PRE-OPERATIVE MEDIOLATERAL LEFT STIFLE RADIOGRAPH. A “fat pad sign” is identified as a smaller triangle of dark lucency that does not reach the femoral condyle. The increased soft tissue density caudal to the lucency is caused by joint effusion or by fibrosis of the fat pad (Piermattei 2006). Distension of the caudal aspect of the joint capsule can be seen. Enthesiophytosis of the distal apex of the patella and osteophytosis of the femoral trochlear ridges and tibial plateau are evident. A: Femur B: Patella C: Lateral and medial fabella D: Tibia E: Fibula F: Fat pad sign and caudal joint capsule distension
PRE-OPERATIVE CAUDOCRANIAL LEFT STIFLE RADIOGRAPH The patella luxated medially during positioning. A: Femur B: Patella C: Lateral and medial fabella D: Tibia E: Fibula
INTRA-OPERATIVE PHOTOGRAPH LEFT STIFLE. Erosion of the cartilage surface of the lateral aspect of the patella.
INTRA-OPERATIVE PHOTOGRAPH LEFT STIFLE. Completed wedge recession sulcoplasty. The patella is displaced medially. A: Gelpi retractors B: Osteochondral wedge C: Exposed subchondral bone.
INTRA-OPERATIVE PHOTOGRAPH LEFT STIFLE. Completed tibial tuberosity transposition. A: Lateralization of the tibial tuberosity B: Tension band wire
POST-OPERATIVE MEDIOLATERAL LEFT STIFLE RADIOGRAPH. The K-wires are engaging the caudal tibial cortex. The tibial osteotomy line can be seen. Adequate TT fixation is essential. In this case the two K-wires were used to give rotational stability, the distal periostal attachment was left intact to counteract the distracting forces of the patella ligament. A tension band wire was also used as strongly recommended in medium/large breed dogs (Harasen 2006, Gibbons 2006, Schulz 2007)
POST-OPERATIVE CAUDOCRANIAL LEFT STIFLE RADIOGRAPH. The patella is within the trochlear groove. The K-wires are angled caudomedially
INTRA-OPERATIVE PHOTOGRAPH. Erosion of the cartilage surface of the lateral aspect of the patella.
