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Prabakaran A, Jenkins PL. Kinetic and Radiographic Outcomes of Unilateral Double Pelvic Osteotomy in Six Dogs. Vet Comp Orthop Traumatol 2023. [PMID: 37019152 DOI: 10.1055/s-0043-1766092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
OBJECTIVE The aim of this study was to assess the kinetic and radiographic outcome of unilateral double pelvic osteotomy (DPO) using a temporospatial pressure walkway, preoperative and postoperative radiographs. STUDY DESIGN Retrospective case series of six dogs that underwent unilateral DPO for canine hip dysplasia. The untreated limb was unfit for DPO due to radiographic evidence of osteoarthritis and was therefore managed non-surgically. Preoperative and postoperative radiographs and kinetic data were compared between untreated and DPO-treated hips using a Wilcoxon signed-rank test. RESULTS There was no significant difference in British Veterinary Association Hip Dysplasia Scheme (BVA-HD) scores between untreated and DPO-treated hips preoperatively (p-value = 0.09) and postoperatively (p-value = 0.06). The median postoperative GAIT4 Dog Lameness Score was lower in untreated hips than DPO-treated hips but was not statistically different (p-value = 0.18). CONCLUSIONS All dogs in this case series achieved a total pressure index and GAIT4 Dog Lameness Score on the DPO-treated hip comparable to normal limbs. All untreated hips in this series had increased BVA-HD scores at follow-up, whereas all DPO-treated hips had reduced BVA-HD scores. This difference was not significant and warrants further studies. We conclude total pressure index may be preserved in hips treated with unilateral DPO, while the contralateral hip is managed non-surgically.
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Affiliation(s)
- Adheip Prabakaran
- Department of Small Animal Surgery, Small Animal Specialist Hospital, North Ryde, NSW, Australia
| | - Paul L Jenkins
- Department of Small Animal Surgery, Small Animal Specialist Hospital, North Ryde, NSW, Australia
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Kwananocha I, Magré J, Willemsen K, Weinans H, Sakkers RJB, How T, Verseijden F, Tryfonidou MA, van der Wal BCH, Meij BP. Acetabular rim extension using a personalized titanium implant for treatment of hip dysplasia in dogs: short-term results. Front Vet Sci 2023; 10:1160177. [PMID: 37152693 PMCID: PMC10157081 DOI: 10.3389/fvets.2023.1160177] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 03/27/2023] [Indexed: 05/09/2023] Open
Abstract
Hip dysplasia (HD) is a common orthopedic problem in young dogs. To decrease the laxity of the hip joint related to HD, the surgical treatments are recommended to increase femoral head coverage. ACEtabular rim eXtension (ACE-X) using a personalized 3-dimensional printed titanium shelf implant is a new surgical treatment to increase femoral head coverage and decrease laxity of the dysplastic hip joint, however, the efficacy is less know. Client-owned dogs older than 6 months with clinical signs of coxofemoral joint subluxation and radiographic evidence of HD with no or mild osteoarthritis (OA) were included. The Norberg angle (NA), linear percentage of femoral head overlap (LFO), and percentage of femoral head coverage (PC) were investigated radiographically and with computed tomography (CT) before and after surgery. OA was graded (scores 0-3) according to the maximum osteophyte size measured on CT. In addition, joint laxity (Ortolani) test results, gait analysis, and the Helsinki chronic pain index (HCPI) questionnaire were obtained at preoperative, immediately postoperative and at 1.5- and 3-month evaluations. Acetabular rim extension was performed in 61 hips of 34 dogs; NA, LFO, and PC were significantly higher immediately postoperatively and at the 1.5- and 3-month follow-up examinations compared with preoperative values (p < 0.05). Osteophyte size gradually increased over time (p < 0.05). The OA score significantly increased between preoperatively and directly postoperatively, and between preoperatively and at 3-month follow-up (p < 0.05). The laxity test normalized in 59 out of 61 hips after surgery, and the HCPI questionnaire showed that the pain score decreased significantly at 1.5 and 3 months, postoperatively. The force plate showed no significant improvement during the 3 months follow-up. Although pain reduction by the implant was unclear in short-term results, a personalized shelf implant significantly increased femoral head coverage and eliminated subluxation of the dysplastic hip joint. Further studies are required to study the long-term efficacy of gait, chronic pain, and progression of osteoarthritis.
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Affiliation(s)
- Irin Kwananocha
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
- Research and Academic Service, Faculty of Veterinary Medicine, Kasetsart University, Bangkok, Thailand
| | - Joëll Magré
- Department of Orthopedics, University Medical Center Utrecht, Utrecht, Netherlands
- 3D Lab, Division of Surgical Specialties, University Medical Center Utrecht, Utrecht, Netherlands
| | - Koen Willemsen
- Department of Orthopedics, University Medical Center Utrecht, Utrecht, Netherlands
- 3D Lab, Division of Surgical Specialties, University Medical Center Utrecht, Utrecht, Netherlands
| | - Harrie Weinans
- Department of Orthopedics, University Medical Center Utrecht, Utrecht, Netherlands
| | - Ralph J. B. Sakkers
- Department of Orthopedics, University Medical Center Utrecht, Utrecht, Netherlands
| | - Thijs How
- Diergeneeskundig Specialisten Centrum Den Haag, The Hague, Netherlands
| | - Femke Verseijden
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
| | - Marianna A. Tryfonidou
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
| | | | - Björn P. Meij
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
- *Correspondence: Björn P. Meij
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Alves JC, Santos A, Jorge P, Lavrador C, Carreira LM. Effect of a single intra-articular administration of stanozolol in a naturally occurring canine osteoarthritis model: a randomised trial. Sci Rep 2022; 12:5887. [PMID: 35393497 PMCID: PMC8989994 DOI: 10.1038/s41598-022-09934-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 03/23/2022] [Indexed: 11/21/2022] Open
Abstract
Osteoarthritis (OA) is a disease with a high negative impact on patient’s quality of life and a high financial burden. It is a source of chronic pain and affects all mammals, including humans and dogs. As the dog is a common model for translation research of human OA, and exploring spontaneous dog OA can improve the health and well-being of both humans and dogs. To describe the effect of the intra-articular administration of stanozolol in a naturally occurring canine OA model, forty canine (N = 40) hip joints were randomly assigned to receive stanozolol or saline (control). On treatment day and at 8, 15, 30, 90, and 180 days post-treatment, several evaluations were conducted: weight distribution, joint range of motion, thigh girth, digital thermography, and radiographic signs. Also, synovial fluid C-reactive protein and interleukin-1 levels were evaluated. Results from four Clinical Metrology Instruments was also gathered. Results were compared with Repeated Measures ANOVA, with a Huynh–Feldt correction, paired-samples t-test, or Wilcoxon signed-rank test, with p < 0.05. OA was graded as mild (90%), moderate (5%), and severe (5%), including both sexes. They had a mean age of 6.5 ± 2.4 years and a bodyweight of 26.7 ± 5.2 kg. No differences were found between groups at treatment day in all considered evaluations. Weight distribution showed significant improvements with stanozolol from 15 days (p < 0.05) up to 180 days (p < 0.01). Lower values during thermographic evaluation in both views taken and improved joint extension at 90 (p = 0.02) and 180 days (p < 0.01) were observed. Pain and function scores improved up to 180 days. In the control group, radiographic signs progressed, in contrast with stanozolol. The use of stanozolol was safe and produced significant improvements in weight-bearing, pain score, and clinical evaluations in a naturally occurring canine OA model.
