Stifle II - Goh Flashcards
Pathophysiology of Patellar Luxation
Primary malalignment of stifle extensor mechanism:
- shallow trochlear groove
- malpositioning of tibial tuberosity
- distal femoral varus
- excessive laxity and fibrosis of soft tissues
What is the most common luxation in all breeds?
MEDIAL
What is the most common luxation in large breeds>
MEDIAL!
But of the lateral luxations we see, they are usually in large breeds
Subluxates with digital pressure, but spontaneously reduces immediately
Grade 1
Normal in cats?
Luxates manually, and will luxate spontaneously with stifle ROM. Can be manually reduced or spontaneously reduces
Grade II
“Spends most of its time in the groove”
“Skippin lameness”
Patella is luxated, but can be manually reduced
May walked crouched with stifle semi-flexed
Grade III
Patella spends more time “out than in”
Permanently luxated and cannot be reduced
May carry limb or walk crouched
Grade IV
Severe gait changes (hand-stands)
When are femoral alignment rads indicated?
Higher grade MPL
Large breed dog MPL
Sx only indicated if clinically significant
Grade I and II
Sx recommended to minimize arthritis and may avoid CCL dz
Grade II to III
Severe bony and ligamentous deformities may not be repairable if not corrected early :(
Grade IV
Sulcoplasty
Rongeur or high-speed bur to reshape the trochlear groove. Always do an arthrotomy to assess depth of groove 1st
Chondroplasty
This is done in young puppies (<6mo)
Elevate the cartilage –> remove underlying subchondral bone –> replace wedge of cartilage
Tibial crest tranposition
realigning the patella tendon by transpositioning the tibial crest
Post-op care
STRICT rest 8 wks and rehab after
