Deslocamento dorsal de patela: relato de caso / Dorsal displacement of the patella: case report / Desplazamiento dorsal de la rótula: caso clínico

O deslocamento dorsal da patela, não é uma afecção incomum em potros e em animais que são estabulados e mantidos em repouso após uma temporada de exercícios. Existem vários fatores, que pode levar a esta situação, como membros posteriores retos, flacidez do músculo quadríceps femoral, dentre outras. Existem várias formas de tratamento para o deslocamento, como exercícios controlados, ferrageamento corretivo, provocar uma desmite do ligamento patelar medial, com soluções irritantes, ou com a técnica do splitting, e também pode ser realizada a desmotomia do ligamento patelar medial para correção do deslocamento. Diante disso, buscou-se realizar uma revisão bibliográfica que verse sobre a acurácia do exame clínico e os exames complementares tais com ultrassonografia e radiografias, pois o diagnóstico preciso é de suma importância, para que os objetivos clínicos sejam alcançados.

Dorsal displacement of the patella is not an uncommon condition in foals and in animals that are stabled and kept at rest after a season of exercise. There are several factors, which can lead to this situation, such as straight hind limbs, laxity of the quadriceps femoris muscle, among others. There are several forms of treatment for the dislocation, such as controlled exercises, corrective bracing, provoking a demitis of the medial patellar ligament, with irritant solutions, or with the splitting technique, and also a demotomy of the medial patellar ligament can be performed to correct the dislocation. Therefore, a literature review was carried out on the accuracy of the clinical examination and complementary tests such as ultrasound and radiography, as an accurate diagnosis is of utmost importance to achieve the clinical objectives.

El desplazamiento dorsal de la rótula no es una condición infrecuente en potros y en animales estabulados y mantenidos en reposo después de una temporada de ejercicio. Hay varios factores que pueden conducir a esta situación, como miembros posteriores rectos, laxitud del músculo cuádriceps femoral, entre otros. Existen varias formas de tratamiento para la luxación, como ejercicios controlados, ortesis correctoras, provocando una demitis del ligamento rotuliano medial, con soluciones irritantes, o con la técnica del splitting, y también se puede realizar una desmotomía del ligamento rotuliano medial para corregir la luxación. Por ello, se realizó una revisión bibliográfica sobre la exactitud del examen clínico y de las pruebas complementarias como la ecografía y la radiografía, ya que un diagnóstico preciso es de suma importancia para alcanzar los objetivos clínicos.

Short-term outcomes of trochlear recession surgery combined with "Watermelon" autograft for treatment of canine medial patellar luxation: a case series / Resultados a curto prazo da cirurgia de recessão trocolear combinada com o auto-enxerto "Melancia" para tratamento da luxação patelar medial canina: uma série de casos

The aim of this study was to present a novel surgical method for correction of medial patellar luxation in small-breed dogs with trochlear dysplasia and marked hypoplasia of the medial femoral condyle. The "Watermelon" approach was applied together with trochlear wedge recession or trochlear block recession and consisted in increasing the height of the medial condyle with an osteochondral autograft resembling a watermelon slice, placed into an additional slot in the medial femoral condyle to prevent the postoperative reluxation of the patella. The study cohort included 19 dogs (25 joints) from small breeds (Pinscher, Pomeranian, and Chihuahua) with second-grade medial patellar luxation. Fourteen joints were submitted to wedge recession surgery combined with "Watermelon" grafting, and 11 joints: to block recession surgery with "Watermelon" grafting. The sulcus-deepening trochleoplasty combined with "Watermelon" grafting was clinically successful and with low percentage of minor postoperative complications. The mean duration of anesthesia was significantly longer for block recession combined with "Watermelon" (P<0.001), but the recovery period was shorter (P<0.05).

O objetivo deste estudo foi apresentar um novo método cirúrgico para correção da luxação patelar medial em cães de raça pequena com displasia troquelar e hipoplasia marcada do côndilo femoral medial. A abordagem "Melancia" foi aplicada juntamente com a recessão da cunha trocolear ou recessão do bloco trocolear e consistiu em aumentar a altura do côndilo medial com um auto-enxerto osteocondral parecido com uma fatia de melancia, colocado em uma fenda adicional no côndilo femoral medial para evitar o relaxamento pós-operatório da patela. A coorte do estudo incluiu 19 cães (25 juntas) de raças pequenas (Pinscher, Pomeranian, e Chihuahua) com luxação patelar medial de segundo grau. Catorze juntas foram submetidas à cirurgia de recessão em cunha combinada com enxerto de "melancia", e 11 juntas: para bloquear a cirurgia de recessão com enxerto de "melancia". A trocleoplastia de "melancia" combinada com o enxerto de "melancia" foi clinicamente bem sucedida e com baixo percentual de pequenas complicações pós-operatórias. A duração média da anestesia foi significativamente maior para a recessão em bloco combinada com "Melancia" (P<0,001), mas o período de recuperação foi mais curto (P<0,05).

