Medial Patellar Desmotomy in Cattle by Santh

MEDIAL PATELLAR DESMOTOMY
IN CATTLE
BY DR.SANTOSH KUMAR
T.V.O. BALRAMPUR
Patellar fixation is one of the main
functional disorders of the tibia-femoral-
patellar articulation (stiffle joint) in cattle
characterized by temporary or permanent
dislocation of the patella from its regular
position during locomotion .
Such dislocation may be dorsal, lateral or
medial, causing a dorsal, lateral or medial
patellar fixation, respectively .
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
Typical signs
Lameness after extended rest is the most.
The fixation invokes subtle extension of the limb,
phalangeal flexion so that the animal drags the tip of the
hoof .
Medial patellar ligament rigid.
TREATMENT
1. Medial patellar desmotomy (open &
closed/blind/stab) is frequently used .
2.The use of exercises and injection of low

concentration iodine (5-10ml of2.5%tr iod)
solution into the femuro-patellar
articulation as an alternative treatment has
also been reported.
The anatomy of the stifle joint
The femoro-patellar joint is formed between trochlea of the
femur and articular surface of the patella.
Patella is connected to the cranial tibial tuberosity by
patellar ligaments.
The patellar ligaments are medial, middle and lateral.
Medial patellar ligaments in stifle joint are surgical
importance for the medial patellar desmotomy during
upward patellar fixation.
Site
For the medial patellar desmotomy,
usually stab (close/ blind) method is preferable
because
There are either little or no haemorrhage with a
small hole from extarior, not involve suturing, rapid
healing with less post operative complication, no
need to give complete rest for a longer period,
minimum cost of treatment and finally less time
consuming.
Fill the rigidity of medial pt ligament(black
line)with index finger. cut it using no.11/13 bp
blade. fill the depression with index finger.allow
the animal to walk.
Red line is middle pt lig.
Some (4%) cases take about 1-2 weeks time for
complete recovery after close method of medial
patellar desmotomy. In Some cases of blind
method, two or more attempts to severe the
medial patellar ligament require during
incomplete severe of this ligament . In blind
method, it is very important to identify the
medial patellar ligament which off course not an
easy task to by palpation without having the
knowledge of topographic anatomy of this
ligament though it becomes thick, hard and less
elastic during upward fixation of patellar
ligaments
Open method of MPD
Sedative(Aggressive cases) with xylazine

hydrochloride 0.1 mg/kg IM
Restrainted with a rope in lateral recumbency
Prepared aseptically for surgery.
Subcutaneous and deep infiltration with 8 mL of 2%
lidocaine hydrochloride over the medial and middle
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
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 technique of lateral recumbency, proved to be safer for
both the animals and the surgeon. In contrast some authors
indicate lateral recumbency with the affected limb in contact
with the soil. This position, however, makes it harder to
localize the ligament and is even more uncomfortable for the
surgeon. On the other hand, the quadrupedal position
described by some authors was not employed since we
believe it offers greater risk for both the surgeon and the
animal.
Thanks you.

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MEDIAL PATELLAR DESMOTOMY

2.The use of exercises and injection of low

Sedative(Aggressive cases) with xylazine

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