Neuromuscular Hip Dysplasia: Reconstruction with a Proximal Varus Derotational Osteotomy with Blade Plate Fixation and a Volume Reducing Pelvic Osteotomy

SummaryThe triple pelvic osteotomy (TPO) is commonly performed for immature dogs with hip dysplasia despite screw loosening being a prevalent complication. A technique to diminish the incidence of screw loosening by reducing motion at the ilial osteotomy and reducing implant migration, was evaluated. Standard triple pelvic osteotomies, and triple pelvic osteotomies with additional ventral plate stabilization, were performed and biomechanically evaluated in canine cadaver pelves. Additional ventral plate fixation was found to significantly improve axial bending stiffness of TPOs. In vitro cyclical loading, performed in a manner to approximate post-operative weight-bearing, determined that additional ventral plate fixation significantly decreased the incidence of screw loosening and motion at the osteotomy site.

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Force Plate Analysis of Dogs with Bilateral Hip Dysplasia Treated with a Unilateral Triple Pelvic Osteotomy: A Long-term Review of Cases

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0038-1632616 ◽

1998 ◽

Vol 11 (02) ◽

pp. 85-93 ◽

Cited By ~ 10

Author(s):

Joanne R. Cockshutt ◽

H. Dobson ◽

C. W. Miller ◽

D. L. Holmberg ◽

Connie L. Taves ◽

...

Keyword(s):

Gait Analysis ◽

Hip Dysplasia ◽

Weight Bearing ◽

Force Plate ◽

Case Series ◽

Pelvic Osteotomy ◽

Vertical Force ◽

Long Term Outcome ◽

Case Series Study

SummaryA retrospective case series study was done to determine the long-term outcome of operations upon dogs treated for canine hip dysplasia by means of a triple pelvic osteotomy (TPO). Twentyfour dogs with bilateral hip dysplasia, that received a unilateral TPO between January 1988 and June 1995, were re-examined at the Ontario Veterinary College. The assessment included physical, orthopedic and lameness examinations, standard blood work, pelvic radiographs and force plate gait analysis. They were compared to bilaterally dysplastic dogs that had not been treated, and also to normal dogs. Force plate data analysis demonstrated a significant increase in peak vertical force (PVF) and mean vertical force over stance (MVF) in the limb that underwent surgical correction by means of a TPO, when compared to the unoperated hip. It was determined that performing a unilateral TPO on a young dysplastic dog resulted in greater forces and weight bearing being projected through the TPO corrected limb when compared to the unoperated limb.Dogs with bilateral hip dysplasia treated with a unilateral triple pelvic osteotomy (TPO) were assessed by force plate gait analysis, radiographs and orthopedic examination. There was a significant increase in hip Norberg angles over time, although degenerative changes did progress. Limbs that had been operated upon had significantly greater peak and mean ground reaction forces than limbs that had not received an operation.

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Evaluation of Sacroiliac Wedge Rotation to Increase Acetabular Ventroversion

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0038-1632486 ◽

1999 ◽

Vol 12 (04) ◽

pp. 173-177 ◽

Cited By ~ 2

Author(s):

R. L. Aper ◽

M. D. Brown ◽

M. G. Conzemius

Keyword(s):

Hip Joint ◽

Hip Dysplasia ◽

Clinical Effect ◽

Pelvic Osteotomy ◽

Alternative Method ◽

Angular Measurements ◽

Si Joint ◽

In Vivo Effects ◽

Canine Hip Dysplasia

SummaryTreatment of canine hip dysplasia (CHD) via triple pelvic osteotomy (TPO) is widely accepted as the treatment that best preserves the existing hip joint. TPO, however, has several important disadvantages. In an effort to avoid some of the difficulties associated with TPO an alternative method of creating acetabular ventroversion (AW) was sought. The purpose of this study was to explore the effects of placement of a wedge in the sacroiliac (SI) joint on A W and to compare this to the effect of TPO on A W . On one hemipelvis a 30° pelvic osteotomy plate was used for TPO. The contralateral hemipelvis had a 28° SI wedge inserted into the SI joint. Pre- and postsurgical radiographs of each pelvis were taken and the angular measurements were recorded. On average, the 28° SI wedge resulted in 20.9° of A W, the 30° canine pelvic osteotomy plate resulted in 24.9° A W . Significant differences were not found (p >0.05) between the two techniques. Sacroiliac wedge rotation effectively creates A W and has several theoretical advantages when compared to TPO. The in vivo effects of sacroiliac wedge rotation should be studied in order to evaluate the clinical effect of the technique.Sacroiliac wedge rotation was tested as an alternative method to increase the angle of acetabular ventroversion. This technique effectively rotated the acetabulum and has several theoretical advantages when compared to triple pelvic osteotomy.