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Affiliation(s)
- J C Alves
- Divisão de Medicina Veterinária, Guarda Nacional Republicana (GNR), Rua Presidente Arriaga, 9, 1200-771, Lisbon, Portugal. .,MED - Mediterranean Institute for Agriculture, Environment and Development, Instituto de Investigação e Formação Avançada, Universidade de Évora, Pólo da Mitra, Ap. 94, 7006-554, Évora, Portugal.
| | - A Santos
- Divisão de Medicina Veterinária, Guarda Nacional Republicana (GNR), Rua Presidente Arriaga, 9, 1200-771, Lisbon, Portugal
| | - P Jorge
- Divisão de Medicina Veterinária, Guarda Nacional Republicana (GNR), Rua Presidente Arriaga, 9, 1200-771, Lisbon, Portugal
| | - C Lavrador
- MED - Mediterranean Institute for Agriculture, Environment and Development, Instituto de Investigação e Formação Avançada, Universidade de Évora, Pólo da Mitra, Ap. 94, 7006-554, Évora, Portugal
| | - L Miguel Carreira
- Faculty of Veterinary Medicine, University of Lisbon (FMV/ULisboa), Lisbon, Portugal.,Interdisciplinary Centre for Research in Animal Health (CIISA), University of Lisbon (FMV/ULisboa), Lisbon, Portugal.,Anjos of Assis Veterinary Medicine Centre (CMVAA), Barreiro, Portugal
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Elefterescu H, Ober CA, Timen A, Yiapanis C, McCartney W, Milgram J. The Use of Sixty Degree Rotation of the Acetabulum for Treatment of Dogs With Canine Hip Dysplasia. A Short Case Series. Front Vet Sci 2021; 8:669680. [PMID: 34055955 PMCID: PMC8155351 DOI: 10.3389/fvets.2021.669680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 04/16/2021] [Indexed: 11/13/2022] Open
Abstract
Triple pelvic osteotomy (TPO) is a prophylactic surgical procedure performed on dogs with canine hip dysplasia. The procedure is indicated in skeletally immature dogs without secondary osteoarthritis (OA). It has been suggested that 60° of rotation is excessive and is associated with poor outcome. The objective of the study was to assess the medium term outcome in dogs having undergone triple pelvic osteotomy (TPO) using 60° dedicated plates. Nine TPOs were performed in seven dogs with hip dysplasia. Eight of nine hips had 72-100% osseous union at the time of revisit. The mean time to final radiographic recheck was 200 days (range, 185-229 days). The mean time to follow-up was 11.5 months (range 11-12 months). All 7 dogs had regained full function and did not require supplemental analgesia. Pelvic canal narrowing was noted in the two dogs with bilateral surgeries, but no clinical consequences were noted according to owner's statement.If more than 40 degrees reduction angles at Ortolani test, 60° of rotation of the acetabulum can be used successfully in dogs with hip dysplasia. At the time of mid-term follow-up, all dogs in this case series had full function.
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Affiliation(s)
| | - Ciprian Andrei Ober
- Department of Surgery, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, Cluj-Napoca, Romania
| | | | | | | | - Joshua Milgram
- Department of Small Animal Surgery, The Robert H. Smith Faculty of Agriculture, Food and Environment, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
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Alves JC, Santos A, Jorge P, Lavrador C, Carreira LM. Intra-articular Injections With Either Triamcinolone Hexacetonide, Stanozolol, Hylan G-F 20, or a Platelet Concentrate Improve Clinical Signs in Police Working Dogs With Bilateral Hip Osteoarthritis. Front Vet Sci 2021; 7:609889. [PMID: 33537353 PMCID: PMC7849590 DOI: 10.3389/fvets.2020.609889] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 12/02/2020] [Indexed: 12/13/2022] Open
Abstract
Objectives: To compare the effect of intra-articular treatment with triamcinolone hexacetonide (TH), stanozolol, hyaluronan, and a platelet concentrate in police working dogs with bilateral hip osteoarthritis (OA). Study Design: Prospective, longitudinal, double-blinded, negative controlled study. Sample Population: Fifty police working dogs with naturally occurring hip OA. Methods: Animals were randomly assigned to a control group (CG, n = 10), TH group (THG, n = 10), platelet concentrate group (PCG, n = 10), stanozolol group (SG, n = 10), and Hylan G-F 20 group (HG). On days 0 (T0), 8, 15, 30, 90, and 180 days post-treatment, weight-bearing distribution was evaluated. In those days, and on days 60, 120, and 150, four clinical metrology instruments were completed. Kaplan-Meier estimators were conducted and compared with the log-rank test. Cox proportional hazard regression analysis was performed to determine treatment survival. Significance was set at p < 0.05. Results: Patients had a mean age of 6.5 ± 2.4 years and body weight of 26.7 ± 5.2 kg. At T0, hips were classified as mild (n = 35), moderate (n = 10), and severe (n = 5), according to the Orthopedic Foundation for Animals grading scheme. No differences were found between groups at that moment considering age, body weight, OFA hip score, and all assessments performed. All treatments improved clinical signs in various OA dimensions in some groups, with a broad effect interval. PCG showed a lower range of variation while maintaining a positive result for more extended periods (p < 0.01 for symmetry index and 0.01 < p < 0.04 in the majority of scores). Breed, age, sex, and OFA grade did not significantly influence response to treatment. Conclusions and Clinical Relevance: This is the first prospective, negative controlled, double-blinded study to compare the effect of a single administration of these IA treatments in dogs with hip OA. HG and PCG recorded more significant improvements throughout the 180-day follow-up. In particular, PCG also registered a lower variation in results, seemingly the best therapeutic option. Nevertheless, improvements were still observed in THG and SG, and these treatment options can be considered, mainly when the first two treatments are not available.
