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

Abstract

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.

The Single Intra-Articular Injection of Platelet-Rich Plasma vs. Non-Steroidal Anti-Inflammatory Drugs as Treatment Options for Canine Cruciate Ligament Rupture and Patellar Luxation

“…Patellar luxation (PL) is one of the most common orthopedic diseases that can be con-genital or traumatic in its origin. Congenital PL is resulting from the quadriceps mechanism malalignment and inadequate trochlear groove that leads to the development of degenerative joint disease and painfulness in canine patients [ 11 , 12 , 13 , 14 ]. PL can be medial, lateral, or bidirectional, and medial being the most common form of luxations [ 15 , 16 , 17 , 18 , 19 , 20 ].…”