Patellar luxation-Trochlear Block Resection

Patellar luxation-Trochlear Block Resection

In Patellar luxation, Trochlear Block Resection is bone reconstruction technique in which trochlear modification preformed aiming to increase the depth the trochlear groove with maintaining the hyaline cartilage to prevent consequent osteoarthritis. The advantage of this technique is that the proximal trochlea can be made deeper than with the V–shaped wedge recession.

:Case History:

A 4y old Cocker Spaniel represented to our small animal hospital with intermittent lameness and hopping on the right hindlimb, which progressed to be shifting limb lameness when his owner ignored this sign.

:Orthopedic Exam:

Orthopedic exam preformed and it revealed hopping upon gait observation, palpation bones and joints were all normal except rt. Stifle joint which showed discomfort and elicit pain, patellar luxation test with stifle partially flexed and toes rotated laterally rotate the patella laterally. It revealed that the patella out of the trochlear groove put with digital manipulation could be replaced in.

:Diagnostic Imaging:

Radiography confirmed the presumptive diagnosis of patellar luxation showing medial patellar luxation.

Case file passed to orthopedic surgeons in our facility for tailoring the preferred technique for such case.

:Surgical Approach In Patellar luxation-Trochlear Block Resection

Patellar luxation-Trochlear Block Resection

Doing arthrotomy craniolateral skin incision 4cm proximal to the patella, and extend the incision 2cm below the tibial tuberosity. Incise the subcutaneous tissue along the same line and the lateral retinaculum and joint capsule to expose the joint.

TBR- Using a power saw, two parallel incisions in cartilage and bone along the widest part of the trochlear ridges are made from the top of the trochlea to a level almost at the origin of the caudal cruciate ligament, A wide osteotome is used to make the cut above the caudal cruciate origin connecting the previously made cuts.

The trough should be deep enough so that the patella does not touch bone in the bottom of the trough and wide enough so that the patella rides deeply in the new sulcus.

Activity should be restricted 2wks staying in crate then to specific physical rehabilitation exercises of passive flexion and extension, range of motion and leash walking for 6 to 8 weeks; then the animal should be gradually returned to normal activity over a 6-week period.

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Thanks to our extraordinary team in the Patellar luxation-Trochlear Block Resection surgery, You regularly go above and beyond, and it makes a huge impact. We’re so grateful for your exceptional efforts.🌟

Orthopedic surgeons:
ahmad tarek Barakat
Moataz Galal