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Complications Associated with
Corrective Surgery for Patellar
Luxation in 109 Dogs
             G.I.Arthurs, S.J.Langley-Hobbs




Summarised by Kertu Brutus
About the article
 Retrospective
 Medical records reviewed (109 dogs,
  131 surgeries)
 Complication risks for different
  correction techniques calculated
 Clinical relevance: estimation of
  postoperative complication risk
Patellar luxation
 Common orthopedic condition
 Cause:
    abnormal conformation of hind limb
 Small dog breeds mostly
 Congenital, sometimes trauma-based
 4 grades of severity
 Medial-lateral (MPL more common)
 Unilateral, bilateral
   Concurrent diseases common:
   Hip luxation or dysplasia,
   Femoral fractures,
   Muscle tears
   Tendon or ligament rupture
Medial patellar
luxation
Surgical correction
 femoral trochlear sulcoplasty
 tibial tuberosity transposition (TTT)
 capsular/retinacular release
 capsular/retinacular imbrication
 anti-rotational suture placement
Femoral groove deepened,
tibial crest moved laterally,
wire (arrow) added to fixate tibial crest
Post-op complications
Major:
 Patellar reluxation
 TTT implant migration
 Tibial tuberosity fracture avulsion
 Fracture of the proximal tibia and fibula
 Septic arthritis
 Trochlear wedge migration
 Development of degenerative joint
  disease
 Inability to fully extend the stifle joint
 Failure to correct luxation at surgery
Post-op complications
Minor:
 Patellar luxation that did not require
  further surgery
 Seroma formation
 Wound dehiscence
Results
 Frequency of complications was 18%
 Trochlear sulcoplasty and
  capsular/retinacular TTT reduced
  complications
 Capsular/retinacular release had
  higher complication risk
 Other methods did not affect
  complication risk
   Higher complication risk:
                         larger dogs
                       higher grade of
     luxation

   In conclusion: TTT and trochlear
    sulcoplasty
    should be considered in all surgical cases
    of patellar luxation
Thank you for listening
References
 “Complications Associated with
  Corrective Surgery for Patellar
  Luxation in 109 Dogs” 2006 Arthurs,
  G. I., Langley-Hobbs, S. J. Veterinary
  Surgery 35:559–566
 “Patellar luxations” 2004 Griffon, D.
  American College of Veterinary
  Surgeons

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Presentation

  • 1. Complications Associated with Corrective Surgery for Patellar Luxation in 109 Dogs G.I.Arthurs, S.J.Langley-Hobbs Summarised by Kertu Brutus
  • 2. About the article  Retrospective  Medical records reviewed (109 dogs, 131 surgeries)  Complication risks for different correction techniques calculated  Clinical relevance: estimation of postoperative complication risk
  • 3. Patellar luxation  Common orthopedic condition  Cause: abnormal conformation of hind limb  Small dog breeds mostly  Congenital, sometimes trauma-based  4 grades of severity  Medial-lateral (MPL more common)  Unilateral, bilateral
  • 4. Concurrent diseases common:  Hip luxation or dysplasia,  Femoral fractures,  Muscle tears  Tendon or ligament rupture
  • 6. Surgical correction  femoral trochlear sulcoplasty  tibial tuberosity transposition (TTT)  capsular/retinacular release  capsular/retinacular imbrication  anti-rotational suture placement
  • 7. Femoral groove deepened, tibial crest moved laterally, wire (arrow) added to fixate tibial crest
  • 8. Post-op complications Major:  Patellar reluxation  TTT implant migration  Tibial tuberosity fracture avulsion  Fracture of the proximal tibia and fibula  Septic arthritis  Trochlear wedge migration  Development of degenerative joint disease  Inability to fully extend the stifle joint  Failure to correct luxation at surgery
  • 9. Post-op complications Minor:  Patellar luxation that did not require further surgery  Seroma formation  Wound dehiscence
  • 10. Results  Frequency of complications was 18%  Trochlear sulcoplasty and capsular/retinacular TTT reduced complications  Capsular/retinacular release had higher complication risk  Other methods did not affect complication risk
  • 11. Higher complication risk: larger dogs higher grade of luxation  In conclusion: TTT and trochlear sulcoplasty should be considered in all surgical cases of patellar luxation
  • 12. Thank you for listening
  • 13. References  “Complications Associated with Corrective Surgery for Patellar Luxation in 109 Dogs” 2006 Arthurs, G. I., Langley-Hobbs, S. J. Veterinary Surgery 35:559–566  “Patellar luxations” 2004 Griffon, D. American College of Veterinary Surgeons