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Implant Complications in 20 Triple Pelvic Osteotomies

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0038-1633059 ◽

1993 ◽

Vol 06 (04) ◽

pp. 202-207 ◽

Cited By ~ 19

Author(s):

Cindy Fries ◽

Audrey Remedios

Keyword(s):

Postoperative Complication ◽

Hip Dysplasia ◽

Pelvic Osteotomy ◽

Implant Failure ◽

Screw Loosening ◽

Common Complication ◽

Implant Complications ◽

Gait Abnormalities

SummaryIn 12 dogs with hip dysplasia, 20 triple pelvic osteotomies (eight bilateral and four unilateral) were performed. Screw loosening, occurring in six of 12 dogs (seven of 20 osteotomies), was the most common complication after surgery. Implants loosened from the cranial ilium in six hemipelvises (30%) and from both fragments in one hemipelvis, two to six weeks (mean — three) after the operation. Medial acetabular displace-ment caused pelvic narrowing (6 to 9%, mean = 8%) in three of four dogs. Medial ischial displacement decreased pelvic diameter (11 to 21%, mean = 17%) in four of seven osteotomies. All of the dogs with implant failure were treated conservatively with cage rest and in two cases Ehmer slings were used. Although none were lame, gait abnormalities were evident in three of seven dogs on follow-up examinations four to 12 months (mean = six) later.Screw loosening, occurring in seven of 20 hemipelvises, was the most common postoperative complication associated with triple pelvic osteotomy. Fixation failures were managed conservatively. Despite decreased pelvic diameter in four of seven animals, none were lame or showed signs of pelvic obstruction at follow-up examinations four to 12 months later.

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BLADE-PLATE FIXATION IN NON-UNION AND IN COMPLICATED FRACTURES OF THE SUPRACONDYLAR REGION OF THE FEMUR

The Journal of Bone and Joint Surgery (American) ◽

10.2106/00004623-194931020-00009 ◽

1949 ◽

Vol 31 (2) ◽

pp. 312-316 ◽

Cited By ~ 19

Author(s):

Alfons R. Altenberg ◽

Richard L. Shorkey

Keyword(s):

Plate Fixation ◽

Non Union ◽

Blade Plate

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Long-term Results of Conservative Treatment, Excision Arthroplasty and Triple Pelvic Osteotomy for the Treatment of Hip Dysplasia in the Immature Dog

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0038-1632578 ◽

1997 ◽

Vol 10 (02) ◽

pp. 101-110 ◽

Cited By ~ 19

Author(s):

J. Dupuis ◽

G. Beauregard ◽

N. H. Bonneau ◽

L. Breton ◽

J. Planté

Keyword(s):

Femoral Head ◽

Conservative Treatment ◽

Head And Neck ◽

Hip Dysplasia ◽

Clinical Signs ◽

Pelvic Osteotomy ◽

Long Term Results ◽

Radiographic Examination ◽

Conservative Group ◽

Excision Arthroplasty

SummaryThe efficiency of conservative treatment, excision arthroplasty of the femoral head and neck and triple pelvic osteotomy for the treatment of hip dysplasia in the immature dog were compared using locomotor, physical and radiographic examinations and owner’s evaluation. Cases selected for this study were dogs diagnosed with bilateral hip dysplasia, initially admitted with clinical signs (lameness, pain), immature at the beginning of the treatment (less than 12 months of age), with both hips subjected to the same treatment (conservative treatment, excision arthroplasty of the femoral head and neck or triple pelvic osteotomy). These dogs never showed any musculoskeletal problems other than hip dysplasia and the surgical treatment had been completed at least 20 months prior to re-evaluation time. Fourteen hips were re-evaluated in the conservative group, 16 in the triple pelvic osteotomy group and ten in the excision arthroplasty group. Locomotor, physical and owner’s evaluations demonstrated the superiority of the triple pelvic osteotomy. These evaluations also showed that excision arthroplasty was more efficient than conservative treatment. Radiographic examination demonstrated the obvious superiority of the triple pelvic osteotomy over conservative treatment.Locomotor, physical and owner’s evaluations demonstrated the superiority of the triple pelvic osteotomy over conservative treatment and excision arthroplasty for the treatment of hip dysplasia in the immature dog. Radiographic examination demonstrated the obvious superiority of the triple pelvic osteotomy over conservative treatment for joint congruence and control of degenerative joint disease.

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