Radiological measures of patellofemoral alignment in healthy small-breed dogs: reference values and sex variability

Background: The evaluation of vertical kneecap position within the trochlear groove is essential for understanding the anatomical changes that may lead to canine patellar luxation. Unlike other important diagnostic imaging measurements (e.g. measures of pelvic limb alignment), no data on patellofemoral congruence parameters of canine stifles (congruence angle, linear axial patellar displacement, lateral patellofemoral angle, patellar tilt angle) are reported. The aim of this study was to present metric values of these parameters in healthy dogs from small breeds from both sexes in order to use them for identification of animals with increased risk for medial patellar luxation. Materials, Methods & Results: The study was performed on 44 stifle joints from 22 healthy dogs of both sexes from 4 small breeds (Pinscher, Pomeranian, Chihuahua and Yorkshire terrier). Inclusion criteria were negative patellar displacement and dancing patella tests after orthopaedic examination, lack of femoral and gluteal muscles asymmetry after palpation, lack of signs of long-term proprioceptive dysfunction, normal patellar and withdrawal reflexes after neurological examination. The translation of the patella in the axial plane was evaluated by means of congruence angle and axial linear patellar displacement. The rotation of the patella in the axial plane was evaluated through measurement of lateral patellofemoral angle and patellar tilt angle. Reference ranges of parameters were analysed in agreement with the guidelines of the American College of Veterinary Pathologists for the determination of reference intervals in veterinary species for sample sizes of 40-120 with non-Gaussian distribution - robust method, 95% confidence interval (CI) with 90 % CI for upper and lower reference limits. All measured patellofemoral congruence angles were negative. Their reference range was from -8.06o to -0.58o (median value -3o ). The axial patellar displacement was negligible, with values ranging from 0.1 to 0.8 mm. Lateral patellofemoral angles in all dogs were open to the lateral side (positive); the computed reference interval was from 21.61o to 41.80o (median 31.5o ). Patellar tilt angles ranged from 2o to 8o (median 5o ). A statistically significant difference between sexes was demonstrated for angles describing the rotation of the patella in the axial plane: the lateral patellofemoral angle (P = 0.0248) and the patellar tilt angle (P = 0.0004) were greater in stifles of male dogs. Discussion: This is the first study presenting reference values of parameters describing patellofemoral alignment in healthy dogs from small breeds on tangential radiographs. The values of one of most commonly measured parameters on tangential radiographs (the lateral patellofemoral angle) in stifles of small breed dogs were higher than values in humans, supposedly due to the specific joint anatomy. The patellar tilt angle is considered as more objective and not influenced by limb rotation. For the detection of patellar misalignment, the tilt angle was reported to be almost as specific as the congruence angle but more sensitive and more accurate. It is the most specific and sensitive parameter determining the direction of patellar luxation. In male dogs, the median lateral patellofemoral angle was greater than in females (P = 0.0248). Similar tendency was shown for patellar tilt angle that was also greater in male stifles (P = 0.0004). The reported statistically significant between-sex differences in lateral patellofemoral angle and patellar tilt angle with higher values of both angles in stifles of male dogs could be attributed to the better developed femoral muscles, in particular m. vastus medialis and m. sartorius, and to differences in trochlear groove and kneecap morphology. The presented reference intervals may be useful for early detection of subjects with increased risk to medial patellar luxation.

Desvio angular tibial varo bilateral em dachshund: relato de caso / Angular deviation pes tibial varus in Dachshund: case report

Varos tibial é um desvio angular decorrente do fechamento precoce parcial da linha fisária de crescimento do osso, levando a um desalinhamento articular com apoio e sobrecarga anormais, causando, secundariamente, osteoartrite, claudicação, luxação de patela, dor e problemas articulares. Neste relato, uma cadela da raça dachshund foi diagnosticada com tal afecção bilateralmente. Foi observado um desvio de ambos os membros posteriores aos 6 meses de idade. A confirmação da deformidade varo foi feita por meio do exame radiográfico e, posteriormente, foi realizada a tomografia e estereolitografia para o planejamento da cirurgia para correção do desvio angular, utilizando a metodologia de correção para desvio angular, denominada de técnica do centro de rotação da angulação (CORA) fechada, removendo uma cunha do osso para a correção da deformidade. A cirurgia foi bem-sucedida, apresentando bons resultados conformacionais, evoluindo sem complicações.(AU)

Tibial pes varus is an angular deviation resulting from the early partial closure of the physeal line of bone growth, leading to joint misalignment with abnormal support and overload, secondarily causing osteoarthritis, claudication, patellar dislocation, pain, among other joint problems. In this report, a female Dachshund canine was diagnosed with this condition bilaterally in the tibias. It was observed a deviation of both hind limbs at 6 months of age. Confirmation of the varus deformity was made through radiographic examination, and later computed tomography and stereolithography were performed to plan the surgery to correct bilateral angular deviation of the tibia, using the angular deviation technique (CORA) closed, removing a wedge from the bone to correct the deviation angular. The surgery was successful, and the angular deviation was correctly corrected, presenting good results to the animal, without complications.(AU)

