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Archive (2005–2015)

Distal femoral lateral closing wedge osteotomy as a component of comprehensive treatment of medial patellar luxation and distal femoral varus in dogs

Journal: Veterinary and Comparative Orthopaedics and Traumatology (VCOT)
ISSN: 0932-0814
DOI: https://doi.org/10.3415/VCOT-16-07-0103
Issue: 2017: Issue 1 2017
Pages: 20-27
Ahead of Print: 2016-12-09

Distal femoral lateral closing wedge osteotomy as a component of comprehensive treatment of medial patellar luxation and distal femoral varus in dogs

Online Supplementary Material

B. E. Brower (1), M. P. Kowaleski (2), A. M. Peruski (3), A. Pozzi (4), J. Dyce (5), K. A. Johnson (6), R. J. Boudrieau (2)

(1) Veterinary Medical Center of Long Island, West Islip, NY, USA; (2) Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA, USA; (3) Care Center, Cincinnati, OH, USA; (4) Vetsuisse Faculty, University Zurich, Zurich, Switzerland; (5) Department of Veterinary Clinical Sciences, Ohio State University, Columbus, OH, USA; (6) Faculty of Veterinary Science, School of Life and Environmental Sciences, University of Sydney, Sydney, NSW, Australia

Keywords

Medial patellar luxation, Femoral varus, distal femoral osteotomy

Summary

Objective: To describe a cohort of dogs with medial patellar luxation managed with a distal femoral lateral closing wedge ostectomy (DFO) as a component of comprehensive treatment, and to report radiographic and long-term clinical outcome of this technique. Methods: Medical records of dogs that had a lateral closing wedge DFO as part of management of medial patellar luxation at three veterinary teaching hospitals were reviewed. Surgical reports as well as the preoperative, postoperative, and follow-up radiographs were reviewed. The anatomical lateral distal femoral angle (aLDFA) was determined. Long-term clinical outcome was assessed by telephone interview with the owner. Results: A lateral closing wedge DFO was performed on 66 limbs. The mean pre- and postoperative aLDFA was 107.6° ± 5.8° and 94.1° ± 4.2°, respectively. Cranial cruciate ligament disease was identified in 28/66 affected limbs. Tibial angular deformity, torsional deformity, or both was identified in nine of the 66 limbs. Ostectomy healing was confirmed radiographically in 51/66 limbs. The mean time to union was 73 ± 37 days. All patellae were in the normal position and stable. Complications included infection (2/51), fixation failure (1/51), delayed healing (2/51), and persistent lameness (1/51). Clinical significance: In this cohort of cases, DFO was a highly successful and repeatable component of surgical treatment for dogs with medial patellar luxation associated with femoral varus. This study also provides more evidence of the high rate of concurrent cranial cruciate ligament disease in cases of medial patellar luxation complicated by femoral varus, and supports an association between stifle instability and medial patellar luxation.

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