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Major complications and risk factors associated with surgical correction of congenital medial patellar luxation in 124 dogs

Journal: Veterinary and Comparative Orthopaedics and Traumatology (VCOT)
ISSN: 0932-0814
DOI: http://dx.doi.org/10.3415/VCOT-13-08-0100
Issue: 2014: Issue 4 2014
Pages: 263-270
Ahead of Print: 2014-05-07

Major complications and risk factors associated with surgical correction of congenital medial patellar luxation in 124 dogs

Online Supplementary Material

R. G. Cashmore (1, 2), M. Havlicek (1, 2), N. R. Perkins (3), D. R. James (1, 2), S. M. Fearnside (1, 2, 4), A. M. Marchevsky (1), A. P. Black (1, 2, 4)

(1) Small Animal Specialist Hospital, Surgical Department, North Ryde, Sydney, NSW, Australia; (2) Veterinary Specialist Centre, Surgical Department, North Ryde, Sydney, NSW, Australia; (3) AusVet, Animal Health Services, Toowoomba, Qld, Australia; (4) Northern Sydney Veterinary Specialist Centre, Surgical Department, North Turrarmurra, Sydney, NSW,Australia

Keywords

patellar luxation, avulsion, trochleoplasty, MPL

Summary

Dogs treated for congenital medial patellar luxation were reviewed for the purpose of determining the incidence of postoperative major complications requiring surgical revision and the risk factors for their occurrence. Major complications occurred in 18.5% of the patellar luxation stabilization procedures with implant associated complications being the most frequent, patellar reluxation the second, and tibial tuberosity avulsion the third most common major complication. Other complications included patellar ligament rupture and trochlear wedge displacement. When recession trochleoplasty was performed in addition to tibial tuberosity transposition, a 5.1-fold reduction in the rate of patellar reluxation was observed. Release of the cranial belly of the sartorius muscle further reduced the incidence of patellar reluxation, while patella alta (pre- or postoperative) and patellar luxation grade were not found to influence the rate of reluxation. Tibial tuberosity avulsion was 11.1-times more likely when using a single Kirschner wire to stabilize a transposition, compared with two Kirschner wires. Independent to the number of Kirschner wires used, the more caudodistally the Kirschner wires were directed, the higher the risk for tibial tuberosity avulsion. Tension bands were used in 24.4% of the transpositions with no tuberosity avulsion occurring in stifles stabilized with a tension band. Overall, grade 1 luxations had a significantly lower incidence of major complications than other grades, while body weight, age, sex, and bilateral patellar stabilization were not associated with risk of major complication development.

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