Partial parasagittal patellectomy: a novel method for augmenting surgical correction of patellar luxation in four cats

Rutherford, Lynda; Arthurs, Gareth

doi:10.1177/1098612x13509996

Cited by 14 publications

(31 citation statements)

References 16 publications

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“…Femoral trochleoplasty is a recommended technique for surgical treatment of patellar luxation. 1,2 However, a recent publication questioned its benefit as it did not correct patellar luxation in four cats 3 ; in that report, intraoperative assessment of the stifle revealed that following trochleoplasty, the patella rode the trochlear ridges instead of tracking in contact with the recessed sulcus. This was thought to be a consequence of the flat and wide shape of the feline patella and was addressed with bilateral partial parasagittal patellectomy (PPP).…”

Section: Introductionmentioning

confidence: 99%

Computed Tomographic Assessment of Block Recession Trochleoplasty and Partial Parasagittal Patellectomy in Cats

Brioschi

Rutherford

Newell

et al. 2020

Vet Comp Orthop Traumatol

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Objective The aim of this study was to assess computed tomography (CT) images of cadaveric feline stifles and record the relationship between the patella and femoral trochlea in normal stifles; then to investigate the effect of block recession trochleoplasty (BRT) with and without partial parasagittal patellectomy (PPP) on patellofemoral contact, depth of patellar recession and size of trochlea and patella. Materials and Methods The sample population included six cat cadavers (12 stifles). Preoperative CT scans with stifles in three positions: extended (155–165°), neutral (85–95°) and flexed (35–45°). Lateral stifle arthrotomy was followed by BRT. CT scans were taken as above. PPP was performed so the width of the patella was 1 mm narrower than the BRT. CT scans were repeated and CT measurements were taken. Results The area of contact between the patella and femoral trochlea was significantly reduced after BRT and then significantly increased after PPP. The depth of patellar recession was unchanged after BRT, but then was significantly higher after PPP. The patella was wider than the trochlea preoperatively and post-BRT and narrower post-PPP. Reduction in bone volume following PPP (mean: 20%) was 50% the reduction in patella width (mean: 40%). Conclusion Block recession trochleoplasty did not improve patellar recession and decreased patellofemoral contact area. Following BRT, the patella rides the trochlear ridges and loses contact with the trochlear sulcus. Block recession trochleoplasty alone should not be performed in cats. Instead, BRT should be combined with PPP.

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Section: Introductionmentioning

confidence: 99%

Computed Tomographic Assessment of Block Recession Trochleoplasty and Partial Parasagittal Patellectomy in Cats

Brioschi

Rutherford

Newell

et al. 2020

Vet Comp Orthop Traumatol

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“…Partial parasagittal patellectomy was necessary in all four surgeries described in this case series in order to establish patellar tracking in contact with the recessed sulcus and to stabilize the patella. This technique has been previously reported clinically, 24 and was shown to improve the depth of patellar recession over that achieved with block recession trochleoplasty alone in a cadaveric study using CT. 55 The feline patella is relatively wider than the feline femoral trochlear sulcus, 56 and ex vivo studies in cats have shown that following block recession trochleoplasty alone, the feline trochlea becomes too narrow to accommodate it. 55 Instead, the patella rides the trochlear ridges and loses contact with the trochlear sulcus.…”

Section: Discussionmentioning

confidence: 75%

“…As such, partial parasagittal patellectomy was performed as previously described to achieve appropriate patellar tracking. 24 , 46 A TTTA was completed in a standard fashion 41 using a 6 mm cage, two-prong plate and 4 mm spacer (TTA; KYON) with the following modifications: (1) owing to the paucity of bone stock available for screw purchase, in the cranial ear of the cage a 2.0 mm screw with a washer was applied rather than the 2.4 mm screw conventionally placed; (2) no Kirschner wire was used to maintain lateralization of the osteotomised tibial tuberosity; and (3) to lateralize the tibial tuberosity, a titanium spacer (TTA; KYON) was used beneath the cranial cage ear instead of a recessed notch caudally ( Figure 1c ).…”

