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Vet Comp Orthop Traumatol 2017; 30(01): 20-27
DOI: 10.3415/VCOT-16-07-0103
Original Research
Schattauer GmbH

Distal femoral lateral closing wedge osteotomy as a component of comprehensive treatment of medial patellar luxation and distal femoral varus in dogs

Barry E. Brower
1   Veterinary Medical Center of Long Island, West Islip, NY, USA
,
Michael P. Kowaleski
2   Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA, USA
,
Ann M. Peruski
3   Care Center, Cincinnati, OH, USA
,
Antonio Pozzi
4   Vetsuisse Faculty, University Zurich, Zurich, Switzerland
,
Jonathan Dyce
5   Department of Veterinary Clinical Sciences, Ohio State University, Columbus, OH, USA
,
Kenneth A. Johnson
6   Faculty of Veterinary Science, School of Life and Environmental Sciences, University of Sydney, Sydney, NSW, Australia
,
Randy J. Boudrieau
2   Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA, USA
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Publikationsverlauf

Received: 14. Juli 2016

Accepted: 01. August 2016

Publikationsdatum:
26. Dezember 2017 (online)

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Summary

Objective: To describe a cohort of dogs with medial patellar luxation managed with a distal femoral lateral closing wedge ostectomy (DFO) as a component of comprehensive treatment, and to report radiographic and long-term clinical outcome of this technique.

Methods: Medical records of dogs that had a lateral closing wedge DFO as part of management of medial patellar luxation at three veterinary teaching hospitals were reviewed. Surgical reports as well as the preoperative, postoperative, and follow-up radiographs were reviewed. The anatomical lateral distal femoral angle (aLDFA) was determined. Long-term clinical outcome was assessed by telephone interview with the owner.

Results: A lateral closing wedge DFO was performed on 66 limbs. The mean pre- and postoperative aLDFA was 107.6° ± 5.8° and 94.1° ± 4.2°, respectively. Cranial cruciate ligament disease was identified in 28/66 affected limbs. Tibial angular deformity, torsional deformity, or both was identified in nine of the 66 limbs. Ostectomy healing was confirmed radiographically in 51/66 limbs. The mean time to union was 73 ± 37 days. All patellae were in the normal position and stable. Complications included infection (2/51), fixation failure (1/51), delayed healing (2/51), and persistent lameness (1/51).

Clinical significance: In this cohort of cases, DFO was a highly successful and repeatable component of surgical treatment for dogs with medial patellar luxation associated with femoral varus. This study also provides more evidence of the high rate of concurrent cranial cruciate ligament disease in cases of medial patellar luxation complicated by fe-moral varus, and supports an association between stifle instability and medial patellar luxation.

keywords

Medial patellar luxation - femoral varus - distal femoral osteotomy

* Note: The reviewing and processing of this paper was fully conducted by the Deputy Editorin-Chief Simon Roe, and was completely independent of any involvement of the Editor-in-Chief. Original Submission received under a different manuscript number on April 20, 2016.


 

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