Resumo

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.

Resumo

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).

Resumo

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.

Resumo

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)

Resumo

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...

Resumo

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

Resumo

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.

Resumo

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.

Resumo

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.

Resumo

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)

Resumo

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.

Resumo

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)

Resumo

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...

Resumo

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.

Resumo

A luxação patelar é uma das condições mais comuns da articulação do joelho em cães e pode evoluir para doença articular degenerativa. A luxação pode ocorrer medial ou lateralmente, sendo unilateral ou bilateral, onde a ocorrência medial é mais frequente em animais de raças pequenas e a lateral é mais comum em animais de raças grandes. A classificação da luxação patelar compreende quatro graus, de acordo com a posição patelar, sinais clínicos e gravidade das deformidades ósseas encontradas. O diagnóstico é feito com base na avaliação clínica, associada a uma radiografia. O presente estudo apresenta uma fêmea de 10 meses de idade, na qual o tutor relatou que o animal já havia sido submetido à cirurgia para corrigir o deslocamento medular da patela e ainda apresentava claudicação e dor. Após a radiografia, foi encontrado o diagnóstico de luxação patelar medial do membro em que a cirurgia havia sido realizada.

Patellar dislocation is one of the most common knee joint conditions in dogs and may progress to degenerative joint disease. The dislocation can run medially or laterally, being unilateral or bilateral, where the medial occurrence is more frequent in small breed animals and the lateral one is more common in large breed animals. The classification of patellar luxation comprises four grades, according to the patellar position, clinical signs and seriousness of the bone deformities found. The diagnosis is made based on the clinical evaluation, associated with a radiograph. The present study presents a 10-month-old female canine in which the tutor reported that the animal had already undergone surgery to correct medial patellar dislocation and still had lameness and pain. After x-ray the diagnosis of medial patellar dislocation of the limb in which surgery had been performed was found.

Resumo

Background: The most common conditions that compromise the stifle joint in dogs are medial patellar luxation (MPL) and cranial cruciate ligament (CCL) rupture. Surgical procedures are usually indicated for the treatment of these diseases. One ordinarytechnique for the treatment of MPL is the tibial tuberosity transposition, and one prominent technique for CCL rupture is the tibialtuberosity advancement. These techniques can be associated in one surgical procedure called tibial tuberosity transposition andadvancement (TTTA) for the simultaneous treatment of both stifle diseases. The aim of this study is to report the surgical treatmentof a dog with MPL and CCL rupture affecting the same joint by the TTTA technique with the use of a TTA-Maquet cage-only.Case: A 3-year-old Pitbull dog weighing 39 kg was attended at Veterinary Hospital with a history of marked lameness in theleft pelvic limb. The orthopedic examination showed positive results for cranial drawer motion and tibial compression tests,and a complete CCL rupture was diagnosed. The presence of patellar luxation was evaluated by manual pressure on the patella, and grade 3 of MPL was diagnosed. Both conditions were affecting the same stifle joint. In addition, survey radiographsof the affected joint were performed. Surgical treatment was indicated by the TTTA technique. Radiographic measurementswere taken to calculate the cranial tibial tuberosity advancement by the tibial plateau and the common tangent methods, and atitanium TTA-Maquet cage-only of 10.5 x 20.0 mm was selected. Linear osteotomy was performed on the tibial tuberosity withthe aid of an oscillating saw, based on the Maquet hole technique. The tibial tuberosity was carefully displaced cranially and thecage was inserted at the site of osteotomy. The cage ears were molded on the tibial surface and fixed with 2.4 mm self-tappingcortical screws...