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Affiliation(s)
- João C. Alves
- Divisão de Medicina Veterinária, Guarda Nacional Republicana (GNR), Lisbon, Portugal,MED - Mediterranean Institute for Agriculture, Environment and Development, Instituto de Investigação e Forma Avana, Universidade de Évora, Évora, Portugal,*Correspondence: João C. Alves
| | - Ana Santos
- Divisão de Medicina Veterinária, Guarda Nacional Republicana (GNR), Lisbon, Portugal
| | - Patrícia Jorge
- Divisão de Medicina Veterinária, Guarda Nacional Republicana (GNR), Lisbon, Portugal
| | - Catarina Lavrador
- MED - Mediterranean Institute for Agriculture, Environment and Development, Instituto de Investigação e Forma Avana, Universidade de Évora, Évora, Portugal
| | - L. Miguel Carreira
- Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal,Interdisciplinary Centre for Research in Animal Health (CIISA), University of Lisbon, Lisbon, Portugal,Anjos of Assis Veterinary Medicine Centre (CMVAA), Barreiro, Portugal
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Alves JC, Santos A, Jorge P, Lavrador C, Carreira LM. Clinical and diagnostic imaging findings in police working dogs referred for hip osteoarthritis. BMC Vet Res 2020; 16:425. [PMID: 33160336 PMCID: PMC7648415 DOI: 10.1186/s12917-020-02647-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 10/27/2020] [Indexed: 12/17/2022] Open
Abstract
Background Osteoarthritis (OA) is the most commonly diagnosed joint disease in veterinary medicine, with at least 80% of the cases of lameness and joint diseases in companion animals being classified as OA. Sporting and working animals are more predisposed to develop OA since they are exposed to chronic fatigue injuries, leading to bone and muscular tissue damage and failure, resulting in clinical signs. To characterize the clinical signs and diagnostic findings of Police working dogs presenting with bilateral hip OA at the time of diagnosis. Fifty animals were evaluated with a bodyweight ≥ 15 kg, be older than two years, and without any medication or nutritional supplements for ≥ 6 weeks. Results Weight distribution, joint range of motion at flexion and extension, thigh girth, digital thermography, and radiographic signs were collected. Data from different Clinical Metrology Instruments (CMI) were collected: Canine Brief Pain Inventory, Liverpool Osteoarthritis in Dogs, Canine Orthopedic Index, and the Hudson Visual Analogue Scale. Results were compared by breed, age, sex, and Orthopaedic Foundation for Animals hip grades with the Independent Samples T-Test, ANOVA followed by a Bonferroni post hoc test, and Pearson correlation coefficient, with p < 0.05. The sample included 30 males and 20 females, with a mean age of 6.5 ± 2.4 years and a bodyweight of 26.7 ± 5.2 kg. Animals with weight distribution below normal levels had significant variations of joint extension and function scores. This evaluation was the only not correlated with at least one breed. Animals with caudolateral curvilinear osteophyte showed a poorer clinical presentation and worse scores in all considered CMIs. Radiographic changes correlated with age and corresponded to worse CMIs scores and weight distribution. Dutch Shepherd Dogs showed better CMI scores than the other considered breeds. Conclusions Police working dogs presented with complaints related to hip OA at an early stage of the disease. Hip scores influenced clinical presentation, with moderate cases showing lower thigh girth and worse pain interference and severity, and function scores than mild cases. Patients with severe OA had lower thermographic evaluations than patients with moderate OA. Age was the primary variable influencing considered CMI scores.
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Affiliation(s)
- J C Alves
- Divisão de Medicina Veterinária, Guarda Nacional Republicana (GNR), Rua Presidente Arriaga, 9, 1200-771, Lisbon, Portugal. .,MED - Mediterranean Institute for Agriculture, Environment and Development, Instituto de Investigação e Formação Avançada, Universidade de Évora , Pólo da Mitra, Ap. 94, 7006-554, Évora, Portugal.
