Beer Andrew James Carey, Langley-Hobbs Sorrel, Belch Alex
University of Bristol, Bristol, United Kingdom.
Small Animal Surgery School of Veterinary Sciences, University of Bristol, Langford, Bristol, United Kingdom.
Vet Comp Orthop Traumatol. 2023 Jan;36(1):10-20. doi: 10.1055/s-0042-1756519. Epub 2022 Sep 21.
Medial patellar luxation (MPL) is the most common developmental cause of hindlimb lameness in cats. The association between femoral and tibial conformation and MPL measured on computed tomography (CT) has not been reported in cats. The aims were to report femoral and tibial conformation in cats with and without MPL and to report normal femoral and tibial angles.
Angle of inclination of femoral neck (AI), anatomical lateral distal femoral angle (aLDFA), femoral trochanteric angle (FCT), angle of anteversion of femoral neck (AA), distal and proximal anteversion angle (DAA/PAA), overall tibial valgus (TV), tibial torsion (TT), tibial tuberosity displacement (TTD) and trochlear depth:patellar thickness ratio (T:P) were measured by three observers on CT of cats with and without MPL. Comparisons were made between groups. Inter-observer intraclass correlation coefficient (ICC) was calculated.
Sixteen cats were recruited: eight control and eight with MPL. The aLDFA, PAA, TT, TTD and T:P were significantly less in cats with high-grade MPL. The AI, FCT, AA, DAA and TV were not significantly different. A high correlation was shown with inter-observer ICC in 33.33% and good correlation in 26.67% when comparing measurements between observers.
This study suggests that cats with high-grade MPL have decreased TT, TTD and T:P and may require tibial tuberosity transposition and femoral trochleoplasty. The PAA, TT and aLDFA were decreased, although clinical significance may vary and these cats may not require correctional osteotomies. Results should be interpreted with caution as high/good levels of inter-observer ICC occurred in less than two-thirds of cases between observers.
内侧髌骨脱位(MPL)是猫后肢跛行最常见的发育性病因。尚未见关于猫股骨和胫骨形态与通过计算机断层扫描(CT)测量的MPL之间关联的报道。本研究旨在报告有或无MPL的猫的股骨和胫骨形态,并报告正常的股骨和胫骨角度。
由三名观察者在有或无MPL的猫的CT上测量股骨颈倾斜角(AI)、解剖学外侧远端股骨角(aLDFA)、股骨粗隆角(FCT)、股骨颈前倾角(AA)、远端和近端前倾角(DAA/PAA)、整体胫骨外翻(TV)、胫骨扭转(TT)、胫骨结节移位(TTD)以及滑车深度与髌骨厚度之比(T:P)。进行组间比较,并计算观察者间组内相关系数(ICC)。
共纳入16只猫,其中8只为对照猫,8只为MPL猫。高级别MPL猫的aLDFA、PAA、TT、TTD和T:P显著更小。AI、FCT、AA、DAA和TV无显著差异。观察者间测量值比较时,观察者间ICC显示33.33%为高度相关,26.67%为良好相关。
本研究提示,高级别MPL猫的TT、TTD和T:P降低,可能需要进行胫骨结节移位术和股骨滑车成形术。PAA、TT和aLDFA降低,尽管临床意义可能不同,这些猫可能不需要进行矫正截骨术。由于观察者间ICC在不到三分之二的病例中达到高/良好水平,结果应谨慎解读。