Resumo

This study describes lesions that occur in the stifle joints of dogs with patellar luxation. These lesions are associated with the animal's age, body weight, and degree of luxation. The rate of redislocation was also evaluated. The patellar lesions found include articular cartilage erosion, subchondral bone exposure, a flattened or concave patellar surface, and enthesophytes. Extra-patellar lesions included synovitis, osteophytes, blunting of the trochlear groove, an absent trochlea, erosion of the condylar margins, capsule thickening, a long digital extensor tendon injury, cranial cruciate ligament rupture, and meniscal prolapse. Such lesions were frequently found in animals with Grade II or III luxation who were aged 24 months or more, and they were more severe in dogs weighing more than 15 kg. Patellar luxation causes changes that favor articular degeneration and should be treated surgically. Conservative treatment relieves pain, but does not address tissue alterations.(AU)

O estudo descreve as lesões articulares em cães com luxação de patela. Elas foram associadas com a idade do animal, massa corporal e grau de luxação. Foi avaliada também a porcentagem de casos com recidiva. As lesões patelares observadas foram erosão da cartilagem articular, exposição óssea subcondral, superfície patelar achatada ou côncava e entesófitos. As lesões extra patelares incluíram sinovite, osteófitos, ausência do sulco troclear, erosão das bordas condilares, espessamento da cápsula, lesão do tendão do músculo extensor digital, ruptura do ligamento cruzado cranial e prolapso de menisco. As lesões foram encontradas com maior frequência em animais com luxação de Grau II ou III e idade de 24 meses ou mais, sendo mais graves em cães com massa corporal superior a 15 kg. A luxação patelar ocasiona alterações que favorecem a degeneração articular e devem ser tratadas cirurgicamente. O tratamento conservativo alivia a dor, mas não corrige as alterações teciduais.(AU)

Resumo

The influence of the proximal tibial angles in the cranial cruciate ligament (CCL) rupture in dogs is still controversial, and little is known regarding this topic in cats. The aim of this study was to evaluate and compare the angles of the proximal portion of the tibia in dogs and cats with and without CCL rupture. Retrospective and prospective radiographs of the stifle joints were obtained and divided into four groups. Group 1 was composed of 70 stifle joint images of dogs without orthopedic disorders (healthy dogs), group 2 had 70 stifle joint images of dogs with CCL rupture, group 3 had 50 stifle joint images of cats without orthopedic disorders (healthy cats) and group 4 had 25 stifle joint images of cats with CCL rupture. Radiographs were taken with the stifle joint in the mediolateral projection, positioned at the angle of hind limb support. Between the two groups of dogs evaluated, the dogs with CCL rupture had statistically greater tibial plateau angle (TPA) compared with healthy dogs. No difference was shown in relation to the TPA between healthy cats and cats with CCL rupture. In relation to the patellar ligament angle by tibial plateau method the values for the healthy dogs were significantly higher than those for the CCL ruptured dogs. Similarly, healthy cats had significantly higher mean values than cats with CCL rupture. In the patellar ligament angle by common tangent method there was no significantly difference between the two groups of dogs. Between the two groups of cats, animals with CCL rupture had statistically higher mean values than healthy cats. In general, the groups of dogs showed higher mean values than the groups of cats. For the patellar ligament insertion angle (PLIA) healthy dogs showed a significantly higher mean than dogs with CCL rupture. There was no significant difference between the groups of cats. In conclusion, the TPA and the PLIA possibly influence the etiology of CCL rupture in dogs but not in cats. The low patellar ligament angle measured by common tangent method may favorably influence the reduced incidence of CCL rupture in cats.(AU)

