Five patellar proximodistal positioning indices compared in clinically normal Greenland sled dogs

Miles, James Edward; Dickow, Marlene; Nielsen, Dorte H.; Jensen, Bente Rona; Kirpensteijn, Jolle; Svalastoga, E.; Eriksen, Thomas

doi:10.1016/j.tvjl.2012.01.003

Cited by 13 publications

(38 citation statements)

References 20 publications

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“…A radiographic study on patellar proximodistal positioning indices indicated that visually guided positioning allows the stifle angle to deviate more widely than goniometric positioning. 19 That study reported that the 95% confidence range for the data for each visually guided stifle position (90 and 135 degrees) varied from AE 10 to AE 28 degrees, which is similar to the 95% confidence ranges (AE24 to AE 26 degrees) for each stifle position (50, 90 and 135 degrees) in our study. The data for the initial four dogs (for which the hip and stifle angles were measured with a goniometer) in our study displayed similarly diverse angles; this might be because we tried to adjust the three angles with the dogs in one position and/or because the dogs were placed in supine position with their feet pointed toward the ceiling.…”

Section: Discussionsupporting

confidence: 88%

“…A report on patellar proximodistal positioning indices revealed that it is important to maintain patellar ligament tension when obtaining radiographs on which to measure the PLL. 19 Another study on the human knee showed that the contraction of the quadriceps muscles during weight-bearing causes the patellar ligament to tense and changes the patellar proximodistal position. 20 Thus, placing the stifle extensor mechanism in a stretched position would be advantageous for measuring both the QML/FL and the PLL/PL.…”

Section: Discussionmentioning

confidence: 99%

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Effect of Limb Position on Measurements of the Quadriceps Muscle Length/Femoral Length Ratio in Normal Beagle Dogs

Murakami

Nagahiro

Shimada

et al. 2020

Vet Comp Orthop Traumatol

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Objectives Dogs with patella alta reportedly have a shorter extensor mechanism than normal dogs. The present study aimed to measure the length of the extensor mechanism and to assess the effect of limb position on the quadriceps muscle length (QML)/femoral bone length (FL) ratio. Study Design Three-dimensional computed tomography images were taken of 12 Beagle dogs. Each dog underwent computed tomographic imaging 24 times with different limb positions. The QML/FL was measured on each image, along with the hip flexion–extension, hip abduction–adduction and stifle flexion–extension angles. Multiple regression analysis was used to determine the effect of these angles on the QML/FL. Results The QML/FL was increased with the hip extended (standardized partial regression coefficient 0.855 with linear plotting, 0.829 with log plotting) and with the stifle flexed (standardized partial regression coefficient 0.814 with linear plotting, 0.800 with log plotting). The partial regression coefficient of the hip abduction–adduction angle was small, indicating a small impact on the QML/FL. The 95% confidence range of the QML/FL with the hip extended and stifle flexed was 0.87 to 1.00 (mean ± standard deviation: 0.93 ± 0.03). Conclusion The QML/FL was more influenced by joint angles when the hip was flexed or the stifle was extended. Hence, these positions should be avoided when evaluating the QML/FL so that the QML is less altered by slight positioning disparities.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Effect of Limb Position on Measurements of the Quadriceps Muscle Length/Femoral Length Ratio in Normal Beagle Dogs

Murakami

Nagahiro

Shimada

et al. 2020

Vet Comp Orthop Traumatol

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“…In other studies, a tendency towards higher index values in dogs with high body masses was observed, which may suggest that the breed, size and body shape influences the results [4]. Similar studies are therefore required for other breeds than German shepherd dogs.…”

Section: Resultsmentioning

confidence: 79%

Determination of reference values and frequency of occurrence of patella alta in German shepherd dogs: a retrospective study

