Nagahiro et al: Evaluation of the quadriceps muscle length to femoral length ratio in small breed dogs with medial patellar luxation
Veterinary Surgery 4, 2023

🔍 Key Findings

  • Quadriceps muscle length/femoral length ratio (QML/FL) was significantly lower in dogs with grade IV MPL than grades I–III (p ≤ .002).
  • Shortened QML was associated with increased femoral torsion angle (FTA) and increased aLDFA, indicating correlation with femoral deformity.
  • QML/FL increased with age, possibly due to muscular development or reduced deformity in older dogs (p = .004).
  • Grade IV MPL dogs had QML/FL < 0.87, the lower normal limit based on healthy beagles, suggesting clinically significant muscle shortening.
  • PLL/PL ratio (used to diagnose patella alta) was not associated with QML/FL or MPL severity in small breeds.
  • QML/FL can help preoperatively identify candidates for femoral shortening ostectomy, improving femoropatellar alignment.
  • Multivariate regression model confirmed QML/FL is independently influenced by age, FTA, and aLDFA (R² = 0.45).
  • CT-based 3D measurements enabled objective, noninvasive quantification of femoral and muscle alignment parameters.

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Nagahiro et al: Evaluation of the quadriceps muscle length to femoral length ratio in small breed dogs with medial patellar luxation
Veterinary Surgery 4, 2023

🔍 Key Findings

  • Quadriceps muscle length/femoral length ratio (QML/FL) was significantly lower in dogs with grade IV MPL than grades I–III (p ≤ .002).
  • Shortened QML was associated with increased femoral torsion angle (FTA) and increased aLDFA, indicating correlation with femoral deformity.
  • QML/FL increased with age, possibly due to muscular development or reduced deformity in older dogs (p = .004).
  • Grade IV MPL dogs had QML/FL < 0.87, the lower normal limit based on healthy beagles, suggesting clinically significant muscle shortening.
  • PLL/PL ratio (used to diagnose patella alta) was not associated with QML/FL or MPL severity in small breeds.
  • QML/FL can help preoperatively identify candidates for femoral shortening ostectomy, improving femoropatellar alignment.
  • Multivariate regression model confirmed QML/FL is independently influenced by age, FTA, and aLDFA (R² = 0.45).
  • CT-based 3D measurements enabled objective, noninvasive quantification of femoral and muscle alignment parameters.

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Multiple Choice Questions on this study

In Nagahiro 2023 et al., on quadriceps-femoral mismatch, which MPL grade was associated with significantly shorter quadriceps muscle length relative to femoral length?

A. Grade I
B. Grade II
C. Grade III
D. Grade IV
E. All grades equally

Answer: Grade IV

Explanation: QML/FL was significantly lower in grade IV compared to grades I–III, indicating a shortened quadriceps muscle in severe MPL.
In Nagahiro 2023 et al., on quadriceps-femoral mismatch, which variables were significantly associated with a decreased QML/FL in the final regression model?

A. Age, weight, PLL/PL
B. FTA, FIA, PLL/PL
C. Age, FTA, aLDFA
D. Bodyweight, grade, FIA
E. Sex, side, FTA

Answer: Age, FTA, aLDFA

Explanation: Multivariate regression revealed QML/FL decreased with increased femoral torsion angle (FTA) and aLDFA, but increased with age.
In Nagahiro 2023 et al., on quadriceps-femoral mismatch, what was the reference value for normal QML/FL derived from healthy beagles?

A. >1.05
B. 0.87–1.00
C. <0.85
D. 0.75–0.95
E. 0.90–1.10

Answer: 0.87–1.00

Explanation: The reference QML/FL was 0.87–1.00 based on healthy beagle data. Values below 0.87 were considered abnormal.
In Nagahiro 2023 et al., on quadriceps-femoral mismatch, what was the primary clinical implication of a reduced QML/FL ratio in dogs with MPL?

A. It predicts osteoarthritis severity
B. It indicates need for patellar ligament desmotomy
C. It predicts surgical success following trochleoplasty
D. It suggests a candidate for femoral shortening ostectomy
E. It rules out patella alta

Answer: It suggests a candidate for femoral shortening ostectomy

Explanation: A low QML/FL may indicate the need to shorten the femur surgically to match quadriceps tension and improve patellar alignment.
In Nagahiro 2023 et al., on quadriceps-femoral mismatch, how did the PLL/PL ratio (indicator of patella alta) relate to QML/FL or MPL severity?

A. High PLL/PL predicted lower QML/FL
B. PLL/PL strongly correlated with MPL grade
C. PLL/PL correlated with aLDFA
D. PLL/PL was not associated with QML/FL or MPL severity
E. PLL/PL predicted QML shortening in older dogs

Answer: PLL/PL was not associated with QML/FL or MPL severity

Explanation: PLL/PL ratio did not correlate with quadriceps length or severity of MPL in small breed dogs.

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