Lateral patellar luxation and Ehlers Danlos Syndrome (EDS) in a dog

Background: Ehlers Danlos Syndrome (EDS) is a rare genetic disease characterized by a deficiency in collagen synthesis,which can result in joint laxity. Patellar luxation is one of the main orthopedic conditions that affect the canine knee joint,with limited descriptions of its association with EDS in dogs. The purpose of this report is to describe the surgical management and postoperative evolution of a 1-year-old Chow Chow dog with grade II patellar luxation, tibial valgus and EDS.Case: A 1-year-old Chow Chow dog was referred to the University Veterinary Hospital due to lameness of the left pelvicfor 3 months. At the orthopedic examination were verified severe lameness and lateral deviation of the left stifle joint during the ambulation of the animal. Additionally, it was verified bilateral hyperextension of the tibiotarsal joint and grade IIpatellar luxation of both pelvic limbs with painful hyperextension of the left stifle joint. Radiographic evaluation showedlateral displacement of the patella from both femoral trochlear groove, and a valgus deviation of the proximal left tibialshaft. In addition, it was verified cutaneous hyperextensibility and an extensibility index suggestive of EDS. The animalwas submitted to trochlear block resection technique and medial imbrication, followed by corrective tibial osteotomy.Furthermore, skin biopsies of the scapular and lumbar folds were performed during the corrective tibial osteotomy. Thesamples were sent for histopathological examination, which revealed fragmented and unorganized collagen fibers in thedermis. Histopathological findings were compatible with EDS. The absence of lameness and correct positioning of thepatella in the trochlear sulcus were verified in the post-surgical follow-up. Complete bone consolidation of the closingwedge osteotomy to correct the tibial...

Lateral patellar luxation and Ehlers Danlos Syndrome (EDS) in a dog

Background: Ehlers Danlos Syndrome (EDS) is a rare genetic disease characterized by a deficiency in collagen synthesis,which can result in joint laxity. Patellar luxation is one of the main orthopedic conditions that affect the canine knee joint,with limited descriptions of its association with EDS in dogs. The purpose of this report is to describe the surgical management and postoperative evolution of a 1-year-old Chow Chow dog with grade II patellar luxation, tibial valgus and EDS.Case: A 1-year-old Chow Chow dog was referred to the University Veterinary Hospital due to lameness of the left pelvicfor 3 months. At the orthopedic examination were verified severe lameness and lateral deviation of the left stifle joint during the ambulation of the animal. Additionally, it was verified bilateral hyperextension of the tibiotarsal joint and grade IIpatellar luxation of both pelvic limbs with painful hyperextension of the left stifle joint. Radiographic evaluation showedlateral displacement of the patella from both femoral trochlear groove, and a valgus deviation of the proximal left tibialshaft. In addition, it was verified cutaneous hyperextensibility and an extensibility index suggestive of EDS. The animalwas submitted to trochlear block resection technique and medial imbrication, followed by corrective tibial osteotomy.Furthermore, skin biopsies of the scapular and lumbar folds were performed during the corrective tibial osteotomy. Thesamples were sent for histopathological examination, which revealed fragmented and unorganized collagen fibers in thedermis. Histopathological findings were compatible with EDS. The absence of lameness and correct positioning of thepatella in the trochlear sulcus were verified in the post-surgical follow-up. Complete bone consolidation of the closingwedge osteotomy to correct the tibial...(AU)

Femoral corrective osteotomy associated with trochlear prosthetics and tibial tuberosity transposition with a tool for treatment of canine patellar dislocation / Osteotomia corretiva de fêmur associada à prótese troclear do joelho e transposição da tuberosidade tibial por dispositivo para tratamento da luxação de patela canina

Patellar luxation is one of the main osteoarticular diseases described in the surgical routine of companion animals, whose treatment differs according to the degree of luxation based on the clinical alterations presented by each patient. The present report aims to describe the association of the femoral corrective osteotomy technique, total trochlear replacement of the knee by prosthesis and transposition of tibial tuberosity with device for correction of degree IV patella luxation in a 1.5 year old German Spitz canine with varus femoral deviation and external torsion of the tibia. The treatment allowed the correction of femoral bone deformation, realignment of the extensor mechanism of the quadriceps and permanent maintenance of the patella on the trochlear folds with early functional limb return, absence of pain and claudication.(AU)

luxação de patela é uma das principais enfermidades osteoarticulares descrita na rotina cirúrgica de animais de companhia, cujo tratamento difere de acordo com a graduação da luxação baseando-se nas alterações clínicas apresentadas por cada paciente. O presente relato tem como objetivo descrever a associação da técnica de osteotomia corretiva femoral, subs-tituição troclear total do joelho por prótese e transposição da tuberosidade tibial com dispositivo para correção de luxação de patela grau IV em uma canina da raça Spitz Alemão de 1,5 anos com desvio femoral varus e torção externa da tíbia. O trata-mento permitiu a correção da deformação óssea femoral, realinhamento do mecanismo extensor do quadríceps e manutenção permanente da patela sobre o sulco troclear protético com retorno funcional precoce do membro, ausência de dor e claudicação(AU)

Femoral corrective osteotomy associated with trochlear prosthetics and tibial tuberosity transposition with a tool for treatment of canine patellar dislocation / Osteotomia corretiva de fêmur associada à prótese troclear do joelho e transposição da tuberosidade tibial por dispositivo para tratamento da luxação de patela canina

Patellar luxation is one of the main osteoarticular diseases described in the surgical routine of companion animals, whose treatment differs according to the degree of luxation based on the clinical alterations presented by each patient. The present report aims to describe the association of the femoral corrective osteotomy technique, total trochlear replacement of the knee by prosthesis and transposition of tibial tuberosity with device for correction of degree IV patella luxation in a 1.5 year old German Spitz canine with varus femoral deviation and external torsion of the tibia. The treatment allowed the correction of femoral bone deformation, realignment of the extensor mechanism of the quadriceps and permanent maintenance of the patella on the trochlear folds with early functional limb return, absence of pain and claudication.

