Innovative Techniques in Management of Canine Medial Patellar Luxation – What Are They and When Are They Necessary?

Speaker: Karen Perry

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Innovative Techniques in Management of Canine Medial Patellar Luxation – What Are They and When Are They Necessary?


Medial patellar luxation is one of the most common orthopedic conditions in dogs. Despite extensive review of the anatomic abnormalities associated with medial patellar luxation, they remain incompletely understood and this complicates decision-making in treatment of this condition. Clinical signs associated with medial patellar luxation generally have a poor prognosis for resolution with non-surgical management and surgical treatment is generally recommended. In the past, high recurrence rates of up to 48% following surgery were reported. Success rates improved with recognition of the importance of tibial tuberosity transposition and conventional surgical treatment now focuses on improving alignment of the quadriceps apparatus and stability of the patella via trochleoplasty and tibial tuberosity transposition, in conjunction with soft tissue reconstructive procedures that balance tension within parapatellar soft tissues including medial release and lateral imbrication techniques. Despite this, reluxation still occurs in 8–12% of cases.

Additional surgical techniques such as distal femoral osteotomy, patelloplasty, trochlear groove replacement and augmentation of the medial trochlear ridge have been proposed more recently, to be used either in addition to, or instead of, the conventional techniques described above. These techniques may be more expensive and in some cases more invasive than standard surgical techniques, and may be more likely to require additional training or the expertise of a specialist. So, when are they justified? Decision-making as to if or when these techniques should be considered is complex; few guidelines have been published, and those that have are largely based on personal experience rather than objective measures using a validated method.

This webinar aims to provide an interactive and stimulating discussion regarding treatment of medial patellar luxation. Information on the novel options available will be given, including the evidence-base where this exists. It also aims to provide some guidance regarding decision-making; when is conventional treatment sufficient and when do these novel treatment options need to be considered?

 

Learning Objectives

  1. To be able to determine the likely anatomic abnormalities contributing to the development of medial patellar luxation in a given patient
  2. To be able to establish why medial patellar luxation has recurred in a given patient
  3. To be able to describe the novel techniques of distal femoral osteotomy, patelloplasty, trochlear groove replacement and medial trochlear ridge augmentation
  4. To be able to recognise indications for distal femoral osteotomy, patelloplasty, trochlear groove replacement and medial trochlear ridge augmentation
  5. To be able to formulate a plan for diagnosis and treatment of a patient with medial patellar luxation