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| The most common cause of patellar luxation is '''congenital medial patellar luxation in small dogs''' such as miniature Poodles, Chihuahuas and Yorkshire Terriers. | | The most common cause of patellar luxation is '''congenital medial patellar luxation in small dogs''' such as miniature Poodles, Chihuahuas and Yorkshire Terriers. |
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− | Medial patellar luxation is the most common luxation in all sizes of dogs. '''Lateral luxation''' is much rarer, and in larger dogs carries a poorer prognosis. | + | Medial patellar luxation is the most common luxation in all sizes of dogs. '''Lateral luxation''' is much rarer, and in larger dogs carries a poorer prognosis. Lateral luxation may also occur in horses. |
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| Signs usually appear before '''2 years of age'''. | | Signs usually appear before '''2 years of age'''. |
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| ==Clinical Signs== | | ==Clinical Signs== |
− | '''Acute traumatic patellar luxation''' can be medial or lateral and is associated with acute, non-weightbearing lameness and pain on manipulation of the joint. | + | '''Acute traumatic patellar luxation''' can be medial or lateral and is associated with acute, non-weightbearing lameness and pain on manipulation of the joint. |
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| '''Congenital medial luxations''' are graded according to clinical signs and palpation findings: | | '''Congenital medial luxations''' are graded according to clinical signs and palpation findings: |
− | :'''Grade 1''': Patella luxated medially easily, returns when release, no crepitation or bony deformity and no/infrequent clinical signs | + | :'''Grade 1''': Patella luxated medially easily, returns when released, no crepitation or bony deformity and no/infrequent clinical signs |
| :'''Grade 2''': Spontaneous luxation occurs, with a non-painful, skipping lameness. There may be mild bony deformities such as internal rotation of the tibia and abduction of the hock. | | :'''Grade 2''': Spontaneous luxation occurs, with a non-painful, skipping lameness. There may be mild bony deformities such as internal rotation of the tibia and abduction of the hock. |
− | :'''Grade 3''': The patella is permanently luxation, but can be manually returned. There is marked tibial rotation and a shallow trochlear groove. Often bilateral, crouched gait. | + | :'''Grade 3''': The patella is permanently luxated, but can be manually returned. There is marked tibial rotation and a shallow trochlear groove. It is often bilateral and results in crouched gait. |
− | :'''Grade 4''': Permanent, non-reducible luxation of the patella. Tibia rotated 60-90° relative to the sagittal plane. Severe bony deformities develop if not corrected. Crablike posture and abnormal gait. | + | :'''Grade 4''': Permanent, non-reducible luxation of the patella. Tibia is rotated 60-90° relative to the sagittal plane. Severe bony deformities develop if not corrected. Crablike posture and abnormal gait will be present. |
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| There may be muscle atrophy in the affected limb. | | There may be muscle atrophy in the affected limb. |
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| '''History, clinical signs and palpation''' usually allow diagnosis of the condition and permit grading of congenital medial patellar luxation. | | '''History, clinical signs and palpation''' usually allow diagnosis of the condition and permit grading of congenital medial patellar luxation. |
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− | '''Radiography''': these can document the luxation and are useful to assess bony deformity and degenerative joint changes. | + | '''Radiography'''can document the luxation and is useful to assess bony deformity and degenerative joint changes. |
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− | '''Skyline views''' of the distal femur are usefuly pre and post-operatively to assess the depth and contour of the femoral trochlea. | + | '''Skyline views''' of the distal femur are useful pre and post-operatively to assess the depth and contour of the femoral trochlea. |
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| ==Treatment== | | ==Treatment== |
− | Treatment should be made individual for each patient, as there are such varying presentations and causes for the condition. | + | Treatment should be individual for each patient, as there are such varying presentations and causes for the condition. |
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| '''Traumatic luxations''' should be repaired by suturing the medial or lateral fascial defect. | | '''Traumatic luxations''' should be repaired by suturing the medial or lateral fascial defect. |
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| This can be achieved by: | | This can be achieved by: |
− | :'''Tibial tuberosity transposition'''
| + | *'''Tibial tuberosity transposition''' |
− | :'''Femoral trochleoplasty''' to deepen the groove: abrasion trochleoplasty, recession trochleoplasty
| + | *'''Femoral trochleoplasty''' to deepen the groove: abrasion trochleoplasty, recession trochleoplasty |
− | :'''Wedge resection'''
| + | *'''Wedge resection''' |
− | :'''Releasing incisions''' and imbrication of the capsular tissues
| + | *'''Releasing incisions''' and imbrication of the capsular tissues |
− | :'''Lateral rotation of the tibia'''
| + | *'''Lateral rotation of the tibia''' |
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− | '''Post-operatively''': exercise restriction for 4-6 weeks and passive range-of-motion exercises, weight loss and NSAIDs | + | '''Post-operatively''': exercise restriction for 4-6 weeks and passive range-of-motion exercises, weight loss and [[NSAIDs]] are recommended. |
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− | Recurrence of the luxation can occur if there was inadequate correction of the deformity.
| + | The luxation can recur if there was inadequate correction of the deformity. |
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| ==Prognosis== | | ==Prognosis== |
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| Slatter, D. (2002) '''Textbook of small animal surgery''' ''Elsevier Health Sciences'' | | Slatter, D. (2002) '''Textbook of small animal surgery''' ''Elsevier Health Sciences'' |
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− | [[Category:To Do - Helen]]
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− | [[Category:To Do - Review]]
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| + | {{review}} |
| + | [[Category:Musculoskeletal Diseases - Dog]] |
| + | [[Category:Musculoskeletal Diseases - Cat]] |
| + | [[Category:Musculoskeletal Diseases - Horse]] |
| + | [[Category:Expert Review]] |
| [[Category:Joints - Degenerative Pathology]] | | [[Category:Joints - Degenerative Pathology]] |