luxação de patela é uma das principais enfermidades osteoarticulares descrita na rotina cirúrgica de animais de companhia, cujo tratamento difere de acordo com a graduação da luxação baseando-se nas alterações clínicas apresentadas por cada paciente. O presente relato tem como objetivo descrever a associação da técnica de osteotomia corretiva femoral, subs-tituição troclear total do joelho por prótese e transposição da tuberosidade tibial com dispositivo para correção de luxação de patela grau IV em uma canina da raça Spitz Alemão de 1,5 anos com desvio femoral varus e torção externa da tíbia. O trata-mento permitiu a correção da deformação óssea femoral, realinhamento do mecanismo extensor do quadríceps e manutenção permanente da patela sobre o sulco troclear protético com retorno funcional precoce do membro, ausência de dor e claudicação

Evaluation of trochlear dysplasia in dogs with medial patellar luxation: comparative studies

Medial patellar luxation (MPL) is one of the commonest orthopaedic diseases in small dog breeds. Although the bone deformities associated with canine medial patellar luxation are described in numerous studies, the pathogenesis of the condition is still disputable. What is more, there is no categorical evidence that luxation of the patella is associated to a shallow trochlear groove as no objective method for determination of trochlear depth and shape has been proposed. The aim of the present study was to evaluate the depth and shape of femoral trochlear groove on radiographs obtained from healthy dogs and dogs affected with grade II and grade III MPL. A total of 45 dogs (33 with MPL and 12 healthy) from 4 small breeds (Mini-Pinscher, Pomeranian, Chihuahua and Yorkshire terrier) were included in the study. After deep sedation, stifle radiographs were obtained in tangential projection (skyline view). The dogs were positioned in ventral recumbency, the examined stifle bent as much as possible, and the central beam focused on the patella between femoral condyles. Six morphometric parameters associated with the onset of trochlear dysplasia similar to those used in human medicine were measured: trochlear sulcus angle (SA), lateral and medial trochlear inclination angles (LTI; MTI), trochlear groove depth (TD), patellar thickness (PaT) and the ratio between trochlear depth and patellar thickness (PaT/TD). The non-parametric Mann-Whitney test was used for evaluation of differences between healthy joints and those affected with grade II and III MPL. The association between measured variables was evaluated via the Spearman's rank-order correlation. TD was greater in healthy joints as compared to those affected with MPL grade II and III (P < 0.001). In healthy stifles, PaT value exceeded significantly (P < 0.01) that in joints with grade III MPL. The TD/PaT ratio was significantly greater in healthy joints vs both those with grade II (P < 0.01) and grade III MPL (P < 0.001). In healthy joints, there was a significant negative relationship (rho­0.508; P = 0.0113) between SA and TD: smaller sulcus angles corresponded to deeper trochleas. This correlation was even stronger in joints with patellar luxation (rho ­0.723; P < 0.0001). The LTI and MTI showed a very strong positive correlation in healthy joints (rho 0.854; P < 0.0001) and at the same time, lack of significant association in joints affected with MPL (rho -0.163; P = 0.327 for grade II MPL and rho 0.175; P = 0.448 for grade III MPL) was demonstrated. The altered trochlear shape and depth were more pronounced in joints with grade III MPL. As MPL grade increased, the SA became statistically significantly greater. In grade III MPL it was accompanied with considerably reduced trochlear depth, medial trochlear inclination angle and trochlear depth/patellar thickness ratio. Five of the measured morphometric parameters for radiographic detection of trochlear dysplasia in dogs were found to be important in the evaluation of trochlear morphology in dogs. The obtained results indicated the presence of trochlear dysplasia in dogs with MPL. A 3-stage classification system for assessment of abnormal trochlear development in small dog breeds: mild; moderate and severe trochlear dysplasia, was proposed. The occurrence of shallow trochlear groove and medial femoral condyle's hypoplasia could be accepted as signs of mild and moderate trochlear dysplasia. The pre-operative measurements of these parameters could improve surgical planning and decisions-making.

Feline obesity: risk factors and clinical and metabolic findings / Obesidade felina: fatores de risco, achados clínicos e metabólicos

Excess body fat can cause a series of metabolic and mechanical effects on the body. Therefore, this study aimed to verify the clinical, metabolic, and risk factors of overweight (OW) cats. For the acceptance of participation in the research, the tutors were asked to answer a questionnaire containing 34 questions and to point out the body condition score (BCS) on a sheet containing nine images of different scores (1 to 9 on a 9-point scale). Thereafter, the body evaluations were performed as a classification of the BCS on a scale from 1 to 9, with an ideal score (IS) of BCS 5 and OW for BCS > 5. Further, the lean mass index and morphometric measurements (thoracic and abdominal circumferences and height and length of the patella to calcaneal tuberosity) were performed to estimate the percentage of body fat. Systolic blood pressure was measured using the non-invasive Doppler method and blood was collected for hemogram and serum biochemistry (creatinine, urea, alanine aminotransferase, alkaline phosphatase, gamma-glutamyl transferase, glucose, triglycerides, and cholesterol). After these analyses, we sought to guide and raise the awareness of the tutors to promote the correct nutritional and environmental management of the animals. Thirty adult cats were divided into two groups, based on the classification of the BCS, with eight having an IS and 22 being OW. The OW group was found to have a low level of physical activity, hypercholesterolemia, and higher values of body characteristics. Additionally, there was a median agreement between the perceptions of the clinician and the tutors. Therefore, it was concluded that the main laboratory alteration found in the obese cats was hypercholesterolemia, which was a critical parameter. It was observed that a low degree of physical activity could cause excess weight gain. It was found that the guardians of the cats with ideal weight underestimated the BCS, which could contribute to the supply of excess food and consequently, obesity. Thus, this study was sought to guide and raise the awareness of tutors, to promote the correct nutritional and environmental management thereby providing welfare and quality of life to the animals.(AU)

