Patellar luxation changes tibial plateau angle on dog knee X-rays

Abstract

OBJECTIVE To determine whether medial patellar luxation would affect radiographic tibial plateau angle (TPA) measurements in small-breed dogs. DESIGN Prospective cross-sectional study. ANIMALS 15 small-breed dogs (25 stifle joints) with grade 2 or 3 medial patellar luxation (5 dogs with unilateral luxation and 10 dogs with bilateral luxation). PROCEDURES Digital mediolateral radiographic images of each affected stifle joint were acquired with the patella in manually reduced (n = 25) and luxated (25) positions. In 2 measurement sessions separated by > 48 hours, 3 observers unaware of patella status (luxated or reduced) measured the TPA in each image twice in random order. Mixed linear modeling was performed to determine the effect of patella status on TPA measurements, and intraobserver and interobserver variation in measurements were calculated. RESULTS TPA measurements by all observers differed significantly between the first and second measurement sessions, but by a mean value of only 0.7°. A few significant differences were identified between 1 pair of observers by patella status and between patella statuses for 1 observer, but all mean differences were ≤ 1.7°. No significant difference in intraobserver variation was identified between patella statuses for any observer. Interobserver variation was not affected by patella status and measurement session. CONCLUSIONS AND CLINICAL RELEVANCE Although some significant differences were identified in radiographic TPA measurements in dogs with medial patellar luxation, depending on whether the patella was luxated or manually reduced, these differences were so small they could be considered clinically unimportant. Consequently, we believe that in small-breed dogs with patellar luxation, patella status would be unlikely to have a clinically meaningful effect on the measured TPA.