Vet Comp Orthop Traumatol 2023; 36(01): 10-20
DOI: 10.1055/s-0042-1756519
Original Research

Comparison of Hindlimb Conformation in Cats with and without Medial Patellar Luxation

1   University of Bristol, Bristol, United Kingdom
,
Sorrel Langley-Hobbs
2   Small Animal Surgery School of Veterinary Sciences, University of Bristol, Langford, Bristol, United Kingdom
,
Alex Belch
3   Langford Vets, Bristol, United Kingdom
› Author Affiliations
Funding None.

Abstract

Objectives Medial patellar luxation (MPL) is the most common developmental cause of hindlimb lameness in cats. The association between femoral and tibial conformation and MPL measured on computed tomography (CT) has not been reported in cats. The aims were to report femoral and tibial conformation in cats with and without MPL and to report normal femoral and tibial angles.

Methods Angle of inclination of femoral neck (AI), anatomical lateral distal femoral angle (aLDFA), femoral trochanteric angle (FCT), angle of anteversion of femoral neck (AA), distal and proximal anteversion angle (DAA/PAA), overall tibial valgus (TV), tibial torsion (TT), tibial tuberosity displacement (TTD) and trochlear depth:patellar thickness ratio (T:P) were measured by three observers on CT of cats with and without MPL. Comparisons were made between groups. Inter-observer intraclass correlation coefficient (ICC) was calculated.

Results Sixteen cats were recruited: eight control and eight with MPL. The aLDFA, PAA, TT, TTD and T:P were significantly less in cats with high-grade MPL. The AI, FCT, AA, DAA and TV were not significantly different. A high correlation was shown with inter-observer ICC in 33.33% and good correlation in 26.67% when comparing measurements between observers.

Clinical Significance This study suggests that cats with high-grade MPL have decreased TT, TTD and T:P and may require tibial tuberosity transposition and femoral trochleoplasty. The PAA, TT and aLDFA were decreased, although clinical significance may vary and these cats may not require correctional osteotomies. Results should be interpreted with caution as high/good levels of inter-observer ICC occurred in less than two-thirds of cases between observers.