O excesso de gordura corporal pode ocasionar uma série de efeitos metabólicos e mecânicos no organismo. Portanto, o objetivo deste artigo foi verificar os achados clínicos, metabólicos e fatores de risco em felinos acima do peso ideal. A partir da aceitação da participação na pesquisa, os tutores foram convidados a responder um questionário contendo 34 perguntas e também apontar o escore de condição corporal (ECC) em uma folha contendo nove imagens de diferentes escores (1 a 9 em uma escala de 9 pontos). Posterior a isso, foram realizadas as avaliações corporais como classificação do ECC na escala de 1 a 9, sendo escore ideal (ECC 5) e acima do peso (ECC > 5), índice de massa magra, aferição das medidas morfométricas (circunferência torácia e abdominal, estatura e comprimento da patela a tuberosidade calcânea), com o intuito de estimar o percentual de gordura corporal. Bem como, foram realizadas a aferição da pressão arterial sistólica pelo método Doppler não invasivo e a coleta de sangue para hemograma e bioquímica sérica (creatinina, ureia, alanina aminotransferase, fosfatase alcalina, gama glutamil transferase, glicose, triglicerídeos e colesterol). Posterior a esses procedimentos buscou-se orientar e conscientizar os tutores, com o intuito de promover o correto manejo nutricional e ambiental dos animais. Participaram 30 felinos adultos, que foram agrupados em dois grupos, após a classificação do ECC, sendo EI escore ideal (n=8) e AP acima do peso (n=22). Foi possível verificar no grupo AP baixo nível de atividade física, hipercolesterolemia e valores superiores nas características corporais, bem como, concordância mediana entre a percepção do clínico e dos tutores. Portanto, conclui-se, neste estudo, que a principal alteração laboratorial encontrada em gatos obesos foi a hipercolesterolemia, sendo de grande importância avaliar este parâmetro. E, observou-se que o baixo grau de atividade física pode ocasionar o excesso de peso. Logo, verificou-se que tutores de gatos no peso ideal subestimaram o ECC, o que pode contribuir para o fornecimento de excesso de alimento e, consequentemente, a obesidade. Assim, buscou-se orientar e conscientizar os tutores, a fim de promover o correto manejo nutricional e ambiental e assim proporcionar bem-estar e qualidade de vida aos animais.(AU)

Reparo de ruptura crônica do ligamento patelar em um felino / Repair of chronic patelar ligament rupture in a cat

Relata-se o caso de uma felina, sem raça definida, de oito meses de idade e 3,6 kg, com queixa de impotência funcional completa do membro pélvico esquerdo após trauma. A paciente apresentava aumento de volume em região do joelho, dor à palpação e instabilidade patelar. O diagnóstico de ruptura do ligamento patelar foi realizado com base nos resultados do exame ortopédico, juntamente com exame radiográfico e ultrassonográfico do joelho. O método utilizado para reparo da lesão foi a sutura em oito com fio de tetrafluorcabono associado à sutura interrompida simples para aproximação das bordas do ligamento. Durante a reavaliação de trinta dias pós-operatório, a paciente já apresentava melhora significativa, com atividade funcional completa do membro e ausência de dor.(AU)

We report the case of an eight-month-old, 3.6 kg, crossbred feline, complaining of complete functional impotence of the left pelvic limb after trauma. The patient presented swelling in the knee region, pain on palpation and patellar instability. The diagnosis of patellar ligament rupture was based on the results of the orthopedic examination, together with radiographic and ultrasound examinations of the knee. The method used to repair the lesion was eight-point suture with tetrafluorocabono thread associated with simple interrupted suture for approximation of the ligament edges. During the thirty-day postoperative reassessment, the patient already presented significant improvement, with complete functional activity of the limb. and absence of pain.(AU)

Reparo de ruptura crônica do ligamento patelar em um felino / Repair of chronic patelar ligament rupture in a cat

Relata-se o caso de uma felina, sem raça definida, de oito meses de idade e 3,6 kg, com queixa de impotência funcional completa do membro pélvico esquerdo após trauma. A paciente apresentava aumento de volume em região do joelho, dor à palpação e instabilidade patelar. O diagnóstico de ruptura do ligamento patelar foi realizado com base nos resultados do exame ortopédico, juntamente com exame radiográfico e ultrassonográfico do joelho. O método utilizado para reparo da lesão foi a sutura em oito com fio de tetrafluorcabono associado à sutura interrompida simples para aproximação das bordas do ligamento. Durante a reavaliação de trinta dias pós-operatório, a paciente já apresentava melhora significativa, com atividade funcional completa do membro e ausência de dor.