| | - A Santos
- Divisão de Medicina Veterinária, Guarda Nacional Republicana (GNR), Rua Presidente Arriaga, 9, 1200-771, Lisbon, Portugal
| | - P Jorge
- Divisão de Medicina Veterinária, Guarda Nacional Republicana (GNR), Rua Presidente Arriaga, 9, 1200-771, Lisbon, Portugal
| | - C Lavrador
- MED - Mediterranean Institute for Agriculture, Environment and Development, Instituto de Investigação e Formação Avançada, Universidade de Évora , Pólo da Mitra, Ap. 94, 7006-554, Évora, Portugal
| | - L Miguel Carreira
- Faculty of Veterinary Medicine, University of Lisbon (FMV/ULisboa), Lisbon, Portugal.,Interdisciplinary Centre for Research in Animal Health (CIISA), University of Lisbon, FMV/ULisboa, Lisbon, Portugal.,Anjos of Assis Veterinary Medicine Centre (CMVAA), Barreiro, Portugal
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Janssens LAA, Daems R, Pillin L, Vandekerckhove P, Van Dongen S. Triple pelvic osteotomy with a 12.5° and a 20° Slocum-type plate: A short-term prospective clinical pilot study in 38 dogs. Vet Surg 2020; 49:1449-1457. [PMID: 32706139 DOI: 10.1111/vsu.13471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 04/11/2020] [Accepted: 05/15/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To determine whether using 12.5° Slocum-like triple pelvic osteotomy (TPO) plates would create sufficient femoral head coverage and lower the occurrence of overrotation compared with using 20° TPO plates in dogs with hip dysplasia. STUDY DESIGN Prospective clinical study. SAMPLE POPULATION Thirty-five dogs with hip dysplasia (38 hips). METHODS Nineteen hips were surgically treated with a custom-made Slocum-type 12.5° TPO plate, and these were matched to 19 hips surgically treated with a 20° commercial Slocum TPO plate. Hips were case matched according to size and breed. Ortolani sign, angles of subluxation and reduction, distraction index, and femoral head coverage (FHC) were compared between groups. Excessive coverage was defined as >80%. RESULTS In the 12.5° group, FHC was ≥50% in all hips, with mean FHC (67%), gain (37%), and excessive coverage (11%) all significantly less than in the 20° group (79%, 54%, and 42%, respectively). CONCLUSION The 12.5° plate produced sufficient FHC compared with the 20° plate, with fewer hips with excessive coverage. CLINICAL SIGNIFICANCE The 12.5° TPO plate may result in sufficient FHC with a lower occurrence of excessive coverage compared with 20° plates.
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Affiliation(s)
- Luc A A Janssens
- Evidensia Specialist Clinic for Referral Surgery in Companion Animals, Waalwijk, The Netherlands
| | - Robert Daems
- Clinic for Orthopaedic Surgery Malpertuus, Heusden, Belgium
| | - Lorenzo Pillin
- Referral Clinic for Companion Animals, Barendrecht, The Netherlands
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Jenkins PL, James DR, White JD, Black AP, Fearnside SM, Marchevsky AM, Miller AJ, Cashmore RG. Assessment of the medium- to long-term radiographically confirmed outcome for juvenile dogs with hip dysplasia treated with double pelvic osteotomy. Vet Surg 2020; 49:685-693. [PMID: 32170777 DOI: 10.1111/vsu.13404] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 01/10/2020] [Accepted: 02/15/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess the medium- to long-term radiographically confirmed outcomes in juvenile dogs with hip dysplasia (HD) that did and did not undergo double pelvic osteotomy (DPO). STUDY DESIGN Retrospective case-controlled. ANIMALS Twenty-six dogs with HD that were candidates for DPO; 22 dogs underwent DPO (16 bilateral, six unilateral); four dogs did not. METHODS Initial and follow-up radiographs of DPO candidates (2011-2017) that did and did not undergo surgery were reviewed, and the British Veterinary Association and Kennel Club Hip Dysplasia Scheme score (BVA-HD), osteoarthritis score (OAS) and laxity index score (LI) were determined. Baseline and follow-up BVA-HD, OAS, and change in radiographically confirmed scores were compared by using analysis of variance for correlated samples. RESULTS There was no significant difference in BVA-HD or OAS between surgically treated and nonsurgically treated cohorts at baseline. Follow-up radiographs (median, 49 months) revealed that most (34/38) hips had a BVA-HD ≤10 after DPO, while four of eight hips from the nonsurgical cohort had BVA-HD >10. Follow-up BVA-HD and OAS were lower in hips after surgery (BVA-HD median 2.15, interquartile range [Q1-Q3] 1.3-4.1; OAS median 1.9, Q1-Q3 1.1-4.1) compared with the nonsurgically treated cohort (BVA-HD median 11.4, Q1-Q3 8.1-17.5, P < .01; OAS median 7.0, Q1-Q3 5.1-13.4, P < .01). Seven hips with an LI >1 had no radiographically confirmed progression of osteoarthritis after DPO. CONCLUSION Double pelvic osteotomy prevented radiographically confirmed progression of osteoarthritis in the medium- to long-term. Laxity index score > 1 was not a contraindication for DPO in this study. CLINICAL SIGNIFICANCE Double pelvic osteotomy prevents progression of radiographically confirmed features of osteoarthritis in juvenile dogs with HD.
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Affiliation(s)
- Paul L Jenkins
- Surgery Department, Small Animal Specialist Hospital, Sydney, New South Wales, Australia
| | - Daniel R James
- Surgery Department, Small Animal Specialist Hospital, Sydney, New South Wales, Australia
| | - Joanna D White
- Medicine Department, Small Animal Specialist Hospital, Sydney, New South Wales, Australia
| | - Anthony P Black
- Surgery Department, Small Animal Specialist Hospital, Sydney, New South Wales, Australia
| | - Stephen M Fearnside
- Surgery Department, Small Animal Specialist Hospital, Sydney, New South Wales, Australia
| | - Andrew M Marchevsky
- Surgery Department, Small Animal Specialist Hospital, Sydney, New South Wales, Australia
| | - Amanda J Miller
- Surgery Department, Small Animal Specialist Hospital, Sydney, New South Wales, Australia
| | - Ricky G Cashmore
- Surgery Department, Small Animal Specialist Hospital, Sydney, New South Wales, Australia
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Ulfelder EH, Hudson CC, Beale BS. Correlation of distraction index with arthroscopic findings in juvenile dogs with hip dysplasia. Vet Surg 2019; 48:1050-1057. [PMID: 31222781 DOI: 10.1111/vsu.13265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 04/27/2019] [Accepted: 05/25/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To compare distraction index (DI) with hip arthroscopy findings in juvenile dogs with hip dysplasia undergoing unilateral or bilateral double pelvic osteotomy (DPO). STUDY DESIGN Retrospective case series. ANIMALS Twenty dogs (36 hip joints). METHODS Medical records from dogs undergoing unilateral or bilateral DPO (2011-2016) were reviewed. Distraction index was measured by using distraction view radiographs. Arthroscopic images were analyzed. Cartilage was graded by using the modified Outerbridge scale (0 = arthroscopically normal, 1 = chondromalacia, 2 = surface fibrillation, 3 = deep fissuring, 4 = full-thickness cartilage loss, and 5 = eburnation of exposed subchondral bone). Dorsal acetabular rim, acetabular labrum, the ligament of head of the femur, and synovitis were graded by using a four-point scale (normal, mild, moderate, severe). Spearman and Pearson correlations were used to compare DI between grade groups and age. RESULTS Distraction index ranged from 0.4 to 1.0 (mean 0.69 ± 0.16). Most of the hips had an arthroscopically normal femoral head and acetabulum in most regions, except for the region at the insertion of the ligament of the head of the femur. There was a low positive correlation between synovitis and DI (Spearman ρ = 0.35, P = .0346). No other differences in DI were identified between grade or age groups. CONCLUSION There was a low positive correlation between synovitis and DI. No other differences in DI were identified. CLINICAL SIGNIFICANCE Arthroscopic evaluation of the coxofemoral joint prior to DPO can allow detection of joint pathology that might not be appreciated by using traditional radiographic screening criteria.
