Histopathological evaluation of medial patellar ligament and radiographic evaluation of the stifle joint of upward fixation of patella affected bovines

Aim: To evaluate the medial patellar ligament by histopathology and stifle joint by radiography of upward fixation of patella affected bovines. Materials and Methods: Present study was conducted on 24 clinical cases of bovines. Out of twenty four clinical cases of upward fixation of patella, twelve were buffaloes, six were cows and remaining six were bullocks. Histopathological evaluation of medial patellar ligament from the affected animals and radiographic evaluation of stifle joint were done as per standard procedure. Results: Histopathological observations were made as follows. Nuclei of the fibroblasts were oval shaped and hypertrophied, as compared to thin, elongated normal nuclei. There was an excessive proliferation of fibrous connective tissue. There was a presence of mononuclear cells and fibrin exudates in the surrounding loose connective tissue of the ligament and medial coat of the blood vessels of medial patellar ligament was thickened. Plain radiographs that were taken in the medio-lateral view did not reveal any evidence of upward or dorsal deviation of patella in relation to the femoral condyle. Conclusions: Histopathological evaluation of the medial patellar ligaments of upward fixation of patella affected bovines showed various pathological changes, while radiography of the stifle joint did not confirm the condition.

The present study was aimed to evaluate the Upward fixation of patella is one of the most medial patellar ligament by histopathology and stifle commonly seen condition in cattle and buffalo [1,2,3].
joint by radiography of upward fixation of patella It is a multifactorial disease [2,3,4].Sporadic occurrences affected bovines.are seen in dairy cattle and it is reported to be quite common with draft bullocks in India [5,6].Incidence is Materials and Methods quite higher in buffaloes compared to cattle [7,8].
Ethical approval: Not necessary.All the clinical cases Among the patellar ligaments, middle patellar ligament under this research were treated and examined as per is thick and strong as compared to medial and lateral standard treatment and examination procedure.patellar ligaments [9,10].In the present study, medial Animals: Twenty four clinical cases of bovines affected patellar ligament of the affected cattle and buffaloes with upward fixation of patella were considered for the was subjected to histopathological study.Plain radiograph study.Twelve out of twenty four animals were buffaloes, of the stifle joint was taken.Whenever lameness occurs six were cows and remaining six were bullocks.These due to medial patellar desmotomy, consideration should animals were randomly divided into four groups with be given to both radiography of the stifle joint and six animals in each group (Table -1).Medial patellar ultrasonagraphy of the middle patellar ligament [11].ligament of the affected bovines was subjected to Medial patellar ligament is thin, flattened like ribbon histopathology and the radiographs of their stifle joint and weaker than middle and lateral patellar ligament were taken.[3,12].From the clinical point of view the stifle joint is very important; it includes the femeropatellar and Histology: Excised piece of medial patellar ligament was collected in neutral buffered formalin.The tissues were processed as per routine paraffin and embedding technique.The paraffin sections were cut to a size of 3-5 microns thickness.The slides were stained with

Histopathological evaluation of medial patellar ligament and radiographic evaluation of the stifle joint of upward fixation of patella affected bovines
Haematoxylin and Eosin for histopathological studies exudates in the surrounding loose connective tissue of [14].Lateral radiograph of stifle joint of the affected the ligament (Figure -5) and medial coat of the blood animal was taken in 500 mA X-ray machine in a vessels of medial patellar ligament was thickened 12"x15" films for diagnosing upward fixation of (Figure -6).patella in bovines.Exposure factors used were 14 to 18 Present study results are in agreement with mAs and 68 to 75 kVp at 90 cm FFD in a grid cassette several earlier studies.There was a mononuclear cell [15].proliferation in the medial patellar ligament of the affected bullocks [16].Histopathological study of