Łojszczyk-Szczepaniak

Silmanowicz

Komsta

et al. 2017

Acta Vet Scand

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BackgroundPatella alta and patella baja are important conditions underlying a predisposition to many joint diseases, including patellar luxation and patellar chondromalacia of the articular cartilage. The frequencies of patella alta and patella baja have not yet been determined. The objectives of this study were to determine the frequency of patella alta and to determine reference values to the position of the vertical patella according to two modified techniques of the Insall–Salvati method in a group of 65 German shepherd dogs (115 stifle joints).ResultsThe upper limits of reference values for the normal vertical position of the patella were 1.79 and 2.13, depending on the method of measurement. A high prevalence of patella alta was observed in the group of German shepherd dogs. A correlation was demonstrated between the classification of dogs’ joints in the patella alta group and the multiplied risk of canine hip dysplasia (CHD) through the estimation of odds ratios.ConclusionsDogs with patella alta were healthy dogs that did not exhibit orthopaedic problems in the stifle joints. The results revealed that the risk of CHD is twice as high in dogs with higher patellar ligament length to patella length ratio.

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“…2 The most widely reported index for characterizing canine patellar proximodistal positioning is the Insall-Salvati index, calculated as patellar ligament length divided by patellar length. 1,[3][4][5][6] This index has the advantage of being simple to quantify, and of being largely independent of femorotibial joint angulation, although a weak linear or curvilinear rela-tionship to joint angulation has been reported in dogs. 1,4,6 The key disadvantage of the Insall-Salvati index is that it is insensitive to changes in position of the patella relative to the femur, since the index remains unchanged regardless of a change in position of the patellar ligament insertion.…”

Section: Introductionmentioning

confidence: 99%

“…Alternative indices have been proposed to counter this disadvantage, including reference to the transcondylar axis on the caudocranial projection and adaptations of various human patellar positioning indices. 1,5,6 Of these humanderived indices, the Blackburne-Peel index appeared the most joint angle independent at typical clinical radiographic angulations, but suffers from its relative complexity compared with the Insall-Salvati index. 7 Calculation requires cranial extension of a line across the tibial plateau, measurement of the patellar articular joint surface length and measurement of the length of a line perpendicular to the first, which joins the patella at the distal aspect of the articular surface.…”

Section: Introductionmentioning

confidence: 99%

Measurement of Patellar Proximodistal Positioning with Limited Joint-Angle Sensitivity

Allberg

Miles

2020

Vet Comp Orthop Traumatol

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Objective Patellar luxation can be associated with abnormal proximodistal positioning of the patella. The current gold standard index (Insall–Salvati) for referencing this position is poorly suited to postoperative use, if the tibial tuberosity is moved surgically, but has the advantage of changing minimally with altered joint angles. The aim of this study was to identify an alternative index, which was simple to use, joint-angle insensitive and suitable for postoperative use. Study Design Candidate indices based on the angle between stifle joint landmarks were screened across a wide range of joint angles for insensitivity to joint angle changes using vulpine and canine stifle radiographs. Intraobserver and interobserver agreements were assessed for a single candidate index using canine radiographs. Results An angular index based on the caudal aspect of the femoral and tibial condyles and the apex of the patella was largely insensitive to joint angle variation. Intra- and interobserver agreements appeared suitable for clinical use, with low within-subject standard deviations (<1.3°) and coefficients of variations (<2.2%), and high intraclass correlation coefficients (>0.89). Conclusion Patellar proximodistal position can be acceptably assessed at a variety of caudal joint angles using the described angular index. Further work is required to define reference intervals across a range of canine breeds.

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Five patellar proximodistal positioning indices compared in clinically normal Greenland sled dogs

Cited by 13 publications

References 20 publications

Effect of Limb Position on Measurements of the Quadriceps Muscle Length/Femoral Length Ratio in Normal Beagle Dogs

Effect of Limb Position on Measurements of the Quadriceps Muscle Length/Femoral Length Ratio in Normal Beagle Dogs

Determination of reference values and frequency of occurrence of patella alta in German shepherd dogs: a retrospective study

Measurement of Patellar Proximodistal Positioning with Limited Joint-Angle Sensitivity

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