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Affiliation(s)
- Emily H Ulfelder
- Department of Small Animal Surgery, Angell Animal Medical Center, Boston, Massachusetts
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Guevara F, Franklin SP. Triple Pelvic Osteotomy and Double Pelvic Osteotomy. Vet Clin North Am Small Anim Pract 2017; 47:865-884. [DOI: 10.1016/j.cvsm.2017.02.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ginja M, Gaspar AR, Ginja C. Emerging insights into the genetic basis of canine hip dysplasia. VETERINARY MEDICINE-RESEARCH AND REPORTS 2015; 6:193-202. [PMID: 30101106 PMCID: PMC6070022 DOI: 10.2147/vmrr.s63536] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Canine hip dysplasia (CHD) is the most common inherited polygenic orthopedic trait in dogs with the phenotype influenced also by environmental factors. This trait was described in the dog in 1935 and leads to a debilitating secondary hip osteoarthritis. The diagnosis is confirmed radiographically by evaluating signs of degenerative joint disease, incongruence, and/or passive hip joint laxity. There is no ideal medical or surgical treatment so prevention based on controlled breeding is the optimal approach. The definitive CHD diagnosis based on radiographic examination involves the exposure to ionizing radiation under general anesthesia or heavy sedation but the image does not reveal the underlying genetic quality of the dog. Phenotypic expression of CHD is modified by environmental factors and dogs with a normal phenotype can be carriers of some mutations and transmit these genes to their offspring. Programs based on selection of dogs with better individual phenotypes for breeding are effective when strictly applied but remain inferior to the selection of dogs based on estimation of breeding values. Molecular studies for dissecting the genetic basis of CHD are ongoing, but progress has been slow. In the future, the recommended method to improve hip quality in controlled breeding schemes, which will allow higher selection pressure, would be based on the estimation of the genomic breeding value. Since 2012, a commercial DNA test has been available for Labrador Retrievers using a blood sample and provides a probability for development of CHD but we await evidence that this test reduces the incidence or severity of CHD.
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Affiliation(s)
- Mário Ginja
- Department of Veterinary Sciences-CITAB, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal,
| | - Ana Rita Gaspar
- Department of Veterinary Sciences-CITAB, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal,
| | - Catarina Ginja
- Ce3C - Centro de Ecologia, Evolução e Alterações Ambientais, Faculdade de Ciências, Universidade de Lisboa, Lisboa, Portugal.,CIBIO-InBIO - Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, Vairão, Portugal
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Pinna S, Pizzuti E, Carli F. Effects of intertrochanteric varus osteotomy on Norberg angle and percent coverage of the femoral head in displastic dogs. J Vet Sci 2013; 14:185-91. [PMID: 23814471 PMCID: PMC3694190 DOI: 10.4142/jvs.2013.14.2.185] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2012] [Revised: 08/03/2012] [Accepted: 10/23/2012] [Indexed: 11/25/2022] Open
Abstract
This study was conducted to assess the effects of femoral varus osteotomy on joint congruency in dogs affected by early stage hip dysplasia. Preoperative planning to move the femoral head within the acetabulum was carried out. Varisation of the femoral inclination angle (fIA) was achieved by Intertrochanteric Osteotomy (ITO). Norberg angle (NA), percent coverage (PC) of the femoral head by the acetabulum and fIA was measured from preoperative, immediate postoperative and first and second recheck radiographs of seven dogs that underwent an ITO (joint n = 9). There was significant (p < 0.05) improvement of both NA and PC in all patients as indicated by a change in the mean ± standard deviation of 78.9° ± 7.5 and 36.9% ± 5.2 to 92.2° ± 6.7 and 50.6% ± 8.3, respectively. No significant difference (p < 0.05) was observed between the values of the planned femoral inclination angle (pfIA) of the femur and the effective femoral inclination angle (efIA) obtained after surgery (115.9° ± 2.5 and 111.3° ± 6.4, respectively). These findings could encourage the use of ITO in veterinary practice and indicate that intertrochanteric varus osteotomy should be re-considered for the treatment of early stage hip dysplasia in dogs with radiological signs of joint incongruency.
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Affiliation(s)
- Stefania Pinna
- Department of Veterinary Clinical Sciences, University of Bologna, 40064 Ozzano Emilia, Italy.
