title: Radiographic and ultrasonographic changes of the patellar ligament following tibial tuberosity advancement in 25 dogs.
abstract: BACKGROUND
  Patellar ligament thickening is a recognized response following osteotomy of the proximal tibia as a treatment for cranial cruciate disease. In humans this is seen as a response to increased loading, but the reason for this thickening in dogs is unclear. A prospective study was undertaken to assess the degree and frequency of patellar ligament desmopathy in 25 consecutive cases undergoing tibial tuberosity advancement (TTA).
  
  
  OBJECTIVE
  To determine the incidence of patellar ligament thickening following TTA.
  
  
  METHODS
  Consecutive cases undergoing TTA had ultrasonographic and radiographic measurements performed of the patellar ligament, at multiple positions on the ligament. This was performed at the time of surgery, and at six weeks and six months (ultrasound only) following surgery. The radiographic measurements were performed by two reviewers who were blinded to the timeframe of each image.
  
  
  RESULTS
  There was great variation in both the incidence and degree of thickening of the ligament. Fifty percent of the cases showed no changes in the thickness of the patellar ligament. A clinical pain response was not associated with patellar ligament thickening. No statistically significant variables which predicted the development of patellar ligament thickening were identified .
  
  
  CONCLUSIONS
  The presence of signs of patellar ligament thickening is of questionable clinical significance and is probably an incidental finding.
authors.affiliation: Rob Pettitt, University of Liverpool, Small Animal Teaching Hospital, Leahust Campus, Chester High Street, Neston, Wirral, Cheshire CH64 7TE, United Kingdom, Phone: +44 151 795 6100, Fax: +44 151 795 6101, E-Mail: r.a.pettitt@liverpool.ac.uk.
authors.forename: R
authors.initials: R
authors.lastname: Pettitt
authors.forename: P
authors.initials: P
authors.lastname: Cripps
authors.forename: M
authors.initials: M
authors.lastname: Baker
authors.forename: R
authors.initials: R
authors.lastname: Hattersley
authors.forename: N
authors.initials: N
authors.lastname: Lorenz
authors.forename: F
authors.initials: F
authors.lastname: McConnell
mesh_terms: D000818:Animals; D016118:Anterior Cruciate Ligament / Q000473:pathology* / Q000601:surgery; D004283:Dog Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D004285:Dogs; D005260:Female; D008297:Male; D017847:Patellar Ligament / Q000000981:diagnostic imaging* / Q000473:pathology; D011859:Radiography; D013977:Tibia / Q000601:surgery*; D014463:Ultrasonography
keywords: Patellar ligament thickening; cranial cruciate ligament; tibial tuberosity advancement