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RAPID Patella Luxation Technique

This step-by-step guide details the correction of patella luxation in cats and dogs using the RAPID Patella Luxation System.

A Tibial Tuberosity Transposition (TTT) Technique

IMPORTANT REMINDER: We strongly recommend attending one of the TTA RAPID® and RAPID Patella Luxation Workshops to acquire the necessary skills to correcting a patella luxation using the RAPID Luxation Plating System.
The RAPID Patella Luxation Technique is a TTT technique which offers enhanced accuracy, stability, and ease of use through high quality implants and specialized instruments. The RAPID Luxation plates and spacers are made of Titanium for best biocompatibility and feature multiple screw fixation for better stability. Specialized instruments like the RAPID Luxation Tibia Tappet allow for controlled transposition of the tibial tuberosity, ensuring safe and accurate realignment of the patella. 
Watch the following animation video to get an overview of the RAPID Patella Luxation Technique: 

Essentials for the RAPID Luxation Procedure

RAPID Patella Luxation Plates, Spacers, and Instrumentation

RAPID Luxation Plates

The RAPID Patella Luxation Plates are available in three different sizes designed to accommodate a range of patient sizes, including small toy dog breeds and cats, as well as larger dogs.

Product Code

Description

Specifications

132-8200-03

RAPID Luxation Plate, Petite

4-hole, 1 mm thick, for 2.0 mm screws

132-8200-02

RAPID Luxation Plate, Medium

4-hole, 1 mm thick, for 2.4 mm screws

132-8200-01

RAPID Luxation Plate, Large

6-hole, 1.5 mm thick, for 2.4 mm screws

RAPID Luxation Spacers

Similar to the RAPID Luxation Plates, the RAPID Luxation Spacers are made of purest Titanium for best biocompatibility. The spacers are available in different thicknesses.

Product Code

Specification

For TTA RAPID® Cage Sizes

132-8030-01L

1 mm height, 2 holes, left

Petite / Tiny

132-8030-01R

1 mm height, 2 holes, right

Petite / Tiny

132-8030-02L

2 mm height, 2 holes, left

Petite / Tiny

132-8030-02R

2 mm height, 2 holes, right

Petite / Tiny

132-8030-03L

3 mm height, 2 holes, left

Petite / Tiny

132-8030-03R

3 mm height, 2 holes, right

Petite / Tiny

132-8030-04L

4 mm height, 2 holes, left

Petite / Tiny

132-8030-04R

4 mm height, 2 holes, right

Petite / Tiny

132-8020-02L

2 mm height, 2 holes, left

3 mm - 7.5 mm

132-8020-02R

2 mm height, 2 holes, right

3 mm - 7.5 mm

132-8020-03L

3 mm height, 2 holes, left

3 mm - 7.5 mm

132-8020-03R

3 mm height, 2 holes, right

3 mm - 7.5 mm

132-8020-04L

4 mm height, 2 holes, left

3 mm - 7.5 mm

132-8020-04R

4 mm height, 2 holes, right

3 mm - 7.5 mm

132-8010-02L

2 mm height, 3 holes, left

9 mm - 15 mm

132-8010-02R

2 mm height, 3 holes, right

9 mm - 15 mm

132-8010-04L

4 mm height, 3 holes, left

9 mm - 15 mm

132-8010-04R

4 mm height, 3 holes, right

9 mm - 15 mm

132-8010-06L

6 mm height, 3 holes, left

9 mm - 15 mm

132-8010-06R

6 mm height, 3 holes, right

9 mm - 15 mm

RAPID Patella Luxation Tibia Tappet

The RAPID Patella Luxation Tibia Tappet is a specialized instrument that facilitates precise and easy tibial tuberosity transposition. By providing controlled realignment of the tibia crest and enabling accurate measurement, this instrument plays a key role in achieving optimal outcomes in cases of patella luxation correction.
Transposition of Tibial Tuberosity
After the RAPID Patella Luxation Plate is inserted into the open partial osteotomy, the RAPID Luxation Tibia Tappet is used to transpose the tibial tuberosity. The Tappet is placed into the cranial or caudal screw holes of the RAPID Luxation Plate, depending on whether there is a medial or lateral patella luxation. The Tappet can then be rotated, and it fixates itself in the holes of the plate, allowing for controlled transposition of the tibia crest to the medial or lateral side.
Measurement Scale for Precision
The RAPID Patella Luxation Tibia Tappet features a scale (in millimeters) on the top of the instrument, which allows for precise measurement of how far the tibia crest is transposed. This scale ensures accuracy and consistency in the transposition process, enabling the surgeon to achieve the desired degree of realignment.
Placement of Patella Spacers
Once the tibial tuberosity has been transposed to the appropriate position, Patella Spacers are placed between the screw holes of the plate and the bone. These spacers serve to fill the gap between the plate and the bone, providing additional stability and support to the transposed tibial tuberosity.
Removal of Tibia Tappet
After the Patella Spacers have been placed, the RAPID Patella Luxation Tibia Tappet
can be removed from the surgical site. The transposition of the tibial tuberosity is now complete, and the surgical site can be further managed according to the specific requirements of the procedure.