We report the case of an eight-month-old, 3.6 kg, crossbred feline, complaining of complete functional impotence of the left pelvic limb after trauma. The patient presented swelling in the knee region, pain on palpation and patellar instability. The diagnosis of patellar ligament rupture was based on the results of the orthopedic examination, together with radiographic and ultrasound examinations of the knee. The method used to repair the lesion was eight-point suture with tetrafluorocabono thread associated with simple interrupted suture for approximation of the ligament edges. During the thirty-day postoperative reassessment, the patient already presented significant improvement, with complete functional activity of the limb. and absence of pain.

Reparo de ruptura crônica do ligamento patelar em um felino / Repair of chronic patelar ligament rupture in a cat

Relata-se o caso de uma felina, sem raça definida, de oito meses de idade e 3,6 kg, com queixa de impotência funcional completa do membro pélvico esquerdo após trauma. A paciente apresentava aumento de volume em região do joelho, dor à palpação e instabilidade patelar. O diagnóstico de ruptura do ligamento patelar foi realizado com base nos resultados do exame ortopédico, juntamente com exame radiográfico e ultrassonográfico do joelho. O método utilizado para reparo da lesão foi a sutura em oito com fio de tetrafluorcabono associado à sutura interrompida simples para aproximação das bordas do ligamento. Durante a reavaliação de trinta dias pós-operatório, a paciente já apresentava melhora significativa, com atividade funcional completa do membro e ausência de dor.

We report the case of an eight-month-old, 3.6 kg, crossbred feline, complaining of complete functional impotence of the left pelvic limb after trauma. The patient presented swelling in the knee region, pain on palpation and patellar instability. The diagnosis of patellar ligament rupture was based on the results of the orthopedic examination, together with radiographic and ultrasound examinations of the knee. The method used to repair the lesion was eight-point suture with tetrafluorocabono thread associated with simple interrupted suture for approximation of the ligament edges. During the thirty-day postoperative reassessment, the patient already presented significant improvement, with complete functional activity of the limb. and absence of pain.

Diagnosis of canine rheumatoid arthritis / Diagnóstico da artrite reumatoide canina

Canine rheumatoid arthritis is a chronic inflammatory disease that affects the joints of dogs. The inflammation can cause damage to cartilage and bones and early diagnosis is the main factor determining treatment success. This report describes an unusual case of rheumatoid arthritis in a dog, highlighting the relevance of radiographic examination in association with histopathology in the definitive diagnosis. An 8 year old, male German Spitz dog, weighing 5kg was admitted with a history of cruciate ligament rupture and grade IV patella dislocation. Previously, surgery had been performed to correct the cranial cruciate ligament rupture, without success. On physical examination, the dog showed a palmigrade stance, severe pelvic limb lameness, and pain on palpation of all joints. Blood count and biochemical analysis were within normal ranges. Orthogonal radiographs of the joints of the pelvic and thoracic limbs were performed. The lesions were bilaterally symmetrical. Samples were taken from the patellofemoral joints for cytology, microbiology, and histopathologic analysis. Rheumatoid factor antibody assay was negative. In conclusion, the combination of more than one clinical sign and diagnostic tests, such as radiographs suggestive of rheumatoid arthritis, histopathologic analysis of the joints, and rheumatoid factor testing is required to reach a definitive diagnosis of rheumatoid arthritis.

A artrite reumatóide canina é por definição uma doença crônica inflamatória que acomete as articulações de cães. Como resultado, a artrite reumatoide pode causar lesões na cartilagem e nos ossos e o diagnóstico precoce é o principal fator para o sucesso do tratamento ideal. Este relato de caso objetivou descrever um caso incomum de artrite reumatóide em um cão, destacando a relevância do exame radiográfico associado à histopatologia no diagnóstico definitivo. Foi atendido um cão da raça Spitz Alemão, 8 anos, com 5kg de peso. Anteriormente, foi realizada procedimento cirúrgico para correção da ruptura bilateral de ligamento cruzado e luxação de patela grau IV, porém sem sucesso. Ao exame físico, o cão apresentava posição palmígrada, intensa claudicação dos membros pélvicos e sensibilidade dolorosa de todas as articulações à palpação. As análises de hemograma e bioquímica sérica básica estavam dentro dos limites normais. Foram realizadas radiografias ortogonais das articulações dos membros pélvicos e torácicos. A distribuição das lesões foi simétrica e em ambos os lados. Considerando esses achados, foram obtidas amostras biológicas das articulações para análise citológica, microbiológica e análise histopatológica. O anticorpo fator reumatóide também foi realizado e o resultado foi negativo. Diante do exposto, é necessária a associação de mais de um sinal clínico e diferentes exames, como por exemplo, radiografias sugestivas de artrite reumatóide, análise histopatológica das articulações e anticorpo fator reumatóide para alcançar o diagnóstico definitivo de artrite reumatóide.

