Management and prognosis

Prognosis in TitanŐs case is good with surgical correction.

Surgical correction of patellar luxation is dependent on the degree of lameness, the grade 
of luxation, any additional problems with
the knee, and the age of the animal.   The point of surgery is to improve the function of 
the leg, and is only indicated when the
animal is lame.  Since Titan has been and is currently demonstrating a lameness, and is of 
an appropriate age and health to consider
surgery, we believe this is a very viable option for her.  Surgical options include a medial 
release, a tibial crest transposition, a
lateral capsulectomy, or a trocheoplasty.  

      Because TitanŐs luxation is due to a shallow trochlear groove, we highly recommend 
a trocheoplasty.  This is a process that
will deepen the trochlear groove.  This should make the patella less likely to move into an 
abnormal position.  Often surgical
corrections of patellar luxation consists not only of deepening the trochlear groove, but 
also removal of redundant (excess) tissues
and possibly, movement of the bone on which the patellar ligament inserts.  When we are 
in the process of surgery we may realize
that some of these additional techniques are required to more fully stabilize the knee.  We 
may need to adjust the soft tissues around
the patella to help hold the patella in place.  The insertion of the patella ligament on the 
patella may also need repositioning.  If this
does need correction it will entail cutting the bone with the ligament attached and moving 
it to a more normal location.  It would then
be secured with pins. 

      We will keep Titan here to evaluate her recovery and will administer any pain 
medications based on need.  We would
recommend a basic pre-anesthetic blood work panel before proceeding with the 
anesthesia.