Product Code

Description

132-4070-00

RAPID Luxation Tibia Tappet, Standard 2.4 mm

132-4071-00

RAPID Luxation Tibia Tappet, Petite / Tiny 2.0 mm

Click to play

TTA RAPID® Saw Guide

The TTA RAPID® Saw Guide is an L-shaped device developed to facilitate accurate positioning of the osteotomy. It was designed to ensure that a sufficiently large cranial fragment is created for screw placement. The vertical arm of the guide has 2.5mm holes placed at strategic points, over a 1mm wide slot. The numbers next to these holes correspond with the size of the cage, preventing the osteotomy from being too distal. Additionally, the horizontal arm of the guide serves as a millimeter scale, preventing the osteotomy from being too caudal.

Product Code

Description

132-4040-00

TTA RAPID® Saw Guide, for cage sizes 6-15 mm

132-4041-00

TTA RAPID® Saw Guide, for cage sizes 3-4.5 mm

132-4042-00

TTA RAPID® Saw Guide, for tiny cage sizes 2-6 mm

132-4030-10

TTA RAPID® Saw Guide Pin, Ø 1.0 mm


The RAPID Patella Luxation Surgery

A brief step-by-step guide to the RAPID Patella Luxation Technique

Placement of the Patient: The dog is placed in a dorsal recumbency with the affected limb suspended from a stand. Care should be taken to avoid securing the dog's paws too tightly, as the affected limb will later be placed against the table during the surgery. RAPID Luxation Surgery is then initiated through a medial skin incision.

1. Making the Osteotomy

1.1
A 2.5mm pin is placed through the joint capsule at the intersection of the femoral condyle and the tibial plateau. On the lateral side, the pin should start slightly in front of the level of “Gerdy’s Tubercle”. This pin is used as the proximal fixation of the saw guide.
1.2
The saw guide is dropped over the pin using one of the numbered holes in the vertical arm, corresponding with the size of the cage measured during pre-operative planning.
1.3
A peg is placed into one of the holes in the horizontal arm of the drill guide, selecting the number of millimeters measured during pre-operative planning.
1.4
Press the saw guide against the medial aspect of the tibia with protruding peg forced up against the cranial side of the tibia. Hold it in that position. Correct use of the drill guide will place the osteotomy just caudal to the cranial cortex of the tibia. (As a guide: In a large dog the cortex is approximately 5mm thick and in a small dog approximately 3mm.) 
Important: Do not press the horizontal arm against the bone as this will cause an oblique osteotomy!
1.5
Use an oscillating saw to create create the osteotomy. Optionally, a blade can be used to open the fascia/periostium prior to the osteotomy.

2. Placing the Implants

In the following, a medial Patella Luxation (PL) is described. In a lateral PL, place the implants in the lateral/medial opposite site.
2.1
The RAPID Luxation Plate is placed on the tibia. The osteotomy should be in the middle of the RAPID Luxation Plate. The plate is then screwed on the caudal side of the tibia (for a medial PL) (Note: Place screws on the cranial side for a lateral patella luxation.)
2.2
The RAPID Luxation Tibia Tappet is inserted on the cranial screw holes (top and centre screw hole for the 3-hole plates) of the RAPID Luxation Plate.
2.3
Then the tappet can be rotated, it fixates itself in the screw holes of the RAPID Luxation Plate and transposes the tibia crest to the lateral side. The scale (in mm) on the top of the instruments shows exactly how far tibia crest is transposed.
2.4
During transposition using the tappet the stifle can be flexed and extended to check if there is perfect alignment of the patella and if the patella stays in place. If the alignment is not optimal, the transposition can be further increased.
2.5
Once the desired position is achieved, insert the RAPID Luxation Spacer between the plate and the bone. The tappet may then be removed.
2.6
Insert the remaining screws to secure the plate and spacer. Close the fascia where possible. Close the wound according to standard procedure. 
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Questions?

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TTA RAPID® & RAPID Patella Luxation

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