Predicting the need for trochleoplasty in canine patellar luxation using pre- and intraoperative assessments of trochlear depth

TY - JOUR

T1 - Predicting the need for trochleoplasty in canine patellar luxation using pre- and intraoperative assessments of trochlear depth

AU - Hansen, Julie Skovgaard Orthmand

AU - Lindeblad, Ken

AU - Buelund, Lene

AU - Miles, James

PY - 2017

Y1 - 2017

N2 - Objectives: To evaluate the repeatability and reproducibility of ultrasonographic femoral trochlear depth measurements and to compare ultrasonographic and intra-operative evaluations of femoral trochlear depth for predictive value in selecting trochleoplasty. Methods: Repeatability and reproducibility of an ultrasonographic protocol were tested in a preclinical cadaveric study. Clinical patients undergoing corrective surgery for patellar luxation were evaluated preoperatively with ultrasound and intra-operatively using a depth gauge. Measurements were assessed for equivalence using linear regression, and agreement between decisions made based on these measurements assessed using Cohen’s kappa. Results: Although ultrasonographic and intra-operative measurements were in broad agreement, the prediction interval was too wide for clinical use. There was no significant agreement between predictions of the need for trochleoplasty using various cut-off values for the two measurements, nor between these and the surgeon’s decision. Clinical significance: Based on our observations, use of ultrasound for evaluation of the femoral trochlea remains a largely qualitative assessment. A simpler and more direct objective measure of femoral trochlear adequacy is required for intra-operative use.

AB - Objectives: To evaluate the repeatability and reproducibility of ultrasonographic femoral trochlear depth measurements and to compare ultrasonographic and intra-operative evaluations of femoral trochlear depth for predictive value in selecting trochleoplasty. Methods: Repeatability and reproducibility of an ultrasonographic protocol were tested in a preclinical cadaveric study. Clinical patients undergoing corrective surgery for patellar luxation were evaluated preoperatively with ultrasound and intra-operatively using a depth gauge. Measurements were assessed for equivalence using linear regression, and agreement between decisions made based on these measurements assessed using Cohen’s kappa. Results: Although ultrasonographic and intra-operative measurements were in broad agreement, the prediction interval was too wide for clinical use. There was no significant agreement between predictions of the need for trochleoplasty using various cut-off values for the two measurements, nor between these and the surgeon’s decision. Clinical significance: Based on our observations, use of ultrasound for evaluation of the femoral trochlea remains a largely qualitative assessment. A simpler and more direct objective measure of femoral trochlear adequacy is required for intra-operative use.

KW - Agreement

KW - Patellar luxation

KW - Repeatability

KW - Trochleoplasty

KW - Ultrasound

U2 - 10.3415/VCOT-16-06-0084

DO - 10.3415/VCOT-16-06-0084

M3 - Journal article

C2 - 28094422

AN - SCOPUS:85019197105

SN - 0932-0814

VL - 30

SP - 131

EP - 136

JO - Veterinary and Comparative Orthopaedics and Traumatology

JF - Veterinary and Comparative Orthopaedics and Traumatology

IS - 2

ER -