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RADIOGRAPHIC AND ULTRASONOGRAPHIC EVALUATION OF THE PATELLAR LIGAMENT FOLLOWING TIBIAL PLATEAU LEVELING OSTEOTOMY
Author(s) -
MATTERN KARA L.,
BERRY CLIFFORD R.,
PECK JEFFREY N.,
HAAN JACEK J.
Publication year - 2006
Publication title -
veterinary radiology and ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.541
H-Index - 60
eISSN - 1740-8261
pISSN - 1058-8183
DOI - 10.1111/j.1740-8261.2006.00126.x
Subject(s) - medicine , patellar ligament , radiography , cruciate ligament , ultrasound , ligament , anterior cruciate ligament , nuclear medicine , surgery , radiology , patellar tendon
Objective evaluation of patellar ligament changes following tibial plateau leveling osteotomy (TPLO) for cranial cruciate ligament injury has not been published to date. In this study, the patellar ligament was evaluated using radiographs and high‐resolution ultrasound in 31 stifles (29 dogs) preoperatively and at 1 month ( n =31), 2 months ( n =18), and 6 months ( n =13) postTPLO. A ratio of the thickness of the proximal to distal patellar ligament was determined for all radiographs evaluated. Ultrasound evaluation included proximal, middle, and distal mid‐sagittal thickness and transverse thickness, and transverse area measurements. Subjective grading (0 being normal through a scale of 3) of the ultrasound changes was also performed at each evaluation. Significant thickening of the distal patellar ligament was noted postoperatively as evidenced by thickness and area measurements and a decreased radiographic ratio ( P <0.01). Preoperative patellar ligament thickness and area were similar at the proximal, middle and distal sites. Ultrasound‐derived thickness and area measurements of the distal patellar ligament were increased at 1 and 2 months ( P <0.01). The radiographic ratio was significantly decreased at 1, 2 and 6 months ( P <0.01). Subjectively, all patellar ligaments scored a 0 preoperatively and 16/31 received a score of 2 or 3 during follow‐up evaluation. Additionally, these dogs had ultrasonographic and radiographic changes consistent with distal patellar ligament thickening. Body weight (kg) and postoperative TPLO angle had a significant influence on 1‐month postoperative distal patellar ligament area using a stepwise logistic model ( P <0.05). Patellar ligament desmitis is a common postoperative sequela to the TPLO procedure, however its clinical significance (i.e., correlation with a residual lameness) was not evaluated in this study.