Relationship between the degree of stifle flexion and the proximal patellofemoral angle in the sagittal plane: A radiographic study.

The objective of this study was to evaluate the position of the patella in relation to the proximal femoral axis in the sagittal plane and to assess its reliability as a surgical landmark for femoral component placement in canine hip replacement. The relationship between the patella and the proximal femoral axis was assessed by defining the proximal patellofemoral angle in medio-lateral radiographic projections with 3 different stifle angles (full flexion, 90°, full extension) in medium to large breed skeletally mature dogs (N = 14). Proximal patellofemoral angle measurements were compared between the 3 different groups of stifle position using ANOVA for statistical analysis. The mean proximal patellofemoral angle measurements were -7.4° (± 1.3°) in the flexion group, -1.6° (± 1.5°) in the 90° group, and 2.1° (± 1.8°) in the extension group. Statistically significant differences were seen in the proximal patellofemoral angle between groups (P ≤ 0.001). These results confirm that position of the patella related to the proximal femoral axis differs depending on the degree of stifle flexion. The degree of stifle flexion should be considered in the preoperative planning and intraoperatively when using the patella as a surgical landmark in the sagittal plane for femoral canal broaching in canine total hip replacement.