Diagnosis of canine rheumatoid arthritis / Diagnóstico da artrite reumatoide canina

Canine rheumatoid arthritis is a chronic inflammatory disease that affects the joints of dogs. The inflammation can cause damage to cartilage and bones and early diagnosis is the main factor determining treatment success. This report describes an unusual case of rheumatoid arthritis in a dog, highlighting the relevance of radiographic examination in association with histopathology in the definitive diagnosis. An 8 year old, male German Spitz dog, weighing 5kg was admitted with a history of cruciate ligament rupture and grade IV patella dislocation. Previously, surgery had been performed to correct the cranial cruciate ligament rupture, without success. On physical examination, the dog showed a palmigrade stance, severe pelvic limb lameness, and pain on palpation of all joints. Blood count and biochemical analysis were within normal ranges. Orthogonal radiographs of the joints of the pelvic and thoracic limbs were performed. The lesions were bilaterally symmetrical. Samples were taken from the patellofemoral joints for cytology, microbiology, and histopathologic analysis. Rheumatoid factor antibody assay was negative. In conclusion, the combination of more than one clinical sign and diagnostic tests, such as radiographs suggestive of rheumatoid arthritis, histopathologic analysis of the joints, and rheumatoid factor testing is required to reach a definitive diagnosis of rheumatoid arthritis.(AU)

A artrite reumatóide canina é por definição uma doença crônica inflamatória que acomete as articulações de cães. Como resultado, a artrite reumatoide pode causar lesões na cartilagem e nos ossos e o diagnóstico precoce é o principal fator para o sucesso do tratamento ideal. Este relato de caso objetivou descrever um caso incomum de artrite reumatóide em um cão, destacando a relevância do exame radiográfico associado à histopatologia no diagnóstico definitivo. Foi atendido um cão da raça Spitz Alemão, 8 anos, com 5kg de peso. Anteriormente, foi realizada procedimento cirúrgico para correção da ruptura bilateral de ligamento cruzado e luxação de patela grau IV, porém sem sucesso. Ao exame físico, o cão apresentava posição palmígrada, intensa claudicação dos membros pélvicos e sensibilidade dolorosa de todas as articulações à palpação. As análises de hemograma e bioquímica sérica básica estavam dentro dos limites normais. Foram realizadas radiografias ortogonais das articulações dos membros pélvicos e torácicos. A distribuição das lesões foi simétrica e em ambos os lados. Considerando esses achados, foram obtidas amostras biológicas das articulações para análise citológica, microbiológica e análise histopatológica. O anticorpo fator reumatóide também foi realizado e o resultado foi negativo. Diante do exposto, é necessária a associação de mais de um sinal clínico e diferentes exames, como por exemplo, radiografias sugestivas de artrite reumatóide, análise histopatológica das articulações e anticorpo fator reumatóide para alcançar o diagnóstico definitivo de artrite reumatóide.(AU)

Dimensões da patela relacionadas à massa corporal do cão para emprego na confecção de prótese: estudo em cadáver / Patellar dimensions related to canine body mass for use in the manufacture of prosthesis: cadaver study

O objetivo deste trabalho foi mensurar as dimensões da patela de cadáveres caninos e avaliar sua relação com a massa corporal. Para a realização das medidas patelares, foram utilizados 70 cadáveres de cães adultos, com massa corpórea de 1 a 50kg, sem evidência clínica de afecção na articulação femorotibiopatelar. Com auxílio de um paquímetro, foram mensurados os comprimentos externo e interno, a largura externa no terço médio, a largura e a espessura internas nos terços proximal, médio e distal das patelas. Também foram mensuradas a largura nos terços proximal, médio e distal, a profundidade nos terços proximal, médio e distal do sulco troclear; essas medidas foram exclusivamente internas. Observou-se, de forma geral, forte correlação entre as medidas patelares e a massa corporal de cadáveres de cães. Nas condições deste estudo, pode-se concluir que o tamanho da patela varia segundo a massa corporal do cão e que essas medidas devem ser consideradas ao se planejar uma substituição protética.(AU)

The aim of this study was to measure the canine cadaver patellar dimensions and evaluate its relationship with body mass. 70 cadavers of adult dogs were used, with a body mass between 1 and 50kg, without clinical evidence of affection in the stifle joint. The external and internal lengths, external width in the middle third, width and thickness of the proximal, middle and distal thirds were measured using a pachymeter. The width was also measured in the proximal third, middle third and distal third, depth in the proximal third, middle third and distal third of the trochlear groove; these measurements were exclusively internal. A strong correlation was observed between the patellar dimension and body mass of canine cadavers. Under this study conditions, it is possible to conclude that the patellar size varies according to the canine body mass and these measures should be considered when planning a prosthetic replacement.(AU)

Dimensões da patela relacionadas à massa corporal do cão para emprego na confecção de prótese: estudo em cadáver / Patellar dimensions related to canine body mass for use in the manufacture of prosthesis: cadaver study

O objetivo deste trabalho foi mensurar as dimensões da patela de cadáveres caninos e avaliar sua relação com a massa corporal. Para a realização das medidas patelares, foram utilizados 70 cadáveres de cães adultos, com massa corpórea de 1 a 50kg, sem evidência clínica de afecção na articulação femorotibiopatelar. Com auxílio de um paquímetro, foram mensurados os comprimentos externo e interno, a largura externa no terço médio, a largura e a espessura internas nos terços proximal, médio e distal das patelas. Também foram mensuradas a largura nos terços proximal, médio e distal, a profundidade nos terços proximal, médio e distal do sulco troclear; essas medidas foram exclusivamente internas. Observou-se, de forma geral, forte correlação entre as medidas patelares e a massa corporal de cadáveres de cães. Nas condições deste estudo, pode-se concluir que o tamanho da patela varia segundo a massa corporal do cão e que essas medidas devem ser consideradas ao se planejar uma substituição protética.(AU)

