Canine Patella Luxation

SURGICAL TECHNIQUE
Canine Patella Luxation
Surgical Technique
Developed in conjunction with Brian S. Beale, DVM, Diplomate ACVS, Gulf Coast Veterinary Surgery
The patient is positioned in lateral or dorsal recumbency
under general anesthesia. A hanging limb technique with
aseptic preparation and appropriate draping should be
performed. The use of a stockinette or adherent impervious
drape is recommended to keep the suture from coming in
contact with the skin.
This technique guide is demonstrating the use of Patella
Sling Suture for surgical management of MPL, the opposite
could be used for LPL.
Postoperative Care Suggestions:
•
•
•
•
•
Cefazolin - 22 mg/kg IV 30 minutes prior to
incision, 90 minutes later, then every 6 hours
Cephalexin - 22-30 mg/kg orally every 8-12
hours for 10 days post-op
Bandaging at your discretion (soft-padded
bandage for at least 24 hours is typical)
Restrict to kennel rest when unobserved
and controlled muscle-building activities
(i.e., leash-walking) for 8 weeks post-op
Professional rehabilitation is encouraged
2
Determine if the trochlear groove needs to be deepened.
Perform trochlear block resection or wedge resection if necessary.
4
Drill .045 K-wire where you will place the anchor in the lateral
femoral condyle. Slide the 2.5 mm Cannulated Drill over the
K-wire and drill. Drill a 1 cm deep bone tunnel.
1
A lateral parapatellar approach is performed. Make an incision
along the patella ligament, starting proximal to patella, coursing
down laterally to the tibial crest. Cut through subcutaneous tissue
and tent deep fascia to make stab incision. Separate fascia from
the joint capsule with stifle in extension. Inset: Perform arthrotomy
along incision and luxate patella.
You can perform this procedure using either a 5 mm Corkscrew®
Suture Anchor with a knot being tied on the lateral femoral condyle
or a knotless version using a 3.5 or 4.75 mm PEEK SwiveLock®.
3
Locate anchor placement in the lateral femoral condyle making
sure the anchor is centered on the trochlear grove and caudal
enough not to interfere with trochlear recession. Inset: Make an
incision in the joint capsule so suture material is extracapsular.
5
Insert a Corkscrew Suture Anchor until horizontal laser line is flush
with surface of the condyle and vertical laser line is positioned
upward towards midline of the extent of the trochlear ridge.
6
8
7
Place the patella back into the trochlear
groove.
Place an 18g needle from medial to lateral
through the insertion of the quadricep
tendon at the proximal pole of the patella.
Slide the suture passer from lateral to medial
through the needle then remove the needle.
Pull one arm of the #5 FiberWire® through
the quadricep tendon.
10
9
Place an 18g needle lateral to medial
through the origin of the patella ligament
at the distal pole of patella ligament.
Slide the suture passer through the
needle. Pull suture through soft tissue.
Place an 18g needle medial to the
patella and slide the Tibial Suture Passer
through. Pull the suture through soft
tissue.
10b
Tension the suture while applying pressure to the top of patella. Tie a surgeon's knot to
prevent medial luxation but not to create excessive lateral tension that could result in
lateral luxation. Put the stifle through range-of-motion to test tension. Close lateral
fascia in "vest-over-pants" suture pattern.
Alternative SwiveLock Anchor Application
Steps 1-3 Same as Corkscrew Suture Anchor method.
Step 4 Drill anchor location with 3.5 or 4.5 mm Drill, and
make a stab incision in the joint capsule so suture
material is extracapsular. Tap predrill hole using 3.5
or 4.5 mm Tap.
Step 5 Place the patella back into the trochlear groove.
Step 6 Place an 18g needle through the proximal pull of the
patella ligament, slide the Tibial Suture Passer through
the needle. Pull FiberTape® through soft tissue.
Step 7 Place an 18g needle medial to the patella and slide the
suture passer through, pull suture through soft tissue.
Step 8 Place an 18g needle through the distal pull of the
patella ligament, slide the suture passer through needle.
Pull suture through soft tissue.
Step 9 Thread FiberTape through the eyelet of the SwiveLock,
leaving slack so the eyelet can be placed into the bottom
of predrilled hole. While holding the
flange of the driver, turn the knob to
insert SwiveLock into bone. Make
sure anchor sits below the surface
of the bone. Put the stifle through
range-of-motion to test tension.
Close fascia in "vest-over-pants"
suture pattern.
O R D E R I N G I N F O R M AT I O N
For Corkscrew Suture Anchor Application:
Corkscrew Suture Anchor w/#5 FiberWire, 5 mm VAR-2100
Tibial Suture Passer
AR-1255-08
Cannulated Drill, 2.5 mm
AR-1530C-25
.045 Guidewire (K-wire)
AR-8933K
For 4.75 mm SwiveLock Anchor Application:
Spade Tip Drill for 4.75 mm SwiveLock Anchor
Tap for 4.75 mm SwiveLock Anchor
Tibial Suture Passer
PEEK SwiveLock, 4.75 mm x 19.1 mm,
closed eyelet, qty. 5
FiberTape, 2 mm, 36" (blue), qty. 6
For 3.5 mm SwiveLock Anchor Application:
Spade Tip Drill for 3.5 mm SwiveLock Anchor
Tap for 3.5 mm SwiveLock Anchor
Tibial Suture Passer
PEEK SwiveLock, 3.5 mm x 14.8 mm,
closed eyelet, qty. 5
FiberTape, 2 mm, 36" (blue), qty. 6
AR-1927D
AR-2324PTB
AR-1255-08
AR-2324PSLC
AR-7237
AR-1678-05
AR-1678-03
AR-1255-08
AR-2325PSLC
AR-7237
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This description of technique is provided as an educational tool and clinical aid to assist properly licensed medical
professionals in the usage of specific Arthrex Vet Systems products. As part of this professional usage, the medical
professional must use their professional judgment in making any final determinations in product usage and technique.
In doing so, the medical professional should rely on their own training and experience and should conduct
a thorough review of pertinent medical literature and the product’s Directions For Use.
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