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13
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Seibert R, Marcellin-Little DJ, Roe SC, DePuy V, Lascelles BDX. Comparison of Body Weight Distribution, Peak Vertical Force, and Vertical Impulse as Measures of Hip Joint Pain and Efficacy of Total Hip Replacement. Vet Surg 2012; 41:443-7. [DOI: 10.1111/j.1532-950x.2012.00957.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Rachel Seibert
- Comparative Pain Research Laboratory; Department of Clinical Sciences; College of Veterinary Medicine; North Carolina State University; Raleigh; NC
| | - Denis J. Marcellin-Little
- Orthopedic Research Laboratory, Department of Clinical Sciences; College of Veterinary Medicine; North Carolina State University; Raleigh; NC
| | - Simon C. Roe
- Orthopedic Research Laboratory, Department of Clinical Sciences; College of Veterinary Medicine; North Carolina State University; Raleigh; NC
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14
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Abstract
Hip dysplasia is a common orthopaedic developmental disorder of dogs. This paper reviews the treatment options available for management of the condition in the skeletally immature and adult dog.
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Affiliation(s)
- A Anderson
- Anderson Abercromby Veterinary Referrals, 1870 Building, Jayes Park Courtyard, Forest Green Road, Ockley, Surrey RH5 5RR
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15
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Ginja MMD, Silvestre AM, Gonzalo-Orden JM, Ferreira AJA. Diagnosis, genetic control and preventive management of canine hip dysplasia: a review. Vet J 2009; 184:269-76. [PMID: 19428274 DOI: 10.1016/j.tvjl.2009.04.009] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2008] [Revised: 04/03/2009] [Accepted: 04/06/2009] [Indexed: 11/17/2022]
Abstract
Despite expensive screening and breeding programmes, hip dysplasia (HD) continues to be one of the most common orthopaedic diseases in dogs. The vast majority of dogs afflicted with HD show minimal to no clinical signs, but it can also be a highly debilitating condition for both working and pet dogs. Hip joint laxity is considered a major risk factor for the development of degenerative joint disease and a definitive diagnosis is made if characteristic signs are evident on a ventrodorsal view of the pelvis. Early prediction of the condition can be made using stress radiographic techniques to evaluate the passive hip laxity. The diagnosis of HD may be used for the purpose of selecting breeding stock or to decide on the best treatment approach. Breeding programmes based on individual dog phenotypes have been ineffective and a selection procedure based on breeding value (BV) estimation is recommended. Traditional conservative and surgical treatment approaches are reserved for dogs with overt clinical signs of the disease but such treatments can be expensive and aggressive, and are often ineffective in eliminating clinical signs or subluxation and in preventing the development of degenerative joint disease. The implementation of breeding programmes based on BVs and further research into early prediction/diagnosis of HD and effective preventive treatment approaches are essential.
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Affiliation(s)
- M M D Ginja
- Department of Veterinary Science - CITAB, University of Trás-os-Montes e Alto Douro, 5001-801 Vila Real, Portugal.
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16
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Manley PA, Adams WM, Danielson KC, Dueland RT, Linn KA. Long-term outcome of juvenile pubic symphysiodesis and triple pelvic osteotomy in dogs with hip dysplasia. J Am Vet Med Assoc 2007; 230:206-10. [PMID: 17223752 DOI: 10.2460/javma.230.2.206] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare long-term outcomes of juvenile pubic symphysiodesis (JPS) and triple pelvic osteotomy (TPO) in dogs with hip dysplasia. DESIGN Prospective clinical trial. ANIMALS 18 dogs with hip dysplasia (ie, distraction index > or = 0.5 in at least 1 hip joint and no, mild, or moderate radiographic evidence of degenerative joint disease [DJD]). PROCEDURES Dogs between 4 and 5.5 months old at enrollment were assigned to undergo JPS, and dogs between 5 and 12 months old were assigned to undergo TPO. All dogs were reexamined at 2 years of age. RESULTS At 2 years of age, there were no significant differences between groups in regard to lameness scores, angle of extension of the hip joints, distraction index, peak vertical force, acetabular angle, radiographic DJD score, or owner-assigned scores of clinical function. Dorsal acetabular rim angle was significantly higher in dogs that underwent JPS than in dogs that underwent TPO. For dogs that underwent TPO, dorsal acetabular rim angle was significantly decreased and acetabular angle was significantly increased at 2 years of age, compared with values obtained prior to surgery. CONCLUSIONS AND CLINICAL RELEVANCE Results suggest that JPS and TPO have similar effects on hip joint conformation in dogs with moderate to severe hip dysplasia but that neither procedure eliminates the hip joint laxity characteristic of hip dysplasia or the progression of degenerative changes.
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Affiliation(s)
- Paul A Manley
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706, USA
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17
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Holsworth IG, Schulz KS, Kass PH, Scherrer WE, Beale BS, Cook JL, Hornof WJ. Comparison of arthroscopic and radiographic abnormalities in the hip joints of juvenile dogs with hip dysplasia. J Am Vet Med Assoc 2005; 227:1087-94. [PMID: 16220668 DOI: 10.2460/javma.2005.227.1091] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare radiographic and arthroscopic abnormalities in juvenile dogs with clinically apparent hip dysplasia. DESIGN Case series. ANIMALS 52 dogs (70 hip joints) with clinical signs of hip dysplasia scheduled to undergo triple pelvic osteotomy. PROCEDURE A ventrodorsal radiographic projection of the pelvis was evaluated by a radiologist unaware of clinical and arthroscopic findings, and radiographic osteoarthritic abnormalities were judged and scored as absent (0), mild (1), moderate (2), or severe (3). Arthroscopy was performed by a surgeon unaware of clinical and radiographic findings, and arthroscopic abnormalities were graded from 0 (normal) to 5 (exposed, eburnated subchondral bone). RESULTS In 30 of the 70 (43%) hip joints, no radiographic osteoarthritic abnormalities were seen. Severe, full-thickness articular cartilage lesions (grade 4) of the femoral head or acetabulum were seen arthroscopically in 14 (20%) joints. Lesions > or = grade 2 were seen in 60 (86%) joints. Partial tearing of the ligament of the femoral head was present in 57 (81%) joints, and complete rupture was seen in 5 (7%). Radiographic abnormalities were seen in 13 of the 14 (93%; 95% confidence interval, 66% to 99.8%) joints with grade 4 arthroscopic abnormalities but in only 23 of the 46 (50%; 95% confidence interval, 35% to 65%) joints with grade 2 or 3 arthroscopic abnormalities. CONCLUSIONS AND CLINICAL RELEVANCE Results suggest that radiography is not a sensitive method for identifying moderate cartilage lesions in juvenile dogs with hip dysplasia. If moderate cartilage lesions are an important prognostic indicator for the success of triple pelvic osteotomy, then methods other than radiography should be used to detect these lesions.
