patellar cartilage

a cartilaginous process borne on the medial side of the patella of horses and cattle.
patellar fossa
the depression in the anterior face of the vitreous humor in which the lens sits.
patellar ligament
the continuation of the central portion of the tendon of the quadriceps femoris muscle distal to the
patella, extending from the patella to the tuberosity of the tibia; it is single in carnivores, pigs and
sheep and triple in horses and cattle; called also patellar tendon.
patellar ligament desmotomy
section of the medial patellar ligament for relief of upward luxation of the patella in horses (and
rarely, cattle).
patellar luxation, patellar dislocation
1. a common, congenital or acquired orthopedic abnormality in dogs, causing mild to severe,
continuous or intermittent lameness. Medial luxation is more common in toy or miniature breeds,
often as an inherited defect and frequently associated with structural abnormalities of the distal
femur and proximal tibia. Lateral luxation is less frequent, and occurs more often in large breeds
associated with genu valgum.
2. Upward luxation and fixation in cattle presents with temporary or permanent stiffness and
extension of the affected hindlimb and the animal drags the tip of the toe. More common in
Brahman cattle. The cause is not known. Correction is by medial patella desmotomy.
patellar reflex
involuntary contraction of the quadriceps muscle and jerky extension of the hindlimb when the
patellar ligament is sharply tapped. It is often used as a test of nervous system function. Absence
of the reflex, together with deficient muscle tone in the limb, suggests paralysis or paresis due to
lower motor neuron lesion. Called also quadriceps reflex.

Testing the patellar reflex. By permission from Sharp NJH, Small Animal Spinal Disorders, Mosby, 2004
patellar tendon
see patellar ligament (above).

Patellar dislocation:
Orthopedics A subluxation, usually lateral, of the patella, due to a sudden change in direction
while running and the knee is under stress; may follow injury, accompanied by pain and inability
to walk. See GLC7.

Patellar desmotomy: It is surgical technique used when there is indication of upward

luxation of patella in cattles. This condition occurred in animals (cattle and Buffaloes)
which are living in Highline areas or hilly areas. Animal usually drag its legs when it
gets up and start walking. This operation is done 1.5 to 2” above the anterior
tuberosity of tibia close to the insertion of medial ligament in a depression between
middle and medial ligament. Local infiltration anesthesia is used under the
supervision of expert veterinary surgeon. In this operation, Animal is casted and
secured in lateral recumbancy on affected side. A rope has tied to the affected limb
at the pastern & pulled backward in the extended position .The area prepared
aseptically. A stab incision is made into the skin with B.P.handle no.3 (blade no.1).the
medial ligament is cut carefully starting from anterior border of ligament towards the
skin. An appreciable gap will be formed between the cut edges & confirm the same
with the thumb. Apply Tr.Iodine at the site. Generally post operative care has not
required .

introduction:
Patellar fixation is one of the main functional disorders of the tibia-femoral-patellar articulation
(knee joint) in cattle (1) characterized by temporary or permanent dislocation of the patella from
its regular position during locomotion (2). Such dislocation may be dorsal, lateral or medial,
causing a dorsal, lateral or medial patellar fixation, respectively (3,4,5).
The major potential factors for patellar fixation in cattle are nutrition deficiency, exploitation
activity, breed and genetic tendency, external traumas, intense contraction of the crural triceps
muscle and morphological changes of the trochlea and medial condyle of the femur (2, 6, 7, 8, 9,
10 ).

Lameness after extended rest is the most typical sign (7). The fixation invokes subtle extension
of the limb, phalangeal flexion so that the animal drags the tip of the hoof (3). Diagnosis is based
upon anamnesis, clinical signs and local palpation (3, 9), radiography may also be useful (11, 12).
Ultrasonography may be employed for studying disorders such as those of the tibia-femoral-
patellar articulation (13).

Medial patellar desmotomy is frequently used in the treatment of dorsal patellar fixation (6 ,
14). The use of exercises and injection of low concentration iodine solution into the femuro-
patellar articulation as an alternative treatment has also been reported (2,5,9).

This present study is aimed to establish the clinical diagnosis and prevalence of dorsal patellar
fixation in cattle, to evaluate the efficiency of the surgical treatment and to provide data which
may be used to elucidate the etiopathogenesis of this condition

Materials and Methods

During two seasons of the year, the rainy and dry, 183 rural properties were visited from 1990
to 2002, including approximately 106 300 animals, which 72% were females and 28% males. Half
of them were evaluated in the rainy season, and the other half in the dry season. Patellar dorsal
fixation was clinically diagnosed, in 309 animals of both sexes, 4 to 6 years of age and of different
breeds (Bos indicus, Bos taurus, crossbreds and buffaloes), usage and reproductive categories.
The animals were raised extensively on pastures, and received supplementary nutrition during
the dry season.

The preoperative care consisted of a 12 hours fast. The animals were cast in lateral
recumbency, the limbs were extended and held by ropes. The limb to be operated was kept
tractioned, remained at about 1m (3,3 ft) from the ground. A cushion was placed under the
scapular area.

Tranquilization was achieved with 0.1 mg/kg live weight Xylazine hydrochloride1, intramuscular
on 267 animals while the rest tranquilization was not necessary. The tibia-femoral-patellar
articulation area was appropriately prepared, and antisepsis was done by a disinfectant solution
containing iodophor2, diluted on water as recommended (15). Local anesthesia was achieved in
all animals by infiltrating approximately 20 ml of lidocaine hydrochloride3 into the gap located
between tibia crest and the medial and intermediate patellar ligaments.
 By placing the thumb and the medium finger respectively at the tibial tuberosity and at the
upper spot of the femoral medial trochleal crest, the medium point between these two anatomic
references was established using the index finger. This procedure facilitated the identification of
the medial patellar ligament. After an incision of about 5 cm on the skin, at the area indicated by
the index finger, the subcutaneous connective tissue was withdrawn, as well as the fasciae,
yielding complete visualization of the medial patellar ligament. Next, a curved haemostatic clamp
was placed between the ligament and the pericapsular connective tissue, in order to fix the
ligament and make its sectioning easier. After the section of the ligament, was fixed several times
to ensure that the problem was completely solved. Closure was made on two levels. First, the
muscle fasciae were brought closer by an X stitch using simple catgut number 1, and, on the
second level, dermorraphy was made using cotton 000 suture using simple separated sutures.

The postoperative antibiotic therapy consisted of penicillin-G-benzathine4 at a dosage of 20

000 IU/ Kg live weight, every 48 hours on five occasions. Daily dressings were made with healing
paste of zinc oxide, pine oil, vitamin A, sulfanilamide and triclorfon5. The removal of the sutures
was recommended 10th to 12th days postoperatively.

The farmers (owners) were given a questionnaire on the affected animals. The questions
concerned information about their age,sex, breed, lactating period, pregnancy, spontaneous
recovery, diet and nutritional supplement, soil characteristics.
For statistical analysis, Chi-square test with continuance correction was employed, so as to verify
any associations of the frequency of dorsal patellar fixation occurrence with dry and rainy
seasons and sex. When the Chi-square value was significant, the association coefficient was
calculated to measure its magnitude (16).

The confidence interval (95%) was calculated for the prevalence of dorsal patellar fixation during
the study period (17).

Conclusions
These results demonstrate that the surgical technique of medial patellar desmotomy, with the
animal extended in lateral recumbency was effective and performed easily. As for the possible
triggering factors, breed predisposition was not observed. Females were more susceptible,
especially those which had just calved. Finally, nutritional deficiency seems to be the most
important factor affecting its pathogenesis.