Oertzenweg 19 b
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Over a long period of time the desmotomy of the medial straight patellar ligament was seen as a relatively safe method of treating habitual or stationary proximal patellar fixation as well as lameness of unclear origin. Doubts as to the correctness of this opinion were first cast towards the end of the 80"s. Alongside the occurance of known postoperative complications several authors reported serious clinical and radiological changes following this operation.The following study describes clinical and radiological changes in the region of the femoropatellar joint following desmotomy of the medial straight patellar ligament.For this purpose 31 horses and 10 ponies were clinically and radiologically investigated 22 days to 148 month after having undergone desmotomy of the madial straight patellar ligament. On examination 5 horses showed visible and palpatory mild or moderate filling of the femoropatellar joint. Of 6 lame horses 4 patients showed lameness in combination with the excessive joint filling described. A connective-tissue thickening at the site of desmotomy could be determined in 13 horses. 20 patients showed use of the ,frame-saw" mechanism without fixation of the patella.With respect to the radiological investigation, 13 horses (= 19 operated knee-joints) showed isolated radiological shadows distal to the point of the patella which represents osteochondral fragmentation of the apex patellae. 3 of the horses were lame. 4 horses (= 4 operated knee-joints) showed exostosis cranioproximal to the tibia which can be seen as an insertion exostosis. One of these horses showed lameness. One horse showed a combination of both findings. A radiological shadow in the region of the medial straight patellar ligament was seen in one horse. A further horse showed changes resulting from calcification of the meniscus. Yet another had a defect in the medial condylus. The latter patient was lame. Clinically relevant changes only occured in sport horses that were worked shortly after the operation. All horses could be used to the owner"s expectations. In the case of 4 horses further treatment was necessary in order to assure the required use.