A influência dos ângulos da parte proximal da tíbia sobre a ruptura do ligamento cruzado cranial (LCC) em cães é ainda controversa, e pouco é descrito sobre este tópico em gatos. O objetivo deste estudo foi avaliar e comparar os ângulos da tíbia proximal em cães e gatos, ambas as espécies com e sem ruptura do LCC. Foram obtidos exames radiográficos retrospectivos e prospectivos das articulações do joelho e divididos em quatro grupos: no grupo 1 foram incluídas 70 imagens radiográficas da articulação do joelho de cães sem distúrbios ortopédicos (cães saudáveis), no grupo 2 foram 70 imagens radiográficas articulação do joelho de cães com ruptura do LCC, no grupo 3 foram 50 imagens radiográficas da articulação do joelho de gatos sem distúrbios ortopédicos (gatos saudáveis), e no grupo 4 foram 25 imagens radiográficas articulação do joelho de gatos com ruptura do LCC. As imagens radiográficas da articulação do joelho foram obtidas na projeção mediolateral, mantendo-se a articulação posicionada na angulação de apoio do membro pélvico. Em relação ao ângulo do platô tibial (APT), os cães com ruptura do LCC tiveram estatisticamente maiores valores médios do APT quando comparados aos cães saudáveis. Não foi observada diferença significativa em relação ao APT entre os gatos saudáveis e os gatos com ruptura do LCC. Em relação ao ângulo do ligamento patelar mensurado pelo método do platô tibial, os valores médios observados para os cães saudáveis foram significativamente mais elevados do que os valores encontrados para os cães com ruptura do LCC. De forma semelhante, os gatos saudáveis também apresentaram valores médios mais elevados do que os gatos com ruptura do LCC. Para o ângulo do ligamento patelar mensurado pelo método da tangente comum, não foram observadas diferenças significativas entre os dois grupos de cães. No entanto, entre os dois grupos de gatos, os animais com ruptura do LCC apresentaram valores médios significativamente mais elevados do que os gatos saudáveis. Em geral, os grupos de cães demonstraram valores médios mais elevados quando comparados aos grupos de gatos. Em relação ao ângulo de inserção do ligamento patelar (AILP), os cães saudáveis apresentaram valores médios significativamente mais elevados do que os cães com ruptura do LCC. No entanto, não foi observada diferença significativa entre os dois grupos de gatos. Em conclusão, o APT e o AILP possivelmente exercem influência na etiologia da ruptura do LCC em cães, mas não influenciam nos gatos. Em gatos, os reduzidos ângulos do ligamento patelar observados pelo método da tangente comum podem influenciar favoravelmente na baixa incidência da ruptura do LCC nessa espécie.(AU)

Resumo

Cranial cruciate ligament is the main responsible for knee stability by preventing cranial tibial displacement regarding the femur. Deficiency in this ligament (CCLD) may cause subluxation of the tibia and dysfunction of the pelvic member due to overloading. Tibial osteotomies are among the more current surgical techniques for treating CCLD in dogs and they proportionate the dynamic stability by means of modifying bone geometry and the distribution of forces acting on the articulation. The objective of this work is to describe the use of the allogeneic cortical bone graft conserved in glycerin as a spacer on the tibial tuberosity advancement (TTA) for treating the CCLD. In order to do that, 34 dogs submitted to TTA surgery correction were evaluated, being 23 males (67.35%) and 11 females (32.35%). Surgical procedures happened from May 2011 to October 2015. Regarding the surgical procedure after osteotomy of the tibial tuberosity, a disk of allogeneic cortical disk, sawn wedge-hapsed, conserved in glycerin, proportions of 2x1mm was applied as spacer, enabling TTA. Advancements from 3 to 12 mm were executed, depending on the need of the patient. For animals with patella dislocation, trochleoplasty and TTA were executed in order to correct the deviation. The mean ± SD age of animals was 6.67±3.58 and weight was 15.16±12.97 kg. Mongrel dogs, Poodles and Yorkshire terriers were the most affected ones. From the 36 evaluated knees, 11 (30.56%) were associated with some traumatic process and in 25 (69.44%) there was no relation with previous trauma. From those wounds, 20 (55.56%) happened in the right limb and 16 (44.44%) in the left limb and two animals had CCLD bilaterally. Animals had continuous support, discreet drawer movement and negative tibial compression 15 days after surgery. At 30 days, 26 cases (72.22%) had firm support (FS); at 45 days, 24 cases (66 test at 7 and 67%) had FS and eight cases (22.22%) without claudication (WC). During subsequent radiographic evaluations the progressive incorporation of the graft and osteotomy union were observed. In this study, most of the diagnosed CCLD occurred in males diverging from results obtained by other authors that found greater frequency in females. Support without claudication it was observed in most of the cases of implants at 60 days. We concluded that the conserved allogeneic cortical bone graft was able to promote bone union in TTA of dogs with CCLD. None of the animals had signs of contamination, infection of the surgical wound or rejection related with the presence of the graft, demonstrated by the complete graft-bone incorporation observed early at 45 days in some animals. The glycerin was a good conservation medium for those fragments intended for grafting because, besides being of low cost, it kept bone fragments free of contamination, reducing antigenicity and preserving the functions of osteoinduction and osteoconduction. The possibility of molding the graft to the animal need is a characteristic favorable to executing the modified technique that could be molded according to the size of the animal, allowing perfect adaptation to the osteotomized local in different breeds. Intercurrences commonly observed in TTA with patellar dislocation, meniscal lesions, tibial crest fracture and displacement were not found in the animals of this study, probably due to the better distribution of forces between the pass screw in TT and the TTA plate confirming that it has good adaptation to the technique conferring to the modified TTA advantages regarding the conventional TTA.(AU)

