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).

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)

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...

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.

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)

Luxação medial de patela grau IV traumática em gato / Medial patellar luxation grade IV traumatic in cat / Luxación medial de patela grado IV traumática en gato

A luxação patelar é o deslocamento medial ou lateral da patela a partir de sua posição anatômica normal no sulco troclear. Ela normalmente é causada por uma má formação congênita ou por trauma e pode ser classificada em 4 graus, sendo uma condição rara o grau IV de causa traumática em felinos. Diagnosticamos a luxação patelar a partir do exame físico, o tratamento pode ser cirúrgico ou conservativo, dependendo do grau da luxação. Foi atendido um felino, macho, de 5 meses, com histórico de trauma e após apresentou claudicação que persistia há 20 dias. Ao exame físico, foi observada presença de luxação patelar medial grau IV, do membro pélvico esquerdo. O raio X evidenciou luxação patelar medial esquerda e ausência de deformidade angular. O tratamento preconizado foi a correção cirúrgica e o paciente apresentou uma ótima recuperação. O objetivo deste relato é evidenciar esse tipo de afecção pouco diagnosticada e investigada nos felinos.

The patellar luxation is a medial or lateral patella displacement from your normal anatomical position in the trochlear groove. It is usually caused by poor congenital formation or by trauma and can be classified in 4 degrees, being a rare condition the 4th degree of traumatic cause in felines. We diagnose the patellar luxation from the physical examination. The treatment can be surgical or conservative, depending on the degree of the luxation. It was attended a feline, male, 5 months old, with a history of trauma and after showing lameness that persisted for 20 days. At physical examination, the presence of medial patellar luxation grade IV, of the left pelvic limb was observed. The x-ray showed left medial patellar dislocation and absence of angular deformity. The recommended treatment was surgical correction and the patient presented an excellent recovery. The purpose of this report is to high light this type of condition that is little diagnosed and investigated in felines.

La luxación patelar es el desplazamiento medial o lateral de la patela a partir de suposición anatómica normal en el surco troclear. Por lo general es causada por una mala formación congénita o por trauma y puede ser clasificada en 4 grados, siendo una condición rara el grado IV de causa traumática en felinos. Diagnosticamos la luxación patelar a partir del examen físico, el tratamiento puede ser quirúrgico o conservador, dependiendo del grado de la luxación. Fue atendido un felino, macho, de 5 meses, con historial de trauma y después, presentó claudicación que persistió hace 20 días. En el examen físico, se observó presencia de luxación patelar medial grado IV, del miembro pélvico izquierdo. El rayo x evidenció luxación patelar medial izquierda y ausencia de deformidad angular. El tratamiento preconizado fue la corrección quirúrgica y el paciente presentó una óptima recuperación. El objetivo de este relato es evidenciar este tipo de afección poco diagnosticada e investigada en los felinos.

Luxação medial de patela grau IV traumática em gato / Medial patellar luxation grade IV traumatic in cat / Luxación medial de patela grado IV traumática en gato

A luxação patelar é o deslocamento medial ou lateral da patela a partir de sua posição anatômica normal no sulco troclear. Ela normalmente é causada por uma má formação congênita ou por trauma e pode ser classificada em 4 graus, sendo uma condição rara o grau IV de causa traumática em felinos. Diagnosticamos a luxação patelar a partir do exame físico, o tratamento pode ser cirúrgico ou conservativo, dependendo do grau da luxação. Foi atendido um felino, macho, de 5 meses, com histórico de trauma e após apresentou claudicação que persistia há 20 dias. Ao exame físico, foi observada presença de luxação patelar medial grau IV, do membro pélvico esquerdo. O raio X evidenciou luxação patelar medial esquerda e ausência de deformidade angular. O tratamento preconizado foi a correção cirúrgica e o paciente apresentou uma ótima recuperação. O objetivo deste relato é evidenciar esse tipo de afecção pouco diagnosticada e investigada nos felinos.(AU)

The patellar luxation is a medial or lateral patella displacement from your normal anatomical position in the trochlear groove. It is usually caused by poor congenital formation or by trauma and can be classified in 4 degrees, being a rare condition the 4th degree of traumatic cause in felines. We diagnose the patellar luxation from the physical examination. The treatment can be surgical or conservative, depending on the degree of the luxation. It was attended a feline, male, 5 months old, with a history of trauma and after showing lameness that persisted for 20 days. At physical examination, the presence of medial patellar luxation grade IV, of the left pelvic limb was observed. The x-ray showed left medial patellar dislocation and absence of angular deformity. The recommended treatment was surgical correction and the patient presented an excellent recovery. The purpose of this report is to high light this type of condition that is little diagnosed and investigated in felines.(AU)

