outcome of tibial plateau levelling osteotomy for treatment of cranial cruciate ligament rupture in dogs: 193 cases (1997-2001). J Am Vet Med Assoc 2003; 222: 1726-1732.
- 26 Carey K, Aiken SW, DiResta GR. et al. Radiographic and clinical changes ofthe patellar tendon after tibial plateau levelling osteotomy 94 cases (2001-2003). Vet Comp Orthop Traumatol 2005; 18: 235-242.
- 27 Arthurs GI, Langley-Hobbs SJ. Complications Associated with Corrective Surgery for Patellar Luxation in 109 Dogs. Vet Surg 2006; 35: 559-556.
- 28 Roush JK. Canine Patellar Luxation. Vet Clin North Am Small AnimPract 1993; 23: 855-868.
- 29 Elkins AD, Pechman R, Kearney MT. et al. A Retrospective Study Evaluating the Degree of Degenerative Joint Disease in the Stifle Joint of Dogs Following Surgical Repair of Anterior Cruciate Ligament Rupture. JAmAnimHosp Assoc 1991; 27: 533-540.
- 30 Whitehair JG, Vasseur PB, Willits NH. Epidemiology of cranial cruciate ligament rupture in dogs. JAmVet Med Assoc 1993; 203: 1016-1019.
- 31 Bennett D, Tennant B, Lewis DG. et al. A reappraisal of anterior cruciate ligament disease in the dog. J Small Anim Pract 1988; 29: 275-297.
- 32 Duvall JM, Budsberg SC, Flo GL. et al. Breed, sex, and body weight as risk factors for rupture of the cranial cruciate ligament in young dogs. JAmVet Med Assoc 1999; 15: 811-814.
- 33 Priester WA. Sex, Size and Breed as Risk Factors in Canine Patella Dislocation. J Am Vet Med Assoc 1972; 160: 740-742.
- 34 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: 716-720.
- 35 Denny Denny, Minter HM. The long term results of surgery of canine stifle disorders. J Small Anim Pract 1973; 14: 695-713.
- 36 Chauvet AE, Johnson AL, Pijanowski GJ. et al. Evaluation of Fibular HeadTransposition, Lateral Fabellar Suture, and Conservative Treatment of Cranial Cruciate Ligament Rupture in Large Dogs: A Retrospective Study. J Am Anim Hosp Assoc 1996; 32: 247-255.
- 37 Kettelkamp DB. Current Concepts Review, Management of Patellar Malalignment. J Bone Joint Surg 1981; 8: 1344-1347.
- 38 Clements DN, Owen MR, Mosley JR. et al. Retrospective study of bacterial infective arthritis in31 dogs. JSmAnim Pract 2005; 46: 171-176.
- 39 Bennett Bennett, Taylor DJ. Bacterial infective arthritis in the dog. J Sm Anim Pract 1988; 29: 207-230.
- 40 Gibbons SE, Macias C, Tonzing MA. et al. Patella luxation in 70 large breed dogs. J Sm Anim Pract 2006; 47: 3-9.
- 41 Johnson AL, Probst CW, Decamp CE. et al. Comparison of trochlear Block Recession and Trochlear Wedge Recession for Canine Patellar Luxation Using a Cadaver Model. Vet Surg 2001; 30: 140-150.