Vet Comp Orthop Traumatol 2017; 30(02): 131-136
DOI: 10.3415/VCOT-16-06-0084
Original Research
Schattauer GmbH

Predicting the need for trochleoplasty in canine patellar luxation using pre- and intra-operative assessments of trochlear depth

Julie Skovgaard Orthmand Hansen
1   Ringsted Veterinary Clinic, Ringsted, Denmark
,
Ken Lindeblad
2   Evidensia Faxe Veterinary Hospital, Faxe, Denmark
,
Lene Buelund
3   Department of Veterinary Clinical and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark
,
James Miles
3   Department of Veterinary Clinical and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark
› Author Affiliations
Further Information

Publication History

Received: 01 June 2016

Accepted: 16 January 2016

Publication Date:
28 December 2017 (online)

Summary

Objectives: To evaluate the repeatability and reproducibility of ultrasonographic fe-moral trochlear depth measurements and to compare ultrasonographic and intra-operative evaluations of femoral trochlear depth for predictive value in selecting trochleoplasty.

Methods: Repeatability and reproducibility of an ultrasonographic protocol were tested in a preclinical cadaveric study. Clinical patients undergoing corrective surgery for patellar luxation were evaluated preoperatively with ultrasound and intra-operatively using a depth gauge. Measurements were assessed for equivalence using linear regression, and agreement between decisions made based on these measurements assessed using Cohen’s kappa.

Results: Although ultrasonographic and intra-operative measurements were in broad agreement, the prediction interval was too wide for clinical use. There was no significant agreement between predictions of the need for trochleoplasty using various cut-off values for the two measurements, nor between these and the surgeon’s decision.

Clinical significance: Based on our observations, use of ultrasound for evaluation of the femoral trochlea remains a largely qualitative assessment. A simpler and more direct objective measure of femoral trochlear adequacy is required for intra-operative use.

Supplementary Material to this article is available online at https://doi.org/10.3415/VCOT-16-06-0084

 
  • References

  • 1 Piermattei DL.. The stifle joint. In: Piermattei DL., Flo GF., Decamp CE.. editors. Handbook of Small Animal Orthopedics and Fracture Repair St Louis, MO: Saunders Elsevier; 2006: 562-632.
  • 2 Linney WR., Hammer DL., Shott S.. Surgical treatment of medial patellar luxation without femoral trochlear groove deepening procedures in dogs: 91 cases (1998-2009). J Am Vet Med Assoc 2011; 238: 1168-1172.
  • 3 Roush JK.. Canine Patellar Luxation. Vet Clin North Am Small Anim Pract 1993; 23: 855-868.
  • 4 Slocum B., Slocum TD.. Trochlear Wedge Recession for Medial Patellar Luxation - An Update. Vet Clin North Am Small Anim Pract 1993; 23: 869-875.
  • 5 Towle HA., Griffon DJ., Thomas MW.. et al. Pre- and postoperative radiographic and computed tomographic evaluation of dogs with medial patellar luxation. Vet Surg 2005; 34: 265-272.
  • 6 Meyer H., Kaiser S., Waibl H.. et al. Radiological parameters for preoperative planning of the surgical correction of canine congenital patellar luxation (Part 2). Kleintierpraxis 2002; 47: 129-138.
  • 7 Miles JE., Westrup U., Svalastoga EL.. et al. Radiographic, ultrasonographic, and anatomic assessment of femoral trochlea morphology in red foxes (Vulpes vulpes). Am J Vet Res 2014; 75: 1056-1063.
  • 8 Meyer H., Kaiser S., Waibl H.. et al. Radiological parameters for preoperative planning of the surgical correction of canine congenital patellar luxation (Part 1). Kleintierpraxis 2002; 47: 65-70.
  • 9 Schnappauf A.. Die Sonographische Untersuchung und Vermessung des Kniegelenkes bei Hunden mit Patellaluxation [Sonographic examination and measurement of the stifle in dogs with patellar luxation]. PhD [Dissertation]. Justus-Liebig-Universität, Giessen 2005
  • 10 Koch DA., Grundmann S., Savoldelli D.. et al. Diagnosing patellar luxation in dogs and cats. Schweiz Arch Tierheilkd 1998; 140: 371-374.
  • 11 Reichler I., Grundmann S., Koch D.. et al. The diagnostic efficiency of screening examinations for patella luxation in toy dog breeds. Kleintierpraxis 1999; 44: 825-829.
  • 12 Bland JM., Altman DG.. Measurement error. BMJ 1996; 313: 744.
  • 13 Bland JM., Altman DG.. Measuring agreement in method comparison studies. Stat Methods Med Res 1999; 8: 135-160.
  • 14 Bland JM., Altman DG.. Statistics notes: Measurement error proportional to the mean. BMJ 1996; 313: 106.
  • 15 Ludbrook J.. A primer for biomedical scientists on how to execute model II linear regression analysis. Clin Exp Pharmacol Physiol 2012; 39: 329-335.
  • 16 Meier HT., Biller DS., Lora-Michiels M.. et al. Additional radiographic views of the pelvis and pelvic limb in dogs. Comp Cont Educ Pract 2001; 23: 871-874.