Patella luxation Flashcards
1
Q
4 primary skeletal abnormalities
A
- Shallow/underdeveloped trochlear groove
- Angular deformity of the femur
- Medialisation of the tibial tuberosity
- Patella alta (patella sits proximally)
2
Q
4 secondary changes assoc. w/ patella lux
A
- Stretching of lateral joint capsule
- Contraction of medial jt capsule
- Internal rotation of the stifle
- OA
3
Q
Grade 1
A
- patella can be manually luxated w/ full extension of the stifle
- no/mild lameness
- radiographically normal stifle w/ no bony deformities
4
Q
Grade 2
A
- patella spont. luxates during stifle ROM and spont returns back into groove
- intermittent, skipping lameness
- mild internal rotation of the tibia and abduction of hock
5
Q
Grade 3
A
- patella permanently luxated but can be manually reduced back into groove
- crouched gait
- more severe internal rotation of the tibia
6
Q
Grade 4
A
- permanent luxation of patella and cannot reduce back
- pain/OA
- severe internal rotation of the tibia and skeletal deformities
7
Q
sx indications
A
- grade 2 or higher
- if assoc. w/ pain/lameness
8
Q
goal of sx
A
to realign the extensor mechanisms through alteration of skeletal abnormalities + correcting secondary soft tissue changes
9
Q
Skeletal alterations
A
- Deepening the trochlear groove: block recession trochleoplasty
- Transposition of the tibial tuberosity
10
Q
Soft tissue corrections
A
- Lateral retinacular imbrication using the biceps femoris fascia
- Medial desmotomy
11
Q
when is a femoral osteotomy indicated?
A
with significant/severe femoral deformity (stabilised w/ a bone plate)
12
Q
technique of transposition of the tibial tuberosity
A
- osteotomy and lateral translation of tibia w/ stabilisation from 2 K wires +/- tension bands
13
Q
post-op care
A
8-10wks strict rest, recheck w/ rads at 10wks post op to confirm healing
