OrthoPets Case Study: Alley
In October 2014, Alley was diagnosed with a grade II medially luxating patella and suspected cranial cruciate disease. Since the cranial cruciate ligament also controls internal rotation of the stifle, CCLD can result in MPL by allowing excessive internal rotation and cranial displacement of the tibia. Both of these contribute to the patella luxating medially. Alley was partial non-weight bearing for almost two weeks and unfortunately was also diagnosed with concurrent transitional cell carcinoma in her bladder. She had been a very active dog until then, however, due to the co-morbidities, surgery was not an option for the owner. They were looking for a palliative solution to keep Alley comfortable until her quality of life was no longer acceptable.
While the orthosis is able to provide global support to the stifle, we generally only recommend orthoses for the treatment of low grade (I-II) patellar luxations. With the addition of a tarsal cuff, we are able control rotation of the affected leg which may assist with controlling the luxation (by providing resistance to internal rotation that is usually controlled by the cranial cruciate ligament). However, with grade III-IV luxation and in dogs without cruciate disease, the orthosis cannot provide enough external rotation of the tibia to allow for appropriate tracking of the patella.
In March 2016, Alley suffered a similar problem on her contralateral leg. Since Alley had done well with the original stifle orthosis, the owners decided to pursue it again. Alley received a stifle orthosis with a tarsal cuff for her contralateral leg. She has been doing well with her new orthosis and has been able to return to her normal activities again.