La luxación patelar es el desplazamiento medial o lateral de la patela a partir de suposición anatómica normal en el surco troclear. Por lo general es causada por una mala formación congénita o por trauma y puede ser clasificada en 4 grados, siendo una condición rara el grado IV de causa traumática en felinos. Diagnosticamos la luxación patelar a partir del examen físico, el tratamiento puede ser quirúrgico o conservador, dependiendo del grado de la luxación. Fue atendido un felino, macho, de 5 meses, con historial de trauma y después, presentó claudicación que persistió hace 20 días. En el examen físico, se observó presencia de luxación patelar medial grado IV, del miembro pélvico izquierdo. El rayo x evidenció luxación patelar medial izquierda y ausencia de deformidad angular. El tratamiento preconizado fue la corrección quirúrgica y el paciente presentó una óptima recuperación. El objetivo de este relato es evidenciar este tipo de afección poco diagnosticada e investigada en los felinos.(AU)

Técnica de avanço e transposição da tuberosidade tibial (TTTA) com uso de espaçador único de TTA-Maquet em cão / Technique of tibial tuberosity transposition and advancement (TTTA) with use of TTA-Maquet cage-only in dog

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...(AU)

Técnica de avanço e transposição da tuberosidade tibial (TTTA) com uso de espaçador único de TTA-Maquet em cão / Technique of tibial tuberosity transposition and advancement (TTTA) with use of TTA-Maquet cage-only in dog

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...

Comparação da TTTT® (Tibial Tuberosity Transposition Tool) com a técnica tradicional de transposição e fixação da tuberosidade tibial em cães com luxação patelar: revisão bibliográfica / Comparison of TTTT® (Tibial Tuberosity Transposition Tool) with the traditional technique for tibial tuberosity transposition and fixation in dogs with patellar luxation: literature review

A luxação de patela representa casuística importante entre as afecções ortopédicas que acometem o membro pélvico dos cães. É consenso que a luxação de patela é sinal clínico e não doença, sendo causada por deformidades musculoesqueléticas, como a torção externa ou interna da tíbia proximal. A transposição da tuberosidade tibial (TTT) é técnica frequentemente empregada para correção desses desvios torcionais, consistindo no deslocamento lateral ou medial da tuberosidade tibial (TT), permitindo o reestabelecimento da posição da patela no sulco troclear do fêmur. Esta técnica é considerada indispensável por muitos autores, mesmo nos casos mais graves. A TTTT® (Tibial Tuberosity Transposition Tool) é técnica que permite o deslocamento da TT após osteotomia parcial e que não necessita de fixação da TT deslocada com banda de tensão. O presente trabalho tem por objetivo comparar os aspectos relacionados à execução, condições de aplicabilidade e incidência de complicações pós-operatórias da técnica tradicional de transposição e fixação da tuberosidade tibial, em relação à TTTT®.

The patellar dislocation is a important casuistry among the orthopedic disorders affecting the dog’s hindlimb. There’s a consensus that patellar luxation is a clinical sign and not the disease, caused by underlying musculoskeletal deformities, which we can highlight the external or internal torsion of the proximal tibia. Tibial tuberosity Transposition (TTT) is the technique commonly performed to correct these torsional deviations, consisting on lateral or medial displacement of the tibial tuberosity (TT), allowing the restoration of the patella neutral path in the femoral trochlear groove. This technique is considered indispensable by many authors, even in the most severe cases. The TTTT® (Tibial Tuberosity Transposition Tool) provides a method that allows the displacement of tibial tuberosity, after partial osteotomy, that doesn’t require fixation of the transposed tuberosity with tension band wire. The present paper aims to compare the aspects related to performance, applicability and incidence of postoperative complications of the established technique of transposition and attachment of tibial tuberosity in relation to TTTT®.