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Affiliation(s)
- Ian G Holsworth
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA 95616, USA
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18
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Whelan MF, McCarthy RJ, Boudrieau RJ, Kraus KH. Increased Sacral Screw Purchase Minimizes Screw Loosening in Canine Triple Pelvic Osteotomy. Vet Surg 2004; 33:609-14. [PMID: 15659016 DOI: 10.1111/j.1532-950x.2004.04091.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To determine if screw loosening in triple pelvic osteotomies (TPO) is minimized when screws cranial to the ilial osteotomy had maximal sacral purchase. STUDY DESIGN Prospective study. ANIMALS Forty-six dogs with decreased acetabular coverage of the femoral head and minimal degenerative joint changes. METHODS TPOs were performed where screws cranial to the ilial osteotomy were inserted to maximally engage sacral bone. Data collected were: use of ilial and ischial cerclage wire, screw length, ventrodorsal radiographic sacral width (most caudal aspect), pelvic canal diameter, and sacral penetration of the 3 cranial screws. On all subsequent radiographs, changes in screw position, pelvic canal diameter, and sacral purchase were noted. RESULTS For 69 TPOs, 414 screws were used. Mean radiographic cranial screw length was 34.54 mm. Combined sacral depth of all 3 screws was 93.3% of sacral width. All osteotomies healed uneventfully. Twenty-four screws (6%) loosened with 12 being in the most cranial positions. Use of ischial or ilial cerclage wires did not statistically influence screw loosening. Pelvic diameter decreased by a mean of 7.79% from postoperative radiographs to the last radiographic recheck. CONCLUSIONS By sufficiently engaging the sacrum with screws cranial to the ilial osteotomy, implant failures can be avoided and screw loosening minimized when a 6-hole TPO plate is used. CLINICAL RELEVANCE To minimize screw-loosening in TPO, screws inserted cranial to the ilial osteotomy should be inserted to maximum sacral depth without penetrating the vertebral canal.
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Affiliation(s)
- Megan F Whelan
- Department of Clinical Sciences, Tufts University School of Veterinary Medicine, 200 Westboro Road, N. Grafton, MA 01536, USA
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Gordon WJ, Conzemius MG, Riedesel E, Besancon MF, Evans R, Wilke V, Ritter MJ. The relationship between limb function and radiographic osteoarthrosis in dogs with stifle osteoarthrosis. Vet Surg 2003; 32:451-4. [PMID: 14569573 DOI: 10.1053/jvet.2003.50051] [Citation(s) in RCA: 101] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To evaluate the relationship between limb function and radiographic evidence of stifle osteoarthrosis (OA) in dogs. STUDY DESIGN The relationship between force platform data and radiographic OA score was evaluated on 2 separate days using regression analysis. Interday variation was also assessed. ANIMALS Forty-one dogs with visible lameness and radiographic evidence of stifle OA. METHODS Force platform data were collected at a velocity of 1.7 to 2.0 m/s for 5 trials on day 1 and day 8. Radiographs taken on day 1 were scored using a previously reported OA scoring system. RESULTS No significant relationship was found between force platform data and OA score. No significant differences were found between any day 1 and day 8 force platform values. CONCLUSIONS Although radiographic evidence of stifle OA provides evidence of pathology, it does a poor job of representing limb function. In addition, the absence of significant differences between day 1 and day 8 values in this population of dogs supports use of only a single force platform evaluation before measuring a treatment effect. CLINICAL RELEVANCE The presence of OA in the stifle joint does not correlate with clinical function; radiographic outcome should be used cautiously as a predictor of clinical outcome.
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Affiliation(s)
- Wanda J Gordon
- Department of Clinical Sciences, Iowa State University College of Veterinary Medicine, Ames, IA 50011, USA
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Borostyankoi F, Rooks RL, Kobluk CN, Reed AL, Littledike ET. Results of single-session bilateral triple pelvic osteotomy with an eight-hole iliac bone plate in dogs: 95 cases (1996-1999). J Am Vet Med Assoc 2003; 222:54-9. [PMID: 12523481 DOI: 10.2460/javma.2003.222.54] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate feasibility of single-session bilateral triple pelvic osteotomy with 8-hole iliac bone plates in dogs with bilateral hip dysplasia. DESIGN Retrospective study. ANIMALS 95 dogs with bilateral hip dysplasia. PROCEDURE Medical records were reviewed, and information was obtained on signalment; body weight; angles of subluxation and reduction prior to surgery; durations of surgery and hospitalization; postoperative mobility; severity of lameness, radiographic grade of hip dysplasia, Norberg angle, and femoral head coverage before and after surgery; time required for radiographic evidence of iliac healing; change in pelvic diameter; implant integrity; and complications. RESULTS Mean age at the time of surgery was 10.8 months, and mean weight was 35.2 kg (77.4 lb). Prior to surgery, mean angles of subluxation were 2.2 degrees on the right and 2.6 degrees on the left; mean angles of reduction were 25.9 degrees on the right and 27.3 degrees on the left. Mean surgical time was 95 minutes. All but 1 dog were able to walk on their own by the fourth day after surgery. Mean hospitalization time was 7.5 days. Clinical signs of lameness and radiographic grade of hip dysplasia were significantly improved during follow-up examinations. Mean time for radiographic iliac healing was 8 weeks. None of the plates and only 7 of the 1,520 (0.5%) screws loosened after surgery. Nineteen dogs had complications, but all complications were minor. CONCLUSIONS AND CLINICAL RELEVANCE Results suggest that single-session bilateral triple pelvic osteotomy with 8-hole iliac bone plates is effective for treatment of dogs with bilateral hip dysplasia.
