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.
Objectives The aim of this study was to evaluate stifle joint rotational stability in response to body position and repositioning in dogs undergoing computed tomography (CT). Materials and Methods Nine dogs (18 stifles) with no history or clinical signs of stifle injury undergoing CT examinations for other reasons were included in the study. Dogs were positioned in alternating dorsal and sternal recumbency with the pelvic limbs extended caudally and unrestrained, for a total of four examinations. Scans included the entire tibia and distal femur. Using defined landmarks on the tibia and femur, stifle joint rotational angles were measured from multiplanar reconstructions made by two independent observers, and repositioning effects and intra- and interobserver agreement evaluated. Results Repositioning produced repeatable stifle joint rotational angles (pooled within-subject standard deviations of 0.9° and 1.4°) and intraobserver repeatability was good (within-subject standard deviations 1.4°), but interobserver agreement was poor. Dorsal and sternal positioning produced equivalent results. Clinical Significance The results indicate that little rotation occurs in the healthy extended canine stifle joint during positioning for CT and support CT as a method for assessing limb alignment around the stifle joint, provided that the limb distal to the femorotibial joint is unrestrained. Clinically, it is likely that measured changes in rotational angles across (and distant to) the stifle joint are real, rather than being due to rotation artefact during imaging.
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