Comparação da TTTT® (Tibial Tuberosity Transposition Tool) com a técnica tradicional de transposição e fixação da tuberosidade tibial em cães com luxação patelar: revisão bibliográfica / Comparison of TTTT® (Tibial Tuberosity Transposition Tool) with the traditional technique for tibial tuberosity transposition and fixation in dogs with patellar luxation: literature review

A luxação de patela representa casuística importante entre as afecções ortopédicas que acometem o membro pélvico dos cães. É consenso que a luxação de patela é sinal clínico e não doença, sendo causada por deformidades musculoesqueléticas, como a torção externa ou interna da tíbia proximal. A transposição da tuberosidade tibial (TTT) é técnica frequentemente empregada para correção desses desvios torcionais, consistindo no deslocamento lateral ou medial da tuberosidade tibial (TT), permitindo o reestabelecimento da posição da patela no sulco troclear do fêmur. Esta técnica é considerada indispensável por muitos autores, mesmo nos casos mais graves. A TTTT® (Tibial Tuberosity Transposition Tool) é técnica que permite o deslocamento da TT após osteotomia parcial e que não necessita de fixação da TT deslocada com banda de tensão. O presente trabalho tem por objetivo comparar os aspectos relacionados à execução, condições de aplicabilidade e incidência de complicações pós-operatórias da técnica tradicional de transposição e fixação da tuberosidade tibial, em relação à TTTT®.(AU)

The patellar dislocation is a important casuistry among the orthopedic disorders affecting the dogs hindlimb. Theres a consensus that patellar luxation is a clinical sign and not the disease, caused by underlying musculoskeletal deformities, which we can highlight the external or internal torsion of the proximal tibia. Tibial tuberosity Transposition (TTT) is the technique commonly performed to correct these torsional deviations, consisting on lateral or medial displacement of the tibial tuberosity (TT), allowing the restoration of the patella neutral path in the femoral trochlear groove. This technique is considered indispensable by many authors, even in the most severe cases. The TTTT® (Tibial Tuberosity Transposition Tool) provides a method that allows the displacement of tibial tuberosity, after partial osteotomy, that doesnt require fixation of the transposed tuberosity with tension band wire. The present paper aims to compare the aspects related to performance, applicability and incidence of postoperative complications of the established technique of transposition and attachment of tibial tuberosity in relation to TTTT®.(AU)

Técnica quirúrgica de reconstrucción de ligamento patelofemoral medial / Surgical technique of medial patellofemoral ligament reconstruction

El ligamento patelofemoral medial (LPFM) es el principal limitador de la lateralización rotuliana. En un episodio de luxación patelar externa se produce una rotura de éste ligamento, el cual tiene una baja capacidad de cicatrización, por lo que una vez dañado, en la mayoría de los casos al no cicatrizar, genera un incremento en la laxitud de las estructuras mediales y síntomas relacionados con inestabilidad. Es relevante describir en forma detallada la técnica quirúrgica, debido que ante un segundo episodio de luxación, en un joven activo (grupo que más afecta), en el cual el primero fue tratado en forma adecuada, consideramos conveniente realizar la reconstrucción de LPFM. Teniendo en cuenta que si bien es una patología que tiene baja incidencia, limita mucho el desarrollo normal del individuo y que la cirugía es un procedimiento efectivo por el bajo índice de re luxación y el alivio de la sintomatología. En la cirugía se debe intentar realizar una reconstrucción anatómica y tener en cuenta si se debe adicionar otros procedimientos como la liberación del retináculo lateral y la osteotomía de la tuberosidad anterior de la tibia (TAT).

The patellofemoral ligament is the main limiting component of the patellar lateral instability. The ligament has poor cicatrization properties, reason why, at the time of injury it does not have a good cicatrization. That situation increases the medial tissue laxity and lateral instability symptoms It is important to describe the surgical technique due to the fact that when a second episode occurs in a active young patient (the most frequent group) and when the first one had been treated correctly, we recommend the ligament reconstruction surgery. Although, this pathology has a low incidence, and it compromise the normal development of young patients. The surgery is an effective procedure, because of its low index of reluxation episodes and relief the symptoms. During the surgery we must try an anatomic reconstruction and the surgeon has to take into account the necessity to add others procedures like anterior tuberosity osteotomy or the lateral retinaculum cut.