Results and Discussion
medial patellar ligaments showed the hypertrophy of Histopathological observations were made as the medial coat of the blood vessels and increased follows; fibrous tissue in the whole ligament [17].Histopatho-Nuclei of the fibroblasts were oval shaped and logy of the medial patellar ligaments of the affected hypertrophied (Figure -1) as compared to thin, elongated bovines showed, hypertrophied and oval nuclei of normal nuclei (Figures -2 and 4).There was an excessive fibroblasts, medial coat of the blood vessels was proliferation of fibrous connective tissue (Figure -3).
thickened, increased white fibrous connective tissue There was a presence of mononuclear cells and fibrin proliferation, individual fibres of the ligament were  hyalinised and the diameter of the collagen fibre in myelin sheath of the nerve from an affected animal [23].bundle was increased [18].Under light microscope, In the present study, plain radiographs that were histology of the ligament showed fibrocytes interspersed taken in the medio-lateral view did not reveal any evidence between the extracellular fibres [19].
of upward or dorsal deviation of patella in relation to The degree of fibrous tissue proliferation was the femoral condyle (Figure -7, 8 and 9).For taking the more in the bovines that were affected for long period radiograph in medio-lateral view, animal was casted to of time.In the group IV, two buffaloes showed the lateral recumbency with the affected hind limb stretched.clinical signs after medial patellar desmotomy by When the leg is stretched, patella automatically moved standing closed method and histology of the medial dorsally.Hence, we could not specifically point out the patellar ligament of the two buffalo's revealed excessive dorsal deviation of the patella in a plain radiograph of proliferation of the fibrous connective tissue.This upward fixation of patella affected animals.indicated that severe fibrosis of the medial patellar Similar observations were reported by several ligament might be the cause for persistent clinical signs workers.There was no evidence of dorsal or medial of lameness after medial patellar desmotomy in these deviation of patella in relation to the femoral condyle in animals.There were no differences noticed in the the plain radiographs of stifle joints of upward fixation histology of the medial patellar ligaments of normal of patella affected animals [18].It was not possible to cows, buffaloes and bullocks.But, the only difference use radiography for the diagnosis of upward fixation of noticed in the present study was the degree of fibrous patella [24].Radiographs of stifle joint of upward tissue proliferation in the medial patellar ligament of fixation of patella affected animals failed to demonthe affected animals.It was more in the medial patellar strate any abnormal anatomical disposition of the patella ligaments of animals affected for long period and lesser in relation to the femoral condyle [25].No radiographic in the ligaments of the animals affected for short period sign could be used to confirm the clinical diagnosis of of time.Animals of different group in the present study recurrent upward fixation of patella in horses and that were presented early to the Teaching Veterinary radiographical examination of the stifle was recomm-Clinical Complex, Veterinary College, Bidar did not ended to exclude other concurrent stifle lesions that show clinical signs of lameness after medial patellar might affect the choice of treatment and prognosis [15].desmotomy and that were presented after 6 months of However, the following observations made in the affected ligament showed persistent clinical signs of present study were not observed by several earlier lameness after medial patellar desmotomy.This was studies reported.There was a flattened condition of the due to severe fibrosis of the medial patellar ligament.
inner lip of the trochlea in a radiograph of stifle joint of However, following observations were not noticed large animals affected with upward fixation of patella [26].Roentgenographic examination of stifle joint of in the present study; the upward fixation of patella affected animals revealed Histologically medial patellar ligament was congenital deformity in the stifle joint [27].There was distinctly weaker than the middle or the lateral [20].Medial a defective shape of the trochlea in a radiograph of the ligament was strengthened by an accessory fibrocartilage stifle joint of upward fixation of patella affected animal [21].Longitudinal sections of medial patellar ligaments [28].Radiographic examination of the stifle joint of of 31 bovine animals (12 normal and 19 affected) were upward fixation of patella affected animals showed the prepared and the diameter of the collagen fibre bundle absorption of fat between the straight ligaments and the was measured and the affected ligaments had the joint [29].Radiograph of the stifle joint of upward largest diameters when compared to normal ones [22].
fixation of patella affected animal indicated fibrosis or On histopathological examinations the saphenous branch osseous proliferation of the stifle joint [30].Radioof femoral nerve which supplies the medial patellar graphic examination of the stifle joint of upward fixation ligament and joint capsule showed degenerative changes

Figure- 1 :Figure- 2 :Figure- 3 :Figure- 4 :Figure- 5 :Figure- 6 :
Figure-1: Photomicrograph of a medial patellar ligament from the affected animal showing oval shaped and h y p e r t r o p h i e d n u c l e u s o f t h e fibroblasts.(40×-H and E) Figure-2: Photomicrograph of a medial patellar ligament from the normal animal showing thin and elongated nuclei.(40×-H and E) Figure-3: Photomicrograph of a medial patellar ligament from the affected animal showing excessive proliferation of fibrous connective tissue.(10×-H and E)

Figure- 7 :
Figure-7: Lateral radiograph of the stifle joint of a buffalo.

Figure- 8 :
Figure-8: Lateral radiograph of the stifle joint of a cow.

Figure- 9 :
Figure-9: Lateral radiograph of the stifle joint of a bullock.
fixation of thepatella is higher in buffalos than in cattle? of patella affected animal revealed dry condition of the of the patellar ligaments before and after medial in the surrounding loose connective tissue.These indicate patellar desmotomy in buffaloes (Bos bubalis).Emir.J.Food Agric.23 (5): 460-465.that the condition will produce some degenerative 12. Roger, W. B and David Weaver, A. (2011) Color Atlas of changes in the medial patellar ligament of the affected rd Diseases and Disorders of Cattle.Edn 3 .Elsvier Ltd. bovines.The different methods of medial patellar p130.desmotomy were successful in complete elimination of 13.Abdalla Hifny., Kamal Eldin Hashem Abdalla., Yousria, A., Abdel Rahman., Khaled Aly and Ruwaida Abdelmoaty the clinical signs of lameness in the affected bovines of Elhanbaly.(2012) Morphometric studies on the passive role different group, when the cases were presented early. of menisci in upward fixation of the patella in buffalo and The radiography was not useful for diagnosis of cattle.Vet Sci.Develop., 2: 63.