CC BY-NC-ND 4.0 · Vet Comp Orthop Traumatol 2024; 37(02): 098-106
DOI: 10.1055/s-0043-1776331
Clinical Communication

Trochlear Ridge Prostheses for Reshaping Femoral Trochlear Ridges in Dogs with Patellar Luxation

Tommaso Nicetto
1   Diagnostica Piccoli Animali, Clinica Veterinaria Pedrani, Vicenza, Italy
2   Clinic for Small Animal Surgery, University of Zurich, Zurich, Switzerland
› Author Affiliations


Objectives To describe the implant characteristics and surgical application of a custom-made trochlear ridge prosthesis (TRP) and to report clinical outcomes in dogs affected by patellar luxation treated with TRP.

Study design Dogs affected by patellar luxation underwent computed tomography. A specific canine bone anatomical replica, a cutting guide, and a TRP were designed and provided for surgery. Surgical records, clinical and radiographic reassessments, complications, pre- and postoperative lameness, type and degree of patellar luxation, and TRP and patellar position after surgery were reviewed. Clinical outcomes were defined as full, acceptable, or unacceptable function.

Results The TRP was implanted in 60 femoral trochleae: 48 unilateral and 12 bilateral. Successful correction of patellar luxation was achieved in 59/60 cases. TRP was applied with other surgical techniques in 36/60 of the cases and as the only surgical procedure in 24/60 cases. Overall, three complications were observed: two minor and one major (patellar luxation recurrence). Neither implant loosening nor infection was observed. The mean radiographic follow-up was 3.8 months. At the time of the final follow-up, 57/60 cases were scored as fully functional.

Conclusion The TRP application either alone or in combination with other surgical techniques allowed for correction of patellar luxation and improvement in preoperative lameness with nominal complications. TRP could represent a potentially reliable alternative to trochleoplasty.


Dr. Tommaso Nicetto holds the patent for TRP (nr. 102019000024472).

Authors' Contribution

T.N.: invented TRP, concepted and designed the study, collected data, reviewed the medical record, and drafted the manuscript. F.L.: participated in the design of the study, reviewed the medical records, collected data, analyzed and interpreted the data, and drafted the manuscript.

Supplementary Material

Publication History

Received: 03 January 2023

Accepted: 26 September 2023

Article published online:
31 October 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (

