Patella luxation Flashcards

1
Q

4 primary skeletal abnormalities

A
  1. Shallow/underdeveloped trochlear groove
  2. Angular deformity of the femur
  3. Medialisation of the tibial tuberosity
  4. Patella alta (patella sits proximally)
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2
Q

4 secondary changes assoc. w/ patella lux

A
  1. Stretching of lateral joint capsule
  2. Contraction of medial jt capsule
  3. Internal rotation of the stifle
  4. OA
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3
Q

Grade 1

A
  • patella can be manually luxated w/ full extension of the stifle
  • no/mild lameness
  • radiographically normal stifle w/ no bony deformities
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4
Q

Grade 2

A
  • patella spont. luxates during stifle ROM and spont returns back into groove
  • intermittent, skipping lameness
  • mild internal rotation of the tibia and abduction of hock
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5
Q

Grade 3

A
  • patella permanently luxated but can be manually reduced back into groove
  • crouched gait
  • more severe internal rotation of the tibia
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6
Q

Grade 4

A
  • permanent luxation of patella and cannot reduce back
  • pain/OA
  • severe internal rotation of the tibia and skeletal deformities
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7
Q

sx indications

A
  • grade 2 or higher

- if assoc. w/ pain/lameness

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8
Q

goal of sx

A

to realign the extensor mechanisms through alteration of skeletal abnormalities + correcting secondary soft tissue changes

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9
Q

Skeletal alterations

A
  1. Deepening the trochlear groove: block recession trochleoplasty
  2. Transposition of the tibial tuberosity
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10
Q

Soft tissue corrections

A
  1. Lateral retinacular imbrication using the biceps femoris fascia
  2. Medial desmotomy
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11
Q

when is a femoral osteotomy indicated?

A

with significant/severe femoral deformity (stabilised w/ a bone plate)

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12
Q

technique of transposition of the tibial tuberosity

A
  • osteotomy and lateral translation of tibia w/ stabilisation from 2 K wires +/- tension bands
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13
Q

post-op care

A

8-10wks strict rest, recheck w/ rads at 10wks post op to confirm healing

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