O ligamento cruzado cranial é o principal responsável pela estabilidade do joelho, impedindo o deslocamento da tíbia cranial em relação ao fêmur. A deficiência neste ligamento (CCLD) pode causar subluxação da tíbia e disfunção do membro pélvico devido à sobrecarga. As osteotomias tibiais estão entre as técnicas cirúrgicas mais atuais para o tratamento de CCLD em cães e proporcionam a estabilidade dinâmica por meio da modificação da geometria óssea da distribuição das forças que atuam sobre a articulação. O objetivo desse estudo é descrever o uso do enxerto ósseo cortical alogênico conservado em glicerina como espaçador no avanço da tuberosidade tibial (TTA) para o tratamento do CCLD. Para isso, 34 cães submetidos à cirurgia de TTA foram avaliados, sendo 23 machos (67,35%) e 11 fêmeas (32,35%). Os procedimentos curúrgicos aconteceram entre maio de 2011 e outubro de 2015. Com relação ao procedimento cirúrgico após a osteotomia da tuberosidade tibial, um disco alogênico cortical, em forma de cunha serrada, conservado em glicerina com proporções de 2 x 1mm foi aplicado como espaçador possibilitando a TTA. Avanços de 3 a 12mm foram executados, dependendo da necessidade do paciente. Para animais com luxação da patela, realizou-se a trocleoplastia e a TTA para a correção do desvio. A idade média dos animais foi de 6,67±3,58 anos e pesos médios de 15,16±12,97kg. Cães sem raça definida, Poodles e Yorkshire Terriers foram os mais afetados. Dos 36 joelhos avaliados, 11 (30,56%) foram associados a algum processo traumático e em 25 (69,44%) não havia nenhuma relação com um trauma prévio. Dos ferimentos, 20 (55,56%) aconteceram no membro direito e 16 (44,44%) no esquerdo, sendo que dois animais apresentavam CCLD bilateralmente. Os animais tiveram suporte contínuo, discreto movimento de gaveta e compressão tibial negativa 15 dias após a cirurgia. Aos 30 dias, 26 casos tinham suporte firme (FS); aos 45 dias, 24 casos tinham FS e oito casos sem claudicação (WC). Durante avaliações radiográficas subsequentes, observou-se a incorporação progressiva da união do enxerto e da osteotomia. Neste estudo, a maior parte do CCLD diagnosticado ocorreu em machos, divergindo dos resultados obtidos por outros autores que encontraram maior frequência em fêmeas. Suporte sem claudicação foi observado na maioria dos casos de implantes aos 60 dias. Foi concluído que o enxerto ósseo cortical alogênico conservado foi capaz de promover a união óssea na TTA de cães com CCLD. Nenhum dos animais apresentou sinais de contaminação, infecção da ferida cirúrgica ou rejeição relacionada à presença do enxerto, demonstrada pela incorporação completa do enxerto ósseo observada precocemente aos 45 dias em alguns animais. A glicerina foi um bom meio de conservação para os fragmentos destinados à enxertia porque, além do menor custo, manteve os fragmentos ósseos livres de contaminação, reduzindo a antigenicidade e preservando as funções de osteoindução e osteocondução. A possibilidade de moldagem do enxerto à necessidade do animal é uma característica favorável à execução da técnica modificada que pode ser moldada de acordo com o tamanho do animal, possibilitando perfeita adaptação ao local osteotomizado em diferentes raças. Intercorrências comumente observadas na TTA com luxação patelar, lesões meniscais, fratura da crista tibial e deslocamento não foram encontradas nos animais deste estudo, provavelmente devido à melhor distribuição de forças entre a passagem do parafuso no TT e a placa do TTA, confirmando que tem boa adaptação à técnica conferindo às vantagens da TTA modificada em relação à TTA convencional.(AU)

