Silva Gabriela Mariano da, Carrera Alefe Luiz Caliani, Cunha Olicies da, Minto Bruno Watanabe, Curuci Eloy Henrique Pares
Department of Animal Science, Federal University of Parana - UFPR, Palotina, Acess Road Pioneiro 2153, Paraná, 85950-000, Brazil.
Department of Clinical and Veterinary Surgery, School of Agricultural and Veterinary Sciences, "Júlio de Mesquita Filho" São Paulo State University - UNESP. Access Road Prof. Paulo Donato Castellane s/n, Jaboticabal, State of São Paulo, 14884-900, Brazil.
Top Companion Anim Med. 2025 Jan-Feb;64:100944. doi: 10.1016/j.tcam.2024.100944. Epub 2024 Dec 17.
There is a lack of literature regarding the surgical management of high-grade patellar luxation in cats. Among the available options, corrective osteotomies are suitable for correcting severe bone deformities. Therefore, this study aimed to report on the surgical management of grade IV medial patellar luxation (MPL) through tibial corrective osteotomies in two cats.
The two cats were diagnosed with grade IV MPL. The marked alterations observed in radiographic and tomographic images indicated external tibial torsion of 15.7° and 21.8°, concomitant with tibial valgus of 13.9° and a tibial plateau angle (TPA) of 20°, respectively. For surgical treatment, chrondoplasty was performed in Case 1, and block recession trochleoplasty in Case 2, followed by a combination of techniques originally developed for dogs. Proximal total tibial osteotomy (PTO) was combined with medial crescentic closing wedge osteotomy (MCCWO) for one case and with cranial closing wedge ostectomy (CCWO) for the other case.
Satisfactory postoperative results were obtained for both cats, resulting in realignment of the stifle extensor mechanism, with both tibial torsions close to 0° in subjective analysis. Additionally, a mechanical medial proximal tibial angle of 91° and a mechanical medial distal tibial angle of 99.3° were achieved for the first cat, whereas a TPA of 9.2° was achieved for the second cat. No major complications were observed, and the cats showed an early return to weight-bearing on the affected limb.
Both cases highlight that tibial corrective osteotomies are suitable for cats and may play a role in the decision-making process for treating high-grade MPL. Moreover, a combination of PTO with MCCWO or CCWO may help achieve satisfactory outcomes.
关于猫严重髌骨脱位的手术治疗，目前缺乏相关文献。在现有治疗方法中，矫正截骨术适用于纠正严重的骨骼畸形。因此，本研究旨在报告两例猫通过胫骨矫正截骨术治疗IV级内侧髌骨脱位（MPL）的手术情况。
两只猫被诊断为IV级MPL。X线和断层扫描图像显示明显异常，分别为胫骨外旋15.7°和21.8°，同时伴有胫骨外翻13.9°和胫骨平台角（TPA）20°。手术治疗方面，病例1进行了软骨成形术，病例2进行了滑车沟阻滞后退成形术，随后采用了最初为犬类开发的联合技术。一例采用近端全胫骨截骨术（PTO）联合内侧新月形闭合楔形截骨术（MCCWO），另一例采用近端闭合楔形截骨术（CCWO）。
两只猫术后均取得了满意的效果，膝关节伸肌机制恢复正常，主观分析显示胫骨扭转均接近0°。此外，第一只猫的胫骨近端内侧机械角度为91°，胫骨远端内侧机械角度为99.3°，而第二只猫的TPA为9.2°。未观察到重大并发症，两只猫患肢均早期恢复负重。
两例均表明胫骨矫正截骨术适用于猫，可能在治疗严重MPL的决策过程中发挥作用。此外，PTO与MCCWO或CCWO联合使用可能有助于取得满意的效果。
