Canis ISSN: 2398-2942

Patella: medial luxation correction

Synonym(s): MPL

Contributor(s): Vetstream Ltd, Gareth Arthurs

Introduction

  • Medial patellar luxation Patella: medial luxation is a common condition in toy, miniaturized and bow-legged breeds.
  • It is most commonly caused by developmental anatomic abnormalites that result in malalignment of tracking of the patella relative to the trochlear sulcus.
  • Infrequently patellar luxation can occur in combination with cranial cruciate ligament disease Stifle: cranial cruciate ligament disease.
  • Very rarely, it has a traumatic etiology, with damage to lateral soft tissues of stifle, ie lateral patella-femoral ligament/retinacular damage.
  • Medial patella luxation is classified into 4 grades according to severity of luxation.
  • Surgical correction of underlying deformity aims to realign the stifle extensor mechanism and stabilize the patella within the trochlear sulcus.

Uses

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • Overall very good to excellent outcome with significantly improved limb function. Providing that surgery is appropriate to the individual patient's needs and carefully planned and executed.
  • Higher grades of patellar luxation and larger dogs are associated with a higher complication rate including a higher risk of patellar re-luxation. This can be successfully mitigated with carefully planned and executed surgery that is often more complex and technically demanding.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Sanders L B & Bevan J M (2019) Comparison of short-term complications between unilateral and single-session bilateral surgery for medial patellar luxation in small/medium breed dogs. JSAP 60 (1), 51-57 PubMed.
  • Bosio F, Bufalari A, Perione B et al (2017) Prevalence, treatment and outcome of patellar luxation in dogs in Italy. A retrospective multicentre study (2009-2014)​. Vet Comp Orthop Traumatol 30 (5), 364-370 PubMed.
  • Brower B E, Kowaleski M P, Peruski A M et al (2017) 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 30 (1), 20-27 PubMed.
  • Newman M, Voss K (2017) Computed tomographic evaluation of femoral and tibial conformation in English Staffordshire Bull Terriers with and without congenital medial patellar luxation. Vet Comp Orthop Traumatol 30 (3), 191-199 PubMed.
  • Dunlap A E, Kim S E, Lewis D D et al (2016) Outcomes and complications following surgical correction of grade IV medial patellar luxation in dogs: 24 cases (2008-2014). J Am Vet Med Assoc 249 (2), 208-213 PubMed.
  • Leonard K C, Kowaleski M P, Saunders W B et al (2016) Combined tibial plateau levelling osteotomy and tibial tuberosity transposition for treatment of cranial cruciate ligament insufficiency with concomitant medial patellar luxation Vet Comp Orthop Traumatol 29 (6), 536-540 PubMed.
  • Cashmore R G, Havlicek M, Perkins N R et al (2014) Major complications and risk factors associated with surgical correction of congenital medial patellar luxation in 124 dogs. Vet Comp Orthop Traumatol 27 (4), 263-270 PubMed.
  • Arthurs G I, Langley-Hobbs S J (2006) Complications associated with corrective surgery for patellar luxation in 109 dogs. Vet Surg 35 (6), 559-566 PubMed.
  • Gibbons S E, Macias C, Tonzing M A et al (2006) Patellar luxation in 70 large breed dogs. J Sm Anim Pract 47 (1), 3-9 PubMed.
  • Johnson A L, Probst C W, Decamp C E et al (2001) Comparison of trochlear block recession and trochlear wedge recession for canine patellar luxation using a cadaver model Vet Surg 30 (2), 140-150 PubMed.
  • Hayes A G, Boudrieau R J & Hungerford L L (1994) Frequency and distribution of medial and lateral patellar luxation in dogs - 124 cases (1982-1992). JAVMA 205 (5), 716-720 PubMed.
  • Remedios A M, Basher A W, Runyan C L et al (1992) Medial patellar luxation in 16 large dogs - a retrospective study. Vet Surg 21 (1), 5-9 PubMed.

Other sources of information

  • Brinker Piermattei & Flos’ Small Animal Orthopedics and Fracture Repair (2016) The stifle joint. 5th edn, Eds DeCamp, Johnston, Déjardin, Schaefer, Elsevier. Chapter 18, pp 597-669.
  • Kowaleski M P, Boudrieau R J, Pozzi A (2012) Stifle Joint. In: Veterinary Surgery Small Animal. Eds Tobias & Johnston. Elsevier Saunders, Chapter 62, pp 906-998.
  • McKee W M & Cook J M (2006) The Stifle.  In: BSAVA Manual of Canine & Musculoskeletal disease. Eds Houlton, Cook, Innes & Langley-Hobbs, Chapter 22, pp 350-395.
  • Roush (1993) Canine patellar luxation. Vet Clin North Am 23, 855-868.


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