Comparison of Semi-Cylindrical Recession Trochleoplasty and Trochlear Block Recession for the Treatment of Canine Medial Patellar Luxation: A Pilot Study

Abstract

Objective The aim of this study was to describe an alternative method for trochleoplasty, semi-cylindrical recession trochleoplasty (SCRT), and compare it to trochlear block recession (TBR) in regard to recessed trochlear depth, patellar depth, patellar articular contact with the trochlea, recessed trochlear surface area, procedure time, complications and functional outcome.

Study Design Ten dogs with bilateral grade II-III medial patellar luxations underwent bilateral simultaneous correction surgery including tibial tuberosity transposition, lateral imbrication and trochleoplasty with one stifle each undergoing TBR and SCRT. Patients received pre-and postoperative stifle computed tomography scans and pre- and 8-week postoperative pressure platform analysis and physical examinations. Recessed trochlear depth, patellar depth, trochlear surface area, patellar articular contact, procedure time, complications and functional outcomes as measured by gait analysis were compared between the two techniques.

Results There was no significant difference in measured outcome variables between techniques at any time point. At the time of the 8-week reassessment, no patella had reluxated.

Conclusion Short-term follow-up shows similar functional outcomes between both techniques regarding rate of reluxation and limb function. The SCRT was subjectively easier to perform than TBR, particularly in small patients. The SCRT is an acceptable method of trochleoplasty for the treatment of medial patellar luxation in dogs and further studies evaluating long-term outcomes are justified.

Keywords

patellar luxation - stifle - dog - recession trochleoplasty - computed tomography

Authors' Contributions

C.L.B.W. and M.G.C. contributed to study conception, design, and data acquisition and manuscript drafting. A.K.R. contributed to study design. M.D. contributed to data acquisition. All authors contributed to data analysis and interpretation, manuscript revision, and approval of submitted manuscript and are held publicly accountable for relevant content.

Publication History

Received: 18 January 2020

Accepted: 12 October 2020

Article published online:
26 November 2020

• References

• 1 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
• 2 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
• 3 Linney WR, Hammer DL, Shott S. Surgical treatment of medial patellar luxation without femoral trochlear groove deepening procedures in dogs: 91 cases (1998-2009). J Am Vet Med Assoc 2011; 238 (09) 1168-1172
• 4 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
• 5 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
• 6 Perry KL, Adams RJ, Andrews SJ, Tewson C, Bruce M. Impact of femoral varus on complications and outcome associated with corrective surgery for medial patellar luxation. Vet Comp Orthop Traumatol 2017; 30 (04) 288-298
• 7 Bosio F, Bufalari A, Peirone B, Petazzoni M, Vezzoni A. Prevalence, treatment and outcome of patellar luxation in dogs in Italy. A retrospective multicentric study (2009-2014). Vet Comp Orthop Traumatol 2017; 30 (05) 364-370
• 8 Kowaleski MP, Pozzi A. Stifle joint. In: Tobias KM, Johnson KA. eds. Veterinary Surgery Small Animal. 2nd edition.. St Louis, MO: Elsevier; 2018: 1141-1159
• 9 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
• 10 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
• 11 Talcott KW, de Hann JJ. Rectangular recession trochleoplasty for treatment of patellar luxation in dogs and cats. Vet Comp Orthop Traumatol 2000; 13: 39-43
• 12 Hansen JSO, 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
• 13 Petazzoni M, De Giacinto E, Troiano D, Denti F, Buiatti M. Computed tomographic trochlear depth measurement in normal dogs. Vet Comp Orthop Traumatol 2018; 31 (06) 431-437
• 14 Boone E, Hohn S, Weisbrode S. Trochlear recession wedge technique for patellar luxation: An experimental study. J Am Anim Hosp Assoc 1983; 19: 153-157
• 15 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
• 16 Putnam RW. Patellar luxation in the dog [PhD Dissertation]. Ontario, Canada: University of Guelph; 1968
• 17 Clerfond P, Huneault L, Dupuis J, Moreau M, Auger J. Unilateral or single-session bilateral surgery for correction of medial patellar luxation in small dogs: short and long-term outcomes. Vet Comp Orthop Traumatol 2014; 27 (06) 484-490
• 18 Besancon MF, Conzemius MG, Derrick TR. et al. Comparison of vertical forces in normal dogs between the AMTI Model OR6–5 force platform and the Tekscan (Industrial Sensing Pressure Measurement System) pressure walkway. Vet Comp Orthop Traumatol 2003; 16: 153-157
• 19 Evans R, Horstman C, Conzemius M. Accuracy and optimization of force platform gait analysis in Labradors with cranial cruciate disease evaluated at a walking gait. Vet Surg 2005; 34 (05) 445-449
• 20 Wucherer KL, Conzemius MG, Evans RB. et al. Short-term and long-term outcomes for overweight dogs with cranial cruciate ligament rupture treated surgically or nonsurgically. J Am Vet Med A 2013; 15 242 (10) 1364-1372
• 21 Biskup JJ, Conzemius MG. Long-term arthroscopic assessment of intra-articular allografts for treatment of spontaneous cranial cruciate ligament rupture in the dog. Vet Surg 2020; 49 (04) 764-771
• 22 Fanchon L, Grandjean D. Accuracy of asymmetry indices of ground reaction forces for diagnosis of hind limb lameness in dogs. Am J Vet Res 2007; 68 (10) 1089-1094