Resumo

A luxação de patela é uma das causas mais comuns de claudicação nos cães; raças grandes e pequenas podem ser afetadas, e resulta em diminuição da função de extensão da articulação do joelho o que compromete o suporte de peso corporal e eventualmente leva a claudicação, dor e osteoartrite. Existem diversas técnicas cirúrgicas descritas para a correção dessa afecção e das alterações musculoesqueléticas associadas. Todavia esse estudo busca demonstrar um novo método de tratamento da instabilidade femoropatelar em associação à severa osteoartrite articular através da substituição da tróclea femoral pela prótese de sulco patelar. Para essa avaliação, foram inclusos 25 animais provenientes de três diferentes hospitais veterinários, os critérios de inclusão envolviam cães acometidos por luxação patelar medial ou lateral, com ou sem lesão do ligamento cruzado cranial, com avaliação de grave osteoartrite de femoropatelar que impediria trocleoplastia eficiente, e tempo mínimo de acompanhamento clínico e radiográfico pelo período um mês. E a avaliação clínica os dividiu em raça, sexo, idade no momento do diagnóstico, peso corporal, membro afetado, direção e grau da luxação de I - IV, envolvimento unilateral ou bilateral, avaliação da marcha com presença ou ausência de claudicação, alterações ortopédicas associadas. Todos os pacientes foram submetidos à colocação da prótese de tróclea, sendo que desses 25, 19 pacientes apresentavam anormalidades musculoesqueléticas associadas e necessitaram da associação de mais de uma técnica cirúrgica. O resultado geral foi considerado bom, complicações ocorreram em apenas dois pacientes sendo 1 o deslocamento da prótese e o outro o retorno do deslocamento da patela em grau pior ao pré-cirúrgico. Todavia a completa resolução do quadro pôde ser avaliada em 23 pacientes, mesmo com período de avaliação de 30 dias. Sendo assim, o uso da prótese de tróclea apresentou potencial em diminuir o escore de claudicação associado ao quadro de LP e melhorou a estabilidade patelar, além de corrigir o alinhamento do mecanismo extensor.

Patellar luxation is one of the most common causes of lameness in dogs, large and small breeds can be affected, and results in decreased knee joint extension function which compromises body weight support and eventually leads to lameness, pain. and osteoarthritis. There are several surgical techniques described for the correction of this condition and associated musculoskeletal changes. However, this study seeks to demonstrate a new method of treating patellofemoral instability in association with severe joint osteoarthritis by replacing the femoral trochlea with a patellar sulcus prosthesis. For this evaluation, 25 animals from three different veterinary hospitals were included, the inclusion criteria involved dogs affected by medial or lateral patellar dislocation, with or without cranial cruciate ligament injury, with evaluation of severe patellofemoral osteoarthritis that would prevent efficient trochleoplasty, and minimum time of clinical and radiographic follow-up for a period of one month. And the clinical evaluation divided them into race, sex, age at diagnosis, body weight, affected limb, direction and degree of I-IV dislocation, unilateral or bilateral involvement, gait assessment with the presence or absence of lameness, orthopedic alterations. associated. All patients underwent placement of a trochlear prosthesis, and of these 25, 19 patients had associated musculoskeletal abnormalities and required the association of more than one surgical technique. The overall result was considered good, complications occurred in only two patients, 1 being the displacement of the prosthesis and the other the return of the displacement of the patella in a worse degree than before the surgery. However, the complete resolution of the condition could be evaluated in 23 patients, even with an evaluation period of 30 days. Thus, the use of the trochlea prosthesis had the potential to decrease the claudication score associated with LP and improve patellar stability, in addition to correcting the alignment of the extensor mechanism.