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  • References

  • 1 Alam MR, Lee JI, Kang HS. et al. Frequency and distribution of patellar luxation in dogs. 134 cases (2000 to 2005). Vet Comp Orthop Traumatol 2007; 20 (01) 59-64
  • 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
  • 3 Perry KL, Déjardin LM. Canine medial patellar luxation. J Small Anim Pract 2021; 62 (05) 315-335
  • 4 Dejour H, Walch G, Neyret P, Adeleine P. Dysplasia of the femoral trochlea [in French]. Rev Chir Orthop Repar Appar Mot 1990; 76 (01) 45-54
  • 5 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 (02) 140-150
  • 6 Katayama M, Ogaya H, Shunsuke S, Uzuka Y. Kite shield-shaped wedge recession for treatment of medial patellar luxation in seven small-breed dogs. Vet Surg 2016; 45 (01) 66-70
  • 7 Nagahiro Y, Murakami S, Kamijo K. et al. Segmental femoral ostectomy for the reconstruction of femoropatellar joint in dogs with grade IV medial patellar luxation. Vet Comp Orthop Traumatol 2020; 33 (04) 287-293
  • 8 Slocum B, Slocum TD. Trochlear wedge recession for medial patellar luxation. An update. Vet Clin North Am Small Anim Pract 1993; 23 (04) 869-875
  • 9 Cashmore RG, Havlicek M, Perkins NR. et al. Major complications and risk factors associated with surgical correction of congenital medial patellar luxation in 124 dogs. Vet Comp Orthop Traumatol 2014; 27 (04) 263-270
  • 10 Wangdee C, Hazewinkel HA, Temwichitr J, Theyse LF. Extended proximal trochleoplasty for the correction of bidirectional patellar luxation in seven Pomeranian dogs. J Small Anim Pract 2015; 56 (02) 130-133
  • 11 van der Zee JH. Lesions in canine stifle joints due to trochleoplasties as treatment for medial patellar luxation. J S Afr Vet Assoc 2015; 86 (01) 1245
  • 12 Chase D, Farrell M. Fracture of the lateral trochlear ridge after surgical stabilisation of medial patellar luxation. Vet Comp Orthop Traumatol 2010; 23 (03) 203-208
  • 13 Ellis LF, House AK. Trochlear block recession sulcoplasty migration in a dog. J Small Anim Pract 2021; 62 (09) 823
  • 14 Rossanese M, German AJ, Comerford E, Pettitt R, Tomlinson A, de Vicente F. Complications following surgical correction of medial patellar luxation in small-to-medium-size dogs. Vet Comp Orthop Traumatol 2019; 32 (04) 332-340
  • 15 Moore JA, Banks WJ, Blass CE. Repair of full-thickness defects in the femoral trochlea of dogs after trochlear arthroplasty. Am J Vet Res 1989; 50 (08) 1406-1413
  • 16 Dokic Z, Lorinson D, Weigel JP, Vezzoni A. Patellar groove replacement in patellar luxation with severe femoro-patellar osteoarthritis. Vet Comp Orthop Traumatol 2015; 28 (02) 124-130
  • 17 Kim Y, Park Y, Park J, Jeong SM, Lee H. Bilateral patellar groove replacement in a dog with iatrogenic trochlear groove damage. J Vet Clin 2016; 33: 295-299
  • 18 Jaworski J, Krukowski M, Gosling M, Burton N. Patellar groove replacement in a cat. VCOT Open. 2022; 5: e71-e77
  • 19 Mills J, Hargittai T. Treatment of feline patellar luxation with polyethylene sulcal ridge prostheses. J Small Anim Pract 2020; 61 (11) 704-709
  • 20 Nicetto TLF. Early experience with trochlear ridge prosthesis for reshaping the femoral trochlear ridges in dogs with patellar luxation. In: Proceedings of the European Society of Veterinary Orthopedics and Traumatology,. Nice, France. 2022
  • 21 Nicetto T, Longo F, Contiero B, Isola M, Petazzoni M. Computed tomographic localization of the deepest portion of the femoral trochlear groove in healthy dogs. Vet Surg 2020; 49 (06) 1246-1254
  • 22 Trindade R, Albrektsson T, Galli S, Prgomet Z, Tengvall P, Wennerberg A. Osseointegration and foreign body reaction: titanium implants activate the immune system and suppress bone resorption during the first 4 weeks after implantation. Clin Implant Dent Relat Res 2018; 20 (01) 82-91
  • 23 Cook JL, Evans R, Conzemius MG. et al. Proposed definitions and criteria for reporting time frame, outcome, and complications for clinical orthopedic studies in veterinary medicine. Vet Surg 2010; 39 (08) 905-908
  • 24 Putnam RW. Patellar Luxation in the Dog. Guelph: University of Guelph,; 1968
  • 25 Tomlinson J, Fox D, Cook JL, Keller GG. Measurement of femoral angles in four dog breeds. Vet Surg 2007; 36 (06) 593-598
  • 26 Dudley RM, Kowaleski MP, Drost WT, Dyce J. Radiographic and computed tomographic determination of femoral varus and torsion in the dog. Vet Radiol Ultrasound 2006; 47 (06) 546-552
  • 27 Longo F, Savio G, Contiero B. et al. Accuracy of an automated three-dimensional technique for the computation of femoral angles in dogs. Vet Rec 2019; 185 (14) 443
  • 28 Longo F, Nicetto T, Pozzi A, Contiero B, Isola M. A three-dimensional computed tomographic volume rendering methodology to measure the tibial torsion angle in dogs. Vet Surg 2021; 50 (02) 353-364
  • 29 Apelt D, Kowaleski MP, Dyce J. Comparison of computed tomographic and standard radiographic determination of tibial torsion in the dog. Vet Surg 2005; 34 (05) 457-462
  • 30 Slocum B, Slocum T. Tibial Plateau Leveling Osteotomy Certification Course. Eugene, OR: Slocum-Enterprises Inc.; 2000
  • 31 Petazzoni M, Jaeger GH. Atlas of Clinical Goniometry and Radiographic Measurements of the Canine Pelvic Limb. Duluth: Merail; 2008
  • 32 DeCamp CE. Brinker, Piermattei, and Flo's Handbook of Small Animal Orthopedics and Fracture Repair. Philadelphia, PA: Saunders; 2016
  • 33 Guiot LP, Déjardin LM. Prospective evaluation of minimally invasive plate osteosynthesis in 36 nonarticular tibial fractures in dogs and cats. Vet Surg 2011; 40 (02) 171-182
  • 34 Flo GL. Surgical Correction of a Deficient Trochlear Groove in Dogs with Severe Congenital Patellar Luxations Utilizing a Cartilage Flap and Subchondral Grooving [MS Thesis]. Michigan: : Michigan State University, Department of Veterinary Surgery and Medicine; 1969
  • 35 Hansen JS, Lindeblad K, Buelund L, Miles J. Predicting the need for trochleoplasty in canine patellar luxation using pre- and intra-operative assessments of trochlear depth. Vet Comp Orthop Traumatol 2017; 30 (02) 131-136
  • 36 Boone E. Trochlear recession wedge technique for patellar luxation: an experimental study. J Am Anim Hosp Assoc 1983; 19 (05) 735-742
  • 37 Donell ST, Joseph G, Hing CB, Marshall TJ. Modified Dejour trochleoplasty for severe dysplasia: operative technique and early clinical results. Knee 2006; 13 (04) 266-273
  • 38 Utting MR, Mulford JS, Eldridge JD. A prospective evaluation of trochleoplasty for the treatment of patellofemoral dislocation and instability. J Bone Joint Surg Br 2008; 90 (02) 180-185
  • 39 Davies MR, Allahabadi S, Diab TE. et al. Sulcus-deepening trochleoplasty as an isolated or combined treatment strategy for patellar instability and trochlear dysplasia: a systematic review. Arthrosc Sports Med Rehabil 2020; 2 (05) e661-e669
  • 40 Elias JJ, Rezvanifar SC, Koh JL. Groove-deepening trochleoplasty reduces lateral patellar maltracking and increases patellofemoral contact pressures: dynamic simulation. J Orthop Res 2022; 40 (07) 1529-1537
  • 41 Trevisan F, Calignano F, Aversa A. et al. Additive manufacturing of titanium alloys in the biomedical field: processes, properties and applications. J Appl Biomater Funct Mater 2018; 16 (02) 57-67