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Affiliation(s)
- Frank Borostyankoi
- All-Care Animal Referral Center, 18440 Amistad St, Fountain Valley, CA 92708, USA
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Tomlinson JL, Cook JL. Effects of degree of acetabular rotation after triple pelvic osteotomy on the position of the femoral head in relationship to the acetabulum. Vet Surg 2002; 31:398-403. [PMID: 12094355 DOI: 10.1053/jvet.2002.33598] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To assess the effect of rotating the acetabulum 20 degrees and 30 degrees on percent coverage (PC) of the femoral head by the acetabulum and Norberg angle (NA) after triple pelvic osteotomy (TPO). STUDY DESIGN Retrospective study. ANIMAL POPULATION Fifty-six client-owned dogs. METHODS PC and NA were measured from preoperative, immediate postoperative, first recheck, and second recheck radiographs to compare the effects of 20 degrees and 30 degrees of rotation of the acetabulum after TPO for treatment of hip dysplasia. RESULTS Within the 20 degrees rotation group, PC and NA values were significantly greater at each subsequent evaluation time starting at the preoperative measurement except for NA between the first and second recheck times. Within the 30 degrees rotation group, PC and NA values were significantly greater at each subsequent evaluation time starting at the preoperative measurement except for PC and NA between the first and second recheck times. No significant differences between the 20 degrees and 30 degrees rotation groups were found at any corresponding times for either PC or NA. CONCLUSIONS Acetabular rotation of 20 degrees provided the same degree of improvement in acetabular femoral head coverage as 30 degrees of rotation after TPO at the immediate postoperative, first recheck, and second recheck evaluation times. CLINICAL RELEVANCE Based on PC and NA, 20 degrees rotation of the acetabulum provides as much benefit as 30 degrees of acetabular rotation when performing a TPO.
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Affiliation(s)
- James L Tomlinson
- Comparative Orthopedic Laboratory, College of Veterinary Medicine, University of Missouri, Columbia, MO 65211, USA
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Dueland RT, Adams WM, Fialkowski JP, Patricelli AJ, Mathews KG, Nordheim EV. Effects of pubic symphysiodesis in dysplastic puppies. Vet Surg 2001; 30:201-17. [PMID: 11340551 DOI: 10.1053/jvet.2001.23350] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To determine the long-term effects of juvenile pubic symphysiodesis (JPS) in dysplastic puppies. STUDY DESIGN Prospective, randomized, clinical trial. ANIMALS Seven dysplastic Chesapeake Bay retrievers and 2 beagle-crosses (BX1 and 2). METHODS Five puppies had JPS performed with electrocauterization at 12, 16, 20, 22, and 24 weeks of age, respectively. Two puppies served as controls. BX1 and BX2 were used to obtain biopsies of the symphysis. Hips were evaluated for: pelvic development (transverse computerized tomography for acetabular angle [AA] and dorsal acetabular rim angle [DARA]); laxity [hip extended and stress radiography [distraction index (DI)]); Ortolani maneuver with reduction angles; acetabular coverage (Norberg angles); and function (coxofemoral range of motion, hip pain, and gait analysis by force-plate technique at 44 and 137 weeks of age). RESULTS The pubis fused prematurely in every puppy that was operated on with the JPS technique. Greater acetabular responses were related to younger ages at surgery. The final mean AA in dogs that had JPS was 25 degrees greater than preoperative values; 40% increased over control. The DARA final mean was 10 degrees, 52% less than preoperative values and 46% less than control. The final mean DI in dogs having JPS was 0.28, 47% improved over preoperative values and 58% better than control. Mean pelvic dimensions in dogs that had JPS were 18% less than control. Gait analyses were normal for all dogs at 137 weeks. No urinary or bowel complications occurred. CONCLUSIONS Significant ventrolateral acetabular rotation, increased hip coverage, diminished hip laxity, normal pain-free gait, and insignificantly reduced pelvic size occurred after JPS. CLINICAL SIGNIFICANCE Dysplastic hips in young dogs were significantly improved by JPS.
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Affiliation(s)
- R T Dueland
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI 53706, USA
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Swainson SW, Conzemius MG, Riedesel EA, Smith GK, Riley CB. Effect of public symphysiodesis on pelvic development in the skeletally immature greyhound. Vet Surg 2000; 29:178-90. [PMID: 10730711 DOI: 10.1111/j.1532-950x.2000.00178.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate the effect of pubic symphysiodesis (PS) on pelvic development in skeletally immature dogs. STUDY DESIGN Prospective randomized clinical trial. ANIMALS Eight 4 month-old, sexually intact female Greyhounds. METHODS Initial PS was performed at 4 months of age using a powered stapling device. Because of failure of the initial surgery, a second PS was performed 1 month later by resecting the pubic symphysis with a rongeur followed by placement of handmade bone staples in four dogs. Sham PS was performed in four control dogs at 4 months of age. Pubic growth rate and pelvic development were evaluated using standard plane radiography and computed tomography. Specific measurements included acetabular ventroversion, Norberg angle, lateral center-edge angle, and pelvic inlet dimensions. Hip distraction indices were determined as well. RESULTS PS at 4 months of age using a stapling device failed. Pubic symphysiodesis using hand made staples was successful at 5 months of age and did not result in any clinically significant intraoperative or postoperative complications. Pubic symphysiodesis markedly decreased pubic symphysis growth in the treatment group. Hip distraction indices and pelvic inlet circumference, area, and width significantly decreased in treated dogs compared to those in the control group. Acetabular ventroversion was significantly increased in treated dogs compared to those in the control group. CONCLUSIONS PS decreases pelvic canal size, increases acetabular ventroversion, and does not appear to have any clinically significant complications. CLINICAL RELEVANCE PS performed in skeletally immature dogs with hip dysplasia may provide an effect similar to a triple pelvic osteotomy and warrants further investigation.
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Affiliation(s)
- S W Swainson
- Department of Veterinary Clinical Sciences, Iowa State University, Ames 50011-1250, USA
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