The aim of this study was to measure the canine cadaver patellar dimensions and evaluate its relationship with body mass. 70 cadavers of adult dogs were used, with a body mass between 1 and 50kg, without clinical evidence of affection in the stifle joint. The external and internal lengths, external width in the middle third, width and thickness of the proximal, middle and distal thirds were measured using a pachymeter. The width was also measured in the proximal third, middle third and distal third, depth in the proximal third, middle third and distal third of the trochlear groove; these measurements were exclusively internal. A strong correlation was observed between the patellar dimension and body mass of canine cadavers. Under this study conditions, it is possible to conclude that the patellar size varies according to the canine body mass and these measures should be considered when planning a prosthetic replacement.(AU)

Avaliação radiográfica da profundidade do sulco troclear e diâmetro patelar em cães / Radiographic assessment of the depth of the troclear groove and patellar diameter in dogs

Background: Patellar luxation is an alteration of bone development for which the indicated treatment is surgery. Failure to correct it may result in clinical worsening. The most commonly used surgical approach is the transposition of the tibial crest with trochleoplasty, which aims to accommodate 50% of the patella in the trochlea. The femoral groove and trochlea can be evaluated radiographically by tangential projection, tomography, or ultrasonography; however, all these methodologies have limitations. The objective of this study was to evaluate the depth of the trochlear groove in three regions and to compare it with the patellar diameter on simple mediolateral radiographic images. Materials, Methods & Results: Fifty non-paired pelvic limbs of adult dogs of a specific breed, weighing less than 40 kg and without orthopedic changes, were used. In the mediolateral radiographic projection, three evaluators measured the femoral trochlear sulcus at three different points and the patellar diameter. After imaging examinations, all limbs were skeletonized, and the trochlea and patella were measured with a digital caliper in the same regions as that of the radiographic measurements. All post-skeletonization calculations were performed by an evaluator. The highest mean radiographic and ex vivo trochlear depth was 3.4 ± 1.2 mm and 2.7 ± 0.8 mm, respectively. The lowest mean radiographic and ex vivo patellar diameter was 7.7 ± 1.7 mm and 7.9 ± 1.6 mm, respectively. The average relationship between the trochlear depth and patellar diameter was less than 50% in all animals, with the highest radiographically determined ratio being 44.15% and that determined ex vivo as 34.17%. The mean patellar diameter calculated radiographically was similar among the animals. Discussion: Radiographic images made it possible to assess the patella and bone surface regions of the femoral condyles. A wide arthrotomy...

Abordagem clínico e cirúrgico da fixação dorsal de patela em equinos - relato de caso

A fixação dorsal de patela (FDP) é uma das afecções que mais acometem a articulação femoro tíbio patelar dos equinos, esta é caracterizada pela hiperextensão do membro pélvico, podendo acometer uni ou bilateral, tem diversas etiologias e pré-disposições, sendo as mais comuns a falta de tônus muscular e aprumos irregulares, os tratamentos são escolhidos de acordo com o grau da lesão, podendo ser estes com fisioterapia, contrairritantes e desmotomia associados ou não. Relata-se neste trabalho um animal atendido pelo hospital veterinário de grandes animais da FAEF, sendo necessário o uso de diferentes tratamentos para a solução do caso.(AU)

Dorsal patellar fixation (PDF) is one of the affections that most affect the patellofemoral articulation of horses, which is characterized by hyperextension of the pelvic limb, which can be uni or bilateral, has several etiologies and pre-dispositions, being the most common lack of muscle tone and irregular, the treatments are chosen according to the degree of the injury, being these with physiotherapy, contrairritantes and desmotomy associated or not. This work reports an animal attended by the veterinary hospital of large animals of the FAEF, where it was necessary to use different treatments for the solution of the case.(AU)

Abordagem clínico e cirúrgico da fixação dorsal de patela em equinos - relato de caso

A fixação dorsal de patela (FDP) é uma das afecções que mais acometem a articulação femoro tíbio patelar dos equinos, esta é caracterizada pela hiperextensão do membro pélvico, podendo acometer uni ou bilateral, tem diversas etiologias e pré-disposições, sendo as mais comuns a falta de tônus muscular e aprumos irregulares, os tratamentos são escolhidos de acordo com o grau da lesão, podendo ser estes com fisioterapia, contrairritantes e desmotomia associados ou não. Relata-se neste trabalho um animal atendido pelo hospital veterinário de grandes animais da FAEF, sendo necessário o uso de diferentes tratamentos para a solução do caso.

Dorsal patellar fixation (PDF) is one of the affections that most affect the patellofemoral articulation of horses, which is characterized by hyperextension of the pelvic limb, which can be uni or bilateral, has several etiologies and pre-dispositions, being the most common lack of muscle tone and irregular, the treatments are chosen according to the degree of the injury, being these with physiotherapy, contrairritantes and desmotomy associated or not. This work reports an animal attended by the veterinary hospital of large animals of the FAEF, where it was necessary to use different treatments for the solution of the case.