Section: Case Series Descriptionmentioning

confidence: 99%

“…14 , 32 The main aim of surgery is to deepen the trochlear groove and restore normal alignment between the quadriceps muscle, patella and tibial tuberosity. Surgical techniques reported for the correction of MPL in cats include femoral trochleoplasty, tibial tuberosity transposition, soft tissue balancing and partial parasagittal patellectomy, 14 , 23 , 24 with a combination of techniques being employed in a single stifle as required to achieve stability.…”

Section: Introductionmentioning

confidence: 99%

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Tibial tuberosity transposition advancement for treatment of concomitant cranial cruciate ligament rupture and medial patellar luxation in four feline stifles

Bula

Perry

2021

Journal of Feline Medicine and Surgery Open Reports

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Case series summary Three cats (four stifles) were diagnosed with varying grades of medial patellar luxation and stifle instability in cranial tibial thrust. Radiographs showed periarticular osteophytosis, intra-articular mineralization and opacification encroachment of the infrapatellar fat pad. Stifle exploration revealed either partial (n = 2) or complete (n = 2) cranial cruciate ligament tear and medial meniscal injury in all cases. Medial meniscectomy, partial parasagittal patellectomy, femoral trochleoplasty and tibial tuberosity transposition advancement using a 6 mm cage, two-fork plate and 4 mm spacer were performed in four stifles. Screws (2.0 mm) and washers were used in the cranial cage ears rather than conventional 2.4 mm screws. By the 2-week recheck, lameness was minimal and stifles were stable. Radiographic follow-up at 8 weeks showed appropriate progression of osseous union in all cases. One cat experienced a major complication, suffering tibial fracture following a lapse in exercise restriction, and revision surgery was performed successfully with subsequent osseus union of the osteotomy site. At the mid-term follow-up, all cats had a return to previous level of function, as assessed by both owner questionnaire and clinical evaluation. Relevance and novel information Tibial tuberosity transposition and advancement has been shown to be successful in dogs for the treatment of concomitant medial patellar luxation and cranial cruciate ligament rupture. To date, there have been no reports of tibial tuberosity transposition and advancement in cats. A benefit of this approach is concomitant alignment of the extensor mechanism and neutralization of the femorotibial shear force. Our case series describes successful use of tibial tuberosity transposition advancement in cats.

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“…Feline patellar luxation is often treated with a combination of tibial crest translocation (TCT), trochlear sulcoplasty, retinacular overlap, soft tissue release, antirotational suture placement and corrective femoral osteotomy (Scott & McLaughlin 0010). Partial parasagittal patellectomy is described to allow the relatively broad feline patella to recess into a relatively narrow sulcoplasty (Rutherford & Arthurs 8).…”

Section: Introductionmentioning

confidence: 99%

Treatment of feline patellar luxation with polyethylene sulcal ridge prostheses

Mills¹

2018

J of Small Animal Practice

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Patellar luxation and associated pelvic limb lameness were treated with polyethylene sulcal ridge augmentation prostheses in four cats. In all cases, the lameness resolved within weeks of a single surgery. No important complications were encountered. On radiographs obtained at least 2 years postoperatively, three cases showed radiographic progression of degenerative joint disease, and one showed evidence of screw loosening, but these were not reflected in apparent lameness and no case required revision.

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Partial parasagittal patellectomy: a novel method for augmenting surgical correction of patellar luxation in four cats

Cited by 14 publications

References 16 publications

Computed Tomographic Assessment of Block Recession Trochleoplasty and Partial Parasagittal Patellectomy in Cats

Computed Tomographic Assessment of Block Recession Trochleoplasty and Partial Parasagittal Patellectomy in Cats

Tibial tuberosity transposition advancement for treatment of concomitant cranial cruciate ligament rupture and medial patellar luxation in four feline stifles

Treatment of feline patellar luxation with polyethylene sulcal ridge prostheses

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