Rectangular Recession Trochleoplasty for Treatment of Patellar Luxation in Dogs and Cats

Summary

Trochleoplasty is a fundamental component of surgical treatment for patients with inadequate trochlear depth associated with patellar luxation. Traditional methods of trochleoplasty include trochlear resection, chondroplasty and wedge recession trochleoplasty. Each technique has its benefits and limitations. Rectangular recession trochleoplasty (RRT) is a new technique that builds upon the strengths of its predecessors while minimizing their limitations. Rectangular recession utilizes a rectangular osteochondral autograft that is harvested from the trochlear groove and replaced into its recipient bed. Unlike wedge recession, the autograft surfaces are compressed and buttressed within the recipient bed. resulting in secure implantation of the autograft. Rectangular recession achieves maximal preservation of hyaline articular cartilage while minimizing exposure of abrasive subchondral bone. Rectangular recession can be performed on dogs and cats as small as 3 kg and has been clinically effective in treating over 100 cases of patellar luxation.

Trochleoplasty is an important surgical procedure for treatment of patellar luxation in the dog and cat. The objective of any trochleoplasty technique is to achieve adequate trochlear depth and width while optimizing preservation of hyaline articular cartilage. Rectangular recession trochleoplasty (RRT) is a new technique that achieves adequate trochlear width and depth utilizing a securely “press-fit” osteochondral autograft that achieves maximal preservation of hyaline articular cartilage.

Keywords

Rectangular recession - trochleoplasty - patellar luxation - dog - cat

This work was presented at the 26th Annual Conference of the Veterinary Orthopedic Society, March 4, 1999, Sun Valley, Idaho, USA

• REFERENCES

• 1 Brinker WO, Piermattei DL, Flo GL. Diagnosis and treatment of orthopedic conditions of the hindlimb. In: Handbook of Small Animal Orthopedics and Fracture Management. Piermattei DL, Flo GL. (eds) Philadelphia, PA: Saunders; 1997: 516-80.
• 2 Vasseur PB. Stifle joint. In: Textbook of Small Animal Surgery. Slatter D. (ed 2) Philadelphia, PA: Saunders; 1993: 1817-65.
• 3 Roush J. Canine patellar luxation. In: Stifle Surgery. Roush J. (ed) Vet Clin North Am. 23 1993: 855-68.
• 4 Vierheller RC. Surgical correction of patellar ectopia in the dog. JAVMA 1959; 134: 429-33.
• 5 Hulse DA. Medial patellar luxation in the dog. In: Disease Mechanisms in Small Animal Surgery. Bojrab JM. (ed 2) Philadelphia, London: Lea & Febiger; 1993: 808-17.
• 6 Boone EG, Hohn RB, Weisbrode SE. Trochlear recession wedge technique for patellar luxation: an experimental study. J Am Anim Hosp Assoc 1983; 19: 735-41.
• 7 Slocum B, Slocum D, Devine T. et al. Wedge recession for treatment of recurrent luxation of the patella: a preliminary report. Clin Orthop 1982; 164: 48-53.
• 8 Slocum B, Devine T. Trochlear recession for correction of luxating patella in the dog. JAVMA 1985; 186: 365-9.
• 9 Slocum B, Slocum TD. Trochlear recession for correction of luxating patella in the dog. In: Stifle Surgery. Roush J. (ed) Vet Clin North Am. 1993. 23 869-73.
• 10 Remedios AM, Basher AW, Runyon CL, Fries CL. Medial patellar luxation in 16 dogs a retrospective study. Vet Surg 1992; 21: 5-9.
• 11 Flo GL. Surgical correction of a deficient femoral trochlear groove in dogs with extreme congenital patella luxations utilizing a cartilage flap and subchondral grooving. Master’s Thesis; MSU: 1969
• 12 Piermattei DL. The hindlimb. In: An Atlas of Surgical Approaches to the Bones and Joints of the Dog and Cat. Piermattei DL. (ed 3) Philadelphia, PA: Saunders; 1993: 276-81.
• 13 Arnoczky SP, Tarvin GB. Surgery of the stifle the patella (part II). Comp Cont Ed Pract Vet 1980; 02: 200-8.
• 14 Flo GL, Brinker WO. Fascia lata overlap procedure for correction of medial luxation of the patella in the dog. JAVMA 1970; 156: 595-599.
• 15 Sammarco JL, Conzemius G, Perkowski SZ, Weinstein MJ, Gregor TP, Smith GK. Postoperative analgesia for stifle surgery: a comparison of intra-articular bupivacaine, morphine, or saline. Vet Surg 1996; 25: 59-69.
• 16 Plumb DC. Drug monographs. In: Abridged Companion to the Veterinary Drug Handbook. Plumb DC. (ed 3) White Bear Lake, Minnesota: Pharma Vet Publishing; 1999. 1-2, 65-7, 74-5, 269-70.
• 17 DeAngelis M, Hohn RB. Evaluation of surgical correction of canine patellar luxation in 142 cases. JAVMA 1970; 156: 587-94.
• 18 Roy RG, Wallace LJ, Johnston GR. et al. A retrospective evaluation of stifle osteoarthritis in dogs with bilateral medial patellar luxation and unilateral surgical repair. Vet Surg 1992; 21: 475-9.
• 19 Willauer CC, Vasseur PB. Clinical results of surgical correction of medial luxation of the patella. Vet Surg 1987; 06: 31-36.
• 20 Van Vechten BJ, Vasseur PB, Rodrigo JJ. et al. A comparison of four different methods of fixation of osteochondral fragments. Vet Comp Orthop Traumatol 1993; 06: 80-4.
• 21 Hansen PD, Markel MD. Bone and cartilage transplantation. Vet Comp Orthop Traumatol 1992; 05: 163-9.