An ur­gent knee-d

Pets (Singapore) - - Ask The Expert -

My one-year-old Corgi was di­ag­nosed with grade four patella lux­a­tion on his right knee and the vet ad­vised me to bring him for hy­drother­apy. Given his stout frame, I’m wor­ried that the chlo­ri­nated wa­ter will get into his nose and ears. How does hy­drother­apy help, and are there al­ter­na­tives to com­bat his con­di­tion?

The grad­ing of patel­lar lux­a­tion is from one (least se­vere) to four (most se­vere), and pa­tients suf­fer­ing from a grade four patella lux­a­tion have their patella per­ma­nently po­si­tioned out­side of the patel­lar groove—this of­ten presents as bow-legged­ness and per­sis­tent lame­ness.

Hy­drother­apy is a re­ha­bil­i­ta­tion tech­nique that em­ploys the re­sis­tive prop­er­ties of wa­ter to im­prove muscle strength, main­tain or im­prove joint range of mo­tion for pa­tients suf­fer­ing from chronic con­di­tions with sec­ondary os­teoarthri­tis, as well as as­sist with gait reed­u­ca­tion and im­prove­ment of stamina for post-op­er­a­tive pa­tients. Pa­tients di­ag­nosed with patel­lar lux­a­tion are of­ten un­able to per­form rou­tine work­outs due to lame­ness, and hy­drother­apy al­lows these pa­tients to ex­er­cise in a com­fort­able en­vi­ron­ment with less muscle ex­er­tion.

In terms of con­ser­va­tive treat­ment op­tions for a pa­tient di­ag­nosed with grade four patel­lar lux­a­tion, weight main­te­nance or re­duc­tion (if over­weight), oral pain re­lief med­i­ca­tion and hy­drother­apy may only tem­po­rar­ily al­le­vi­ate the pre­sent­ing symp­toms. My pro­fes­sional rec­om­men­da­tion for a pa­tient di­ag­nosed with grade four patel­lar lux­a­tion is sur­gi­cal cor­rec­tion. A grade four patel­lar lux­a­tion will in­evitably lead to pro­gres­sive skele­tal de­for­mity if not cor­rected early and the pa­tient’s qual­ity of life will be com­pro­mised.

While con­ser­va­tive ap­proaches such as weight re­duc­tion, phar­ma­co­log­i­cal treat­ment us­ing oral pain re­lief med­i­ca­tion and hy­drother­apy may tem­po­rar­ily al­le­vi­ate the symp­toms and si­mul­ta­ne­ously as­sist in the preser­va­tion of muscle strengths for these pa­tients, the most op­ti­mal treat­ment pro­to­col dif­fers be­tween each in­di­vid­ual and is highly de­pen­dent on clin­i­cal signs, sever­ity of lux­a­tion, con­cur­rent skele­tal de­for­mity, as well as the age of the pa­tient. In terms of man­ag­ing pa­tients di­ag­nosed with a grade four patel­lar lux­a­tion, bone reconstruction via a sur­gi­cal ap­proach is highly war­ranted early in the course of the dis­ease in or­der to mit­i­gate pro­gres­sive skele­tal de­for­mity and sec­ondary os­teoarthri­tis.

Ex­pert: Dr Grace Chen BSc BVSc (Hons) Doc­tors Beck and Stone

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