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

Barry E. Brower; Michael P. Kowaleski; Ann M. Peruski; Antonio Pozzi; Jonathan Dyce; Kenneth A. Johnson; Randy J. Boudrieau

doi:10.3415/VCOT-16-07-0103

Veterinary and Comparative Orthopaedics and Traumatology, Table of Contents

Vet Comp Orthop Traumatol 2017; 30(01): 20-27
DOI: 10.3415/VCOT-16-07-0103

Original Research

Schattauer GmbH

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

Barry E. Brower

¹Veterinary Medical Center of Long Island, West Islip, NY, USA

,

Michael P. Kowaleski

²Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA, USA

,

Ann M. Peruski

³Care Center, Cincinnati, OH, USA

,

Antonio Pozzi

⁴Vetsuisse Faculty, University Zurich, Zurich, Switzerland

,

Jonathan Dyce

⁵Department of Veterinary Clinical Sciences, Ohio State University, Columbus, OH, USA

,

Kenneth A. Johnson

⁶Faculty of Veterinary Science, School of Life and Environmental Sciences, University of Sydney, Sydney, NSW, Australia

,

Randy J. Boudrieau

²Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA, USA

› Author Affiliations

Abstract

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 fe-moral varus, and supports an association between stifle instability and medial patellar luxation.

keywords

Medial patellar luxation - femoral varus - distal femoral osteotomy

Full Text

References

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