Técnica quirúrgica de reconstrucción de ligamento patelofemoral medial / Surgical technique of medial patellofemoral ligament reconstruction

El ligamento patelofemoral medial (LPFM) es el principal limitador de la lateralización rotuliana. En un episodio de luxación patelar externa se produce una rotura de éste ligamento, el cual tiene una baja capacidad de cicatrización, por lo que una vez dañado, en la mayoría de los casos al no cicatrizar, genera un incremento en la laxitud de las estructuras mediales y síntomas relacionados con inestabilidad. Es relevante describir en forma detallada la técnica quirúrgica, debido que ante un segundo episodio de luxación, en un joven activo (grupo que más afecta), en el cual el primero fue tratado en forma adecuada, consideramos conveniente realizar la reconstrucción de LPFM. Teniendo en cuenta que si bien es una patología que tiene baja incidencia, limita mucho el desarrollo normal del individuo y que la cirugía es un procedimiento efectivo por el bajo índice de re luxación y el alivio de la sintomatología. En la cirugía se debe intentar realizar una reconstrucción anatómica y tener en cuenta si se debe adicionar otros procedimientos como la liberación del retináculo lateral y la osteotomía de la tuberosidad anterior de la tibia (TAT). (AU)

The patellofemoral ligament is the main limiting component of the patellar lateral instability. The ligament has poor cicatrization properties, reason why, at the time of injury it does not have a good cicatrization. That situation increases the medial tissue laxity and lateral instability symptoms It is important to describe the surgical technique due to the fact that when a second episode occurs in a active young patient (the most frequent group) and when the first one had been treated correctly, we recommend the ligament reconstruction surgery. Although, this pathology has a low incidence, and it compromise the normal development of young patients. The surgery is an effective procedure, because of its low index of reluxation episodes and relief the symptoms. During the surgery we must try an anatomic reconstruction and the surgeon has to take into account the necessity to add others procedures like anterior tuberosity osteotomy or the lateral retinaculum cut. (AU)

Luxação de patela em cães: estudo retrospectivo / Patellar luxation in dogs: a retrospective study

A five-year retrospective study of dogs with patellar luxation was performed. A total of 75 dogs (n=122limbs) were studied: 82.7% (n=62) had medial luxation, 14.6% (n=11) had lateral luxation, and 2.7%(n=2) had both luxations in same stifle joint. Considering the dogs with medial patellar luxation, 6.7%(n=5) were mixed-breed and 76% (n=57) were purebred, with high prevalence in Poodles (n=27; 35.6%),Pinschers (n=13; 17.3%), and Yorkshires (n=4; 5.3%). Of the dogs with lateral patellar luxation, one(1.3%) was mixed-breed and 13.3% were purebred, with high prevalence in Poodles (n=6; 8%) andPinschers (n=2; 2.7%). Regarding the 62 dogs with medial patellar luxation, 20 were unilateral and 42bilateral. Of the 11 dogs with lateral patellar luxation, five were unilateral and six bilateral. Statistically,females were more affected than males by both medial and lateral patellar luxations. The grade II (25;33.3%) of patellar luxation was the most often in medial luxation followed by grades III (20; 26.7%), IV(11; 14.7%), and I (16; 7.9%). The grade II (5; 6.7%) was the most often in lateral luxation followed bygrade I (4; 5.3%), and simultaneously grades III (1.3%) and IV (1.3%). The surgical treatment wasperformed in 64 dogs and the others were submitted a conservative management. It was possible toconclude that among the dogs with patellar luxation evaluated in this study, the most affected were toyand miniature breeds and female dogs with medial patellar luxation.

Luxação de patela em cães: estudo retrospectivo / Patellar luxation in dogs: a retrospective study

A five-year retrospective study of dogs with patellar luxation was performed. A total of 75 dogs (n=122limbs) were studied: 82.7% (n=62) had medial luxation, 14.6% (n=11) had lateral luxation, and 2.7%(n=2) had both luxations in same stifle joint. Considering the dogs with medial patellar luxation, 6.7%(n=5) were mixed-breed and 76% (n=57) were purebred, with high prevalence in Poodles (n=27; 35.6%),Pinschers (n=13; 17.3%), and Yorkshires (n=4; 5.3%). Of the dogs with lateral patellar luxation, one(1.3%) was mixed-breed and 13.3% were purebred, with high prevalence in Poodles (n=6; 8%) andPinschers (n=2; 2.7%). Regarding the 62 dogs with medial patellar luxation, 20 were unilateral and 42bilateral. Of the 11 dogs with lateral patellar luxation, five were unilateral and six bilateral. Statistically,females were more affected than males by both medial and lateral patellar luxations. The grade II (25;33.3%) of patellar luxation was the most often in medial luxation followed by grades III (20; 26.7%), IV(11; 14.7%), and I (16; 7.9%). The grade II (5; 6.7%) was the most often in lateral luxation followed bygrade I (4; 5.3%), and simultaneously grades III (1.3%) and IV (1.3%). The surgical treatment wasperformed in 64 dogs and the others were submitted a conservative management. It was possible toconclude that among the dogs with patellar luxation evaluated in this study, the most affected were toyand miniature breeds and female dogs with medial patellar luxation.(AU)

