Clinical papers

Question 1

Patellar anti-rotational suture

Answer 1

1) Mazdarani VCOT 2023
-Rads, ideal anchor points
-Use best-fit circle to place suture anchor is preferred to maximise suture isometry during joint flexion and extension

Question 2

DFOs

Segmental ostectomy

Femoral valgus in puppies

Answer 2

1) Hall VS 2019 (Oxley)
-Prospective 10 dogs
-3D printed osteotomy and reduction guides allowed accurate correction of femoral torsion in vivo

2) Nagahiro VCOT 2020
-11 stifles grade 4 MPL
-DFO +/- Segmental femoral ostectomy to reconstruct femoropatellar joint
-Useful for those with shortened quads length relative to femoral length

3) Vezzoni VCOT 2022
-Retrospective, 11 skeletally immature dogs with distal femoral valgus (ALDFA <94deg)
-Hemiepiphysiodesis -> mean increase 11deg
-Uncorrection 12%, removed in 70% and rebound growth in 18%

Question 3

MPL surgeries

Answer 3

1) Rossanese VCOT 2019
-Retrospective 100 small/medium dogs
-37% comp rate
-Preserving TT distal cortical attachment lower risk of implant comp
-Medial release a/w increase relux

2) Winders VCOT 2021
-10 dogs bilateral MPL correction (TTT, trochleoplasty - 1 block, 1 cylindrical)
-Cylindrical easier to perform (3 blocks # intraop)

3) Choi Fr 2023
-Comparing patellofemoral pressures after semi-cylindrical vs block
-feline cadavers
-Both feasible, contact pressure restored

4) Cashmore VCOT 2014
-Retrospective 124 dogs (historic relux 8%)
-18% major comp (implant, 6% relux, TT avulsion, trochlear wedge displacement, patellar lig rupture)
-Trochleoplasty in addition to TTT, 5x reduction in relux
-Caudodistal k wires higher risk of avulsion
-single k wire 11x avulsion vs double k wire

Question 4

Incidental MPL

Answer 4

1) Hamilton JSAP 2020
-Retrospective 53 mature dogs
-50% progressed to requiring sx / frequent lameness

Question 5

TTT

patellectomy

trochlear ridge prostheses

Answer 5

Modified TTT
1) Cortina VS 2023
-300 stifles
-Large steinmann pin medial to transposed TT
-Modified TBW caudal to osteotomy engaging k wire
-4% low grade relux, overall major comp 4% (pin migration, infection, TT #, high grade relux)

Rapid Luxation Plating System
1) Onis VCOT 2023
-8% major comp - none implant related or TT avulsion #
-Good-excellent outcome all

Patellectomy
1) Dumitru VCOT 2023
-24 dog stifles
-Width mismatch intraop
-No major comp

Trochlear ridge prostheses
1) Nicetto VCOT 2024
-60 trochleae dogs - 1 major comp (relux)

2) Mills JSAP 2020
-4 cats