Nor'West News: August 24, 2023

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Thursday August 24 2023
PATELLA SURGERY
Recently I have had the opportunity
to learn a technique for patella
luxation in dogs, under the guidance
of Specialist Surgeon, Dr Helen Milner.
Helen worked as a specialist surgeon
at MMH a few years ago so we have a
very good working relationship. Helen
is now primarily working alongside
veterinarians as a surgical coach so I
thought it would be as good time for
myself and a colleague to learn a new
technique so we can offer our patients
more when it comes to patella luxations.
Essentially patella luxation is a
dislocation of the kneecap either
medially or laterally to the trochlear
groove. Luxations can be medial or
lateral. Medial patella luxation ( MPL) is
relatively common in small breed dogs.
Breeds most at risk of MPL are Poodles,
Pomeranians, Chihuahuas, Yorkies,
Bichon Frise and Retrievers. The disease
can be bilateral. It is considered an
inherited, developmental disease, that
starts early on in life. Some dogs with
MPL will rupture their cranial cruciate
ligament necessitating repair. MPL
also predisposes dogs to developing
degenerative joint disease.
Charlie, a 3 year old Chihuahua was the
patient I selected for the surgery. Charlie
has a grade 2-3 patella luxation, meaning
the patella mostly pops out medially
with each stride, but can slide back into
place. Charlie is difficult to assess awake
as he’s not a fan of vets in general, not
just me. We needed to perform sedation
and radiographs to really evaluate
the stifle and decide if he was a good
candidate for surgery. He often lifts the
left hindleg when standing or running,
skips and double jumps on the left side.
Most days the owners reported he lifted
the left hind leg. Charlie is otherwise
extremely healthy.
Patella luxations are graded 1-4 based
on the severity of disease. Once the
animal is relaxed and sedated the patella
can be manually assessed and graded.
The anterior cruciate ligament can be
palpated. Radiographs are important
as we can see if there is pathology or
osteoarthritis in any other joints, which
may contribute to surgical success.
Surgical correction was considered the
right approach for Charlie based on his
MPL grade and frequent lameness and
daily pain exhibited. The main goal was
to realign the stifle extensor apparatus
and normalise forces acting on growth
plates and joint surfaces. We wanted him
to be able to run on all 4’s, without pain
or lameness, enjoying his life to the full.
A “Tibial Tuberosity Transposition” ( TTT)
surgery was planned for Charlie to move
the patella tendon over, realigning the
quadriceps muscle through the centre of
the trochlear groove. Helen is an expert
here and you can observe from the X-ray
attached, that a section of cranial tibia
was sawn off and repositioned laterally
with the help of pins and a figure of 8
wire. After completion of this technique,
the patella couldn’t be subluxated out
of position. Some soft tissue suture
patterns were also employed to help
keep the patella in its correct position -
the trochlear groove.
A large padded bandage was placed
on Charlies leg for 48 hours, to help
provide stability, stop licking of the
suture line and help with pain. He was
discharged with excellent pain and anti
inflammatory medications and exercise
instructions. Activity is restricted for
6-8 weeks following surgery, but physio
and hydrotherapy can be started after
the sutures are removed. Radiographs
need to be repeated at the 8 week mark
to make sure the osteotomy site has
healed, then exercise can be adjusted
accordingly.
All in all it was a procedure that we
want to be able to offer at McMaster &
Heap vets. We have all the orthopaedic
equipment and the perfect surgical
coach to teach a couple of keen vets
(one young and one a senior!) that want
to learn a new technique that will benefit
many of our patients in the future.
Dr Michele McMaster
IN THE BUSH: Riccarton Bush ranger Mike Steenson (left) and board
chairman Bob Shearing are helping to improve tracks in the forest.
PHOTO: BRIAR ALLEN
Fundraising for paths
• From page 1
“We have been making approaches
to major fundraisers and we also have a
funding source from the city council’s
Long Term Plan, as well as our own funds
we have been putting aside since 2021,”
Willis said.
Riccarton Bush ranger Mike Steenson
said the project is being done on a needs
basis.
“The tracks have reached the end of
their use by date, they are rotten, are trip
hazards and we want to make them more
accessible to the public for prams and
wheelchair access,” he said.
Board chairman Bob Shearing said they
want to do it all properly and look at the
bigger picture.
“It is a major asset to the area, and we
are relying on the community to support
us. It is near everything in town, but it
feels like a different world when you step
into it,” he said.
• People can donate to the
project at christchurchfoundation.
org.nz/giving/project/
putaringamotu-riccarton-bushfund
and can contact Shona
Willis for more information at
manager@riccartonhouse.co.nz
UNIQUE: Riccarton Bush is the only area of podocarp forest remaining
in Christchurch.
PHOTO; NEWSLINE
Open 7 days Cnr Hoon Hay & Coppell place ph: 338 2534
e. reception@mcmasterandheap.co.nz www.mcmasterheap.co.nz
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