Surgical Management of Cruciate Ligament Rupture Combined with Patella Luxation 265(A) (B) (C)Figure 31.3 In dogs with normal femoral angulation and torsion (A), the condyles are often superimposed on
mediolateral radiographs of the femur. In contrast, in dogs with excessive femoral angulation or torsion and in dogs with
abnormal condylar development, the femoral condyles are often offset. A distal femoral condylar offset is present in dogs
with excessive femoral angulation (varus or valgus) (B). The extensor fossa at the origin of the long digital extensor
muscle on the lateral condyle is visible (arrowhead), indicating that the shorter condyle is the medial condyle and that
the dog has excessive varus. A cranial femoral condylar offset is present in dogs with femoral torsion (C). The extensor
fossa on lateral condyle (arrowhead) is more cranial than the medial condyle, indicating the presence of excessive
internal rotation of the distal portion of the femur.
achieved with minimal disruption to the artic-
ular surface using trochlear block or wedge
resection (Johnson et al. 2001). The groove
should be wide enough to allow the patella to
contact the trochlea, and deep enough for at
least half of the thickness of the patella to be cau-
dal to the medial and lateral trochlear ridges.
The trochlear groove should also be proximally
extended to accommodate the potentially prox-
imal patella in large-breed dogs with medial
PL. The cranial part of the sartorius muscle may
be released near its insertion site if the muscle
appears to promote internal rotation of the tibia,
or prevent stifle joint extension.(A) (B) (C)Figure 31.4 In these intraoperative pictures of a patient with Grade 3 MPL and CR made during arthroscopy, the
articular cartilage of the trochlea is slightly irregular (A, bottom). The articular cartilage of the patella is completely
eroded (B). Full-thickness articular cartilage wear is also visible on the medial aspect of the medial trochlear ridge, where
the patella rests in its luxated position (C).