title: Distal femoral lateral closing wedge osteotomy as a component of comprehensive treatment of medial patellar luxation and distal femoral varus in dogs.
abstract: OBJECTIVE
  To describe a cohort of dogs with medial patellar luxation managed with a distal femoral lateral closing wedge ostectomy (DFO) as a component of comprehensive treatment, and to report radiographic and long-term clinical outcome of this technique.
  
  
  METHODS
  Medical records of dogs that had a lateral closing wedge DFO as part of management of medial patellar luxation at three veterinary teaching hospitals were reviewed. Surgical reports as well as the preoperative, postoperative, and follow-up radiographs were reviewed. The anatomical lateral distal femoral angle (aLDFA) was determined. Long-term clinical outcome was assessed by telephone interview with the owner.
  
  
  RESULTS
  A lateral closing wedge DFO was performed on 66 limbs. The mean pre- and postoperative aLDFA was 107.6° ± 5.8° and 94.1° ± 4.2°, respectively. Cranial cruciate ligament disease was identified in 28/66 affected limbs. Tibial angular deformity, torsional deformity, or both was identified in nine of the 66 limbs. Ostectomy healing was confirmed radiographically in 51/66 limbs. The mean time to union was 73 ± 37 days. All patellae were in the normal position and stable. Complications included infection (2/51), fixation failure (1/51), delayed healing (2/51), and persistent lameness (1/51).
  
  
  CONCLUSIONS
  In this cohort of cases, DFO was a highly successful and repeatable component of surgical treatment for dogs with medial patellar luxation associated with femoral varus. This study also provides more evidence of the high rate of concurrent cranial cruciate ligament disease in cases of medial patellar luxation complicated by femoral varus, and supports an association between stifle instability and medial patellar luxation.
authors.forename: Barry E
authors.initials: BE
authors.lastname: Brower
authors.affiliation: Michael P. Kowaleski, DVM, Diplomate ACVS/ECVS, Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, 200 Westboro Road, North Grafton, MA 01536, USA, Phone: +1 508 887 4659, E-mail: mike.kowaleski@tufts.edu.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Kowaleski
authors.forename: Ann M
authors.initials: AM
authors.lastname: Peruski
authors.forename: Antonio
authors.initials: A
authors.lastname: Pozzi
authors.forename: Jonathan
authors.initials: J
authors.lastname: Dyce
authors.forename: Kenneth A
authors.initials: KA
authors.lastname: Johnson
authors.forename: Randy J
authors.initials: RJ
authors.lastname: Boudrieau
mesh_terms: D000818:Animals; D015331:Cohort Studies; D004283:Dog Diseases / Q000601:surgery*; D004285:Dogs; D005269:Femur / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D010027:Osteotomy / Q000379:methods / Q000662:veterinary*; D010329:Patella / Q000000981:diagnostic imaging / Q000601:surgery*; D031222:Patellar Dislocation / Q000000981:diagnostic imaging / Q000601:surgery / Q000662:veterinary*; D011859:Radiography; D013264:Stifle / Q000601:surgery; D016896:Treatment Outcome
keywords: Medial patellar luxation; distal femoral osteotomy; femoral varus