Publication History

Received: 29 September 2021

Accepted: 21 July 2022

Article published online:
21 September 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Loughin CA, Kerwin SC, Hosgood G. et al. Clinical signs and results of treatment in cats with patellar luxation: 42 cases (1992-2002). J Am Vet Med Assoc 2006; 228 (09) 1370-1375
  • 2 Houlton JEF, Meynink SE. Medial patellar luxation in the cat. J Small Anim Pract 1989; 30 (06) 349-352
  • 3 Smith GK, Langenbach A, Green PA, Rhodes WH, Gregor TP, Giger U. Evaluation of the association between medial patellar luxation and hip dysplasia in cats. J Am Vet Med Assoc 1999; 215 (01) 40-45
  • 4 Rutherford L, Arthurs GI. Partial parasagittal patellectomy: a novel method for augmenting surgical correction of patellar luxation in four cats. J Feline Med Surg 2014; 16 (08) 689-694
  • 5 Rutherford L, Langley-Hobbs SJ, Whitelock RJ, Arthurs GI. Complications associated with corrective surgery for patellar luxation in 85 feline surgical cases. J Feline Med Surg 2015; 17 (04) 312-317
  • 6 Brioschi V, Rutherford L, Newell K, Trotter C, Arthurs GI. Computed tomographic assessment of block recession trochleoplasty and partial parasagittal patellectomy in cats. Vet Comp Orthop Traumatol 2020; 33 (02) 102-109
  • 7 Newman M, Voss K. Computed tomographic evaluation of femoral and tibial conformation in English Staffordshire Bull Terriers with and without congenital medial patellar luxation. Vet Comp Orthop Traumatol 2017; 30 (03) 191-199
  • 8 Soparat C, Wangdee C, Chuthatep S, Kalpravidh M. Radiographic measurement for femoral varus in Pomeranian dogs with and without medial patellar luxation. Vet Comp Orthop Traumatol 2012; 25 (03) 197-201
  • 9 Yasukawa S, Edamura K, Tanegashima K. et al. Evaluation of bone deformities of the femur, tibia, and patella in Toy Poodles with medial patellar luxation using computed tomography. Vet Comp Orthop Traumatol 2016; 29 (01) 29-38
  • 10 Lusetti F, Bonardi A, Eid C, Brandstetter de Belesini A, Martini FM. Pelvic limb alignment measured by computed tomography in purebred English Bulldogs with medial patellar luxation. Vet Comp Orthop Traumatol 2017; 30 (03) 200-208
  • 11 Roush JK. Canine patellar luxation. Vet Clin North Am Small Anim Pract 1993; 23 (04) 855-868
  • 12 L'Eplattenier H, Montavon P. Patellar luxation in dogs and cats: pathogenesis and diagnosis. Compendium Continuing Educ 2002; 24 (03) 234-240
  • 13 Arthurs GI, Langley-Hobbs SJ. Complications associated with corrective surgery for patellar luxation in 109 dogs. Vet Surg 2006; 35 (06) 559-566
  • 14 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
  • 15 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
  • 16 Bruecker KA. Femoral corrective osteotomy for the correction of medial patellar luxation. 14th Annual ESVOT, Munich, Germany; 2006
  • 17 Kowaleski MP. Patellar luxation – preoperative evaluation and surgical planning for femoral corrective osteotomy. 13th Conference of the European Society of Veterinary Orthopaedics and Traumatology; September 7–10; Munich, Germany. 2006: 87-90
  • 18 Brower BE, Kowaleski MP, Peruski AM. et al. Distal femoral lateral closing wedge osteotomy as a component of comprehensive treatment of medial patellar luxation and distal femoral varus in dogs. Vet Comp Orthop Traumatol 2017; 30 (01) 20-27
  • 19 Roch SP, Gemmill TJ. Treatment of medial patellar luxation by femoral closing wedge ostectomy using a distal femoral plate in four dogs. J Small Anim Pract 2008; 49 (03) 152-158
  • 20 Swiderski JK, Palmer RH. Long-term outcome of distal femoral osteotomy for treatment of combined distal femoral varus and medial patellar luxation: 12 cases (1999-2004). J Am Vet Med Assoc 2007; 231 (07) 1070-1075
  • 21 Barnes DM, Anderson AA, Frost C, Barnes J. Repeatability and reproducibility of measurements of femoral and tibial alignment using computed tomography multiplanar reconstructions. Vet Surg 2015; 44 (01) 85-93
  • 22 Swanson EA, Tomlinson JL, Dismukes DI, Fox DB. Measurement of femoral and tibial joint reference angles and pelvic limb alignment in cats. Vet Surg 2012; 41 (06) 696-704
  • 23 Phetkaew T, Kalpravidh M, Penchome R, Wangdee C. A comparison of angular values of the pelvic limb with normal and medial patellar luxation stifles in Chihuahua dogs using radiography and computed tomography. Vet Comp Orthop Traumatol 2018; 31 (02) 114-123
  • 24 Perry KL, Déjardin LM. Canine medial patellar luxation. J Small Anim Pract 2021; 62 (05) 315-335
  • 25 Palumbo Piccionello A, Salvaggio A, Volta A. et al. Good inter- and intra-observer reliability for assessment of radiographic femoral and tibial frontal and sagittal planes joints angles in normal cats. Vet Comp Orthop Traumatol 2020; 33 (05) 308-315
  • 26 Singleton WB. The surgical correction of stifle deformities in the dog. J Small Anim Pract 1969; 10 (02) 59-69
  • 27 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
  • 28 Cicchetti DV. Guidelines, criteria, and rules of thumb for evaluating normed and standardized assessment instruments in psychology. Psychol Assess 1994; 6 (04) 284-290
  • 29 Montavon PM, Voss K, Langley-Hobbs SJ. Stifle joint. In: Montavon PM, Voss K, Langley-Hobbs SJ, eds. Feline Orthopedic Surgery and Musculoskeletal Disease. Philadelphia: Elsevier; 2009: 477-481
  • 30 Swiderski JK, Radecki SV, Park RD, Palmer RH. Comparison of radiographic and anatomic femoral varus angle measurements in normal dogs. Vet Surg 2008; 37 (01) 43-48
  • 31 Fitzpatrick CL, Krotscheck U, Thompson MS, Todhunter RJ, Zhang Z. Evaluation of tibial torsion in Yorkshire Terriers with and without medial patellar luxation. Vet Surg 2012; 41 (08) 966-972
  • 32 DeTora MD, Boudrieau RJ. Complex angular and torsional deformities (distal femoral malunions). Preoperative planning using stereolithography and surgical correction with locking plate fixation in four dogs. Vet Comp Orthop Traumatol 2016; 29 (05) 416-425
  • 33 Marretta SM, Schrader SC. Physeal injuries in the dog: a review of 135 cases. J Am Vet Med Assoc 1983; 182 (07) 708-710
  • 34 McCarthy PE. Bilateral pes valgus deformity in a Shetland Sheepdog. Vet Comp Orthop Traumatol 1998; 11 (04) 197-199
  • 35 Towle HA, Griffon DJ, Thomas MW, Siegel AM, Dunning D, Johnson A. Pre- and postoperative radiographic and computed tomographic evaluation of dogs with medial patellar luxation. Vet Surg 2005; 34 (03) 265-272
  • 36 Ferguson J. Patellar luxation in the dog and cat. In Pract 1997; 19 (04) 174-184
  • 37 Matis U. Improving our understanding of patellar luxation. 13th Conference of the European Society of Veterinary Orthopaedics and Traumatology; September 7–10, Munich, Germany; 2006: 106
  • 38 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
  • 39 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
  • 40 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
  • 41 Engvall E, Bushnell N. Patellar luxation in Abyssinian cats. Feline Pract 1990; 18 (04) 20-22
  • 42 Prior JE. Luxating patellae in Devon rex cats. Vet Rec 1985; 117 (07) 154-155