Complications Following Surgical Correction of Medial Patellar Luxation in Small-to-Medium-Size Dogs

Abstract

Objective The main aim of this study was to describe complications in dogs weighing < 20 kg treated for medial patellar luxation and to determine risk factors associated with these complications. Materials and Methods Medical records were reviewed and cases were grouped based on four techniques of stabilization for the tibial tuberosity transposition (TTT). Variables including animal signalment, clinical presentation, TTT technique, other concurrent surgical techniques and associated complications were investigated. Multiple logistic regression was used to determine the association of the same variables with specific complications such as tibial tuberosity fractures or avulsions, patellar reluxation and implant-related complications. Results Of the 100 procedures performed, 37 suffered a complication. There were no significant differences in the overall complication rate between TTT stabilization techniques. Preservation of the tibial tuberosity distal cortical attachment was associated with a reduced risk of implant-related complications, whereas adding a medial release to the surgical techniques was associated with an increased risk of medial patellar reluxation. The type of trochleoplasty performed did not affect the complication rate. Conclusions In the current study, a high rate of complications was found in dogs < 20 kg undergoing medial patellar luxation surgery. Performing a medial release and preserving the distal cortical attachment of the tibial tuberosity were the only variables associated respectively with an increase and a reduction in the risk of postsurgical complications.

Tibial Tuberosity Transposition Fixation with a Locking Plate during Medial Patellar Luxation Surgery: An Ex Vivo Mechanical Study

“…7 In two other studies, there were no significant differences in the overall complication rate between tibial tuberosity stabilization with different pin and tension band wire combinations. 2 9 In another study, large breed dogs were 5.5 times more likely to have major complications than toy breed dogs. Every 5 kg increase in body weight increased the likelihood of major complications by 1.3 times.…”

“…Based on several retrospective studies, the overall complication rate of medial patellar luxation tibial tuberosity transposition surgery is 11 to 43.1% of which 5 to 25% are major complications (►Table 1). 1,4,[6][7][8][9][10][11] Pin migration and tibial tuberosity avulsion are major complications. Tibial tuberosity avulsion with comminution is considered a catastrophic complication that is difficult to resolve and can result in permanent impaired function.…”

Radiographic Assessment of the Depth of the Troclear Groove and Patellar Diameter in Dogs

“…A sulcoplastia, associada a outras técnicas cirúrgicas, é abordagem muito utilizada na correção da luxação de patela [19]. São descritas inúmeras formas de realizar esta técnica [4], entretanto, a artrotomia, mesmo que mínima, pode ocasionar lesões na cartilagem articular [18], dor; hemartrose, aderências articulares; redução da amplitude de movimento e, consequentemente maior tempo de hospitalização [9] por isso, desenvolver exames simples de planejamento pré operatório, que contribua no cálculo do sulco troclear, são importantes para indicar corretamente a sulcoplastia reduzindo, consequentemente, o trauma cirúrgico.…”

“…O objetivo do tratamento é realinhar o movimento extensor do joelho e estabilizar a patela no sulco troclear por meio de combinações de técnicas [16]. Embora existam várias descritas [2,4,12], a abordagem mais utilizada é a transposição da crista tibial associada a trocleoplastia [12,19]. Contudo, há uma preocupação crescente com as complicações [5] e re-luxações associadas ao procedimento [6].…”

Comparison of Semi-Cylindrical Recession Trochleoplasty and Trochlear Block Recession for the Treatment of Canine Medial Patellar Luxation: A Pilot Study

“…8 Despite the reported advantages of TBR, in one retrospective study the type of femoral trochlear osteotomy did not affect postoperative complication rate; limb function and progression of osteoarthritis were not addressed in that study. 15 The objective of this study was to describe an alternative method for trochleoplasty, semi-cylindrical recession trochleoplasty (SCRT), and compare the technique to TBR. In this pilot, clinical, noninferiority trial, our null hypothesis was that surgical technique would not influence postoperative trochlear depth, patellar depth, patellar articular contact with the trochlea, percentage of recessed trochlear surface area, procedure time, complications or limb function.…”