Treatment of the lateral patellar luxation in toy poodles

The purpose of this retrospective study was to report the occurrence of lateral patellar luxation in poodles. The animals were referred to the Orthopedics Service of the Veterinary Hospital, Faculdade de Ciências Agrárias e Veterinárias, - Jaboticabal Campus, São Paulo, Brazil, twelve client-owned poodles, seven females and five males poodles ranging in age from three to nine months. Clinical examination showed lameness, pain and deformities of the affected limbs. Surgical trochleoplasties were performed with medial retinacular overlap and medial tibial tuberosity transposition. The animals recovered their normal activity within a period of one to two weeks after surgery. Although this was a rarely occurring pathological condition in poodles, surgical repair was easy to execute because of its similarity to correction of medial patellar luxation. Lateral patellar luxation in small dogs is rare and, when present, is of congenital origin, at times progressing to marked functional impotence of the affected limbs.

O objetivo deste estudo retrospectivo foi relatar a ocorrência de luxação lateral em poodles. Os animais foram encaminhados ao Serviço de Ortopedia do Hospital Veterinário da Faculdade de Ciências Agrárias e Veterinárias, Campus de Jaboticabal, SP/Brasil, doze poodles, sete fêmeas e cinco machos, com idades variando entre três a nove meses. Ao exame clínico, notaram-se sinais de dor, claudicação e deformidades físicas dos membros afetados. Realizaram-se procedimentos cirúrgicos de condroplastia com sobreposição medial de retalho do retináculo e a transposição medial da crista tibial. O retorno à função do membro afetado ocorreu em um período de uma a duas semanas de pós-cirúrgico. Apesar de ser condição patológica rara em poodles, a reconstituição cirúrgica foi de fácil execução pela similaridade desta com a correção para luxação medial de patela. A luxação lateral de patela é rara em cães de raça pequena, e quando presente, é de origem congênita, podendo progredir para marcante impotência funcional dos membros afetados.

Treatment of the lateral patellar luxation in toy poodles

The purpose of this retrospective study was to report the occurrence of lateral patellar luxation in poodles. The animals were referred to the Orthopedics Service of the Veterinary Hospital, Faculdade de Ciências Agrárias e Veterinárias, - Jaboticabal Campus, São Paulo, Brazil, twelve client-owned poodles, seven females and five males poodles ranging in age from three to nine months. Clinical examination showed lameness, pain and deformities of the affected limbs. Surgical trochleoplasties were performed with medial retinacular overlap and medial tibial tuberosity transposition. The animals recovered their normal activity within a period of one to two weeks after surgery. Although this was a rarely occurring pathological condition in poodles, surgical repair was easy to execute because of its similarity to correction of medial patellar luxation. Lateral patellar luxation in small dogs is rare and, when present, is of congenital origin, at times progressing to marked functional impotence of the affected limbs.

O objetivo deste estudo retrospectivo foi relatar a ocorrência de luxação lateral em poodles. Os animais foram encaminhados ao Serviço de Ortopedia do Hospital Veterinário da Faculdade de Ciências Agrárias e Veterinárias, Campus de Jaboticabal, SP/Brasil, doze poodles, sete fêmeas e cinco machos, com idades variando entre três a nove meses. Ao exame clínico, notaram-se sinais de dor, claudicação e deformidades físicas dos membros afetados. Realizaram-se procedimentos cirúrgicos de condroplastia com sobreposição medial de retalho do retináculo e a transposição medial da crista tibial. O retorno à função do membro afetado ocorreu em um período de uma a duas semanas de pós-cirúrgico. Apesar de ser condição patológica rara em poodles, a reconstituição cirúrgica foi de fácil execução pela similaridade desta com a correção para luxação medial de patela. A luxação lateral de patela é rara em cães de raça pequena, e quando presente, é de origem congênita, podendo progredir para marcante impotência funcional dos membros afetados.