scholarly journals CORR Insights™: Can a Triple Pelvic Osteotomy for Adult Symptomatic Hip Dysplasia Provide Relief of Symptoms for 25 Years?

2012 ◽  
Vol 471 (2) ◽  
pp. 591-592
Author(s):  
Matthew B. Dobbs
Keyword(s):  
Hip Dysplasia ◽  
Pelvic Osteotomy

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

1998 ◽  
Vol 11 (02) ◽  
pp. 85-93 ◽  
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.

Evaluation of Sacroiliac Wedge Rotation to Increase Acetabular Ventroversion

1999 ◽  
Vol 12 (04) ◽  
pp. 173-177 ◽  
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.

Implant Complications in 20 Triple Pelvic Osteotomies

1993 ◽  
Vol 06 (04) ◽  
pp. 202-207 ◽  
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.

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

1997 ◽  
Vol 10 (02) ◽  
pp. 101-110 ◽  
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.

scholarly journals Efficacy of Triple Pelvic Osteotomy in Canine Hip Dysplasia

2014 ◽  
Vol 71 (2) ◽  
Author(s):  
Marius MUSTE ◽  
Aurel TANASE ◽  
Florin BETEG ◽  
Aurel MUSTE ◽  
Radu LACATUS ◽  
...  
Keyword(s):  
Hip Dysplasia ◽  
Pelvic Osteotomy ◽  
Canine Hip Dysplasia

scholarly journals Management of late-detected DDH in children under three years of age

2020 ◽  
Vol 1 (4) ◽  
pp. 55-63
Author(s):  
Terje Terjesen ◽  
Joachim Horn
Keyword(s):  
Closed Reduction ◽  
Hip Dysplasia ◽  
Skeletal Maturity ◽  
Pelvic Osteotomy ◽  
Radiological Outcome ◽  
Femoral Head Coverage ◽  
Spontaneous Improvement ◽  
Skin Traction ◽  
Dislocation Of The Hip

Aims When the present study was initiated, we changed the treatment for late-detected developmental dislocation of the hip (DDH) from several weeks of skin traction to markedly shorter traction time. The aim of this prospective study was to evaluate this change, with special emphasis on the rate of stable closed reduction according to patient age, the development of the acetabulum, and the outcome at skeletal maturity. Methods From 1996 to 2005, 49 children (52 hips) were treated for late-detected DDH. Their mean age was 13.3 months (3 to 33) at reduction. Prereduction skin traction was used for a mean of 11 days (0 to 27). Gentle closed reduction under general anaesthesia was attempted in all the hips. Concurrent pelvic osteotomy was not performed. The hips were evaluated at one, three and five years after reduction, at age eight to ten years, and at skeletal maturity. Mean age at the last follow-up was 15.7 years (13 to 21). Results Stable closed reduction was obtained in 36 hips (69%). Open reduction was more often necessary in patients ≥ 18 months of age at reduction (50%) compared with those under 18 months (24%). Residual hip dysplasia/subluxation occurred in 12 hips and was significantly associated with avascular necrosis (AVN) and with high acetabular index and low femoral head coverage the first years after reduction. Further surgery, mostly pelvic and femoral osteotomies to correct subluxation, was performed in eight hips (15%). The radiological outcome at skeletal maturity was satisfactory (Severin grades 1 or 2) in 43 hips (83%). Conclusions Gentle closed reduction can be attempted in children up to three years of age, but is likely to be less successful in children aged over 18 months. There is a marked trend to spontaneous improvement of the acetabulum after reduction, even in patients aged over 18 months and therefore simultaneous pelvic osteotomy is not always necessary.

scholarly journals The Use of Sixty Degree Rotation of the Acetabulum for Treatment of Dogs With Canine Hip Dysplasia. A Short Case Series

2021 ◽  
Vol 8 ◽  
Author(s):  
Horia Elefterescu ◽  
Ciprian Andrei Ober ◽  
Andrei Timen ◽  
Christos Yiapanis ◽  
William McCartney ◽  
...  
Keyword(s):  
Hip Dysplasia ◽  
Case Series ◽  
Pelvic Osteotomy ◽  
Term Outcome ◽  
Secondary Osteoarthritis ◽  
Clinical Consequences ◽  
The Mean ◽  
Canine Hip Dysplasia ◽  
Mean Time

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.

scholarly journals Chiari pelvic osteotomy in treatment of hip dysplasia

2013 ◽  
Vol 141 (9-10) ◽  
pp. 710-714 ◽  
Author(s):  
Nemanja Slavkovic ◽  
Zoran Vukasinovic ◽  
Milan Apostolovic ◽  
Boris Vukomanovic
Keyword(s):  
Femoral Head ◽  
Distal Part ◽  
Hip Dysplasia ◽  
Young Patients ◽  
Pelvic Osteotomy ◽  
Femoral Head Coverage ◽  
Developmental Hip Dysplasia ◽  
Chiari Osteotomy ◽  
Chiari Pelvic Osteotomy

Chiari pelvic osteotomy is a surgical procedure having been performed for almost sixty years in patients with the insuffcient coverage of the femoral head. It is most frequently used in young patients with dysplastic acetabular sockets as a part of developmental hip dysplasia. Even though performance of the Chiari osteotomy is associated with positive therapeutical results, above all, its main goal is to delay inevitable degenerative changes. Original surgical technique has been modified and improved over time. Nevertheless, the basic idea has remained unchanged - increasing of the femoral head coverage by medial displacement of the distal part of the pelvis along with capsular interpositioning. Given the complexity of operation, the complication percentage is rather low. Chiari pelvic osteotomy has lost its actuality and importance during this past six decades. The role of Chiari pelvic osteotomy has been considerably taken over by other more efficient and more lasting surgical procedures. Nonetheless, Chiari pelvic osteotomy is still present in modern orthopedic practice, above all as ?salvage? osteotomy.

Traumatic Coxofemoral Luxation in Dysplastic Dogs Managed with a Triple Pelvic Osteotomy: Results in four Dogs

1997 ◽  
Vol 10 (03) ◽  
pp. 136-140 ◽  
Author(s):  
D. D. Lewis ◽  
S. C. Kerwin ◽  
S. T. Murphy
Keyword(s):  
Femoral Head ◽  
Hip Dysplasia ◽  
External Rotation ◽  
Pelvic Osteotomy ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Contralateral Limb ◽  
Norberg Angle

SummaryTriple pelvic osteotomy (TPO) was used in the treatment for traumatic coxofemoral luxations in four adult, large breed dogs with hip dysplasia. Initial closed reductions failed in three and one dog had an initial closed reduction and subsequent open reduction of the coxofemoral luxation that failed. Hip dysplasia was thought to be a prominent factor contributing to the reluxation. TPO successfully maintained reduction of the coxofemoral luxation in all of the dogs. An increase in dorsal acetabular coverage of the femoral head following TPO was demonstrated by an increased Norberg angle. The improved congruency was thought to maintain reduction of the femoral head in the acetabulum and decrease stresses on the joint capsule, allowing healing to occur. Long-term (median: 343, mean ± SD: 406 ± 226 days follow-up) function of the affected limb was comparable to the contralateral limb. Three of the four dogs did not have radiographic progression of coxofemoral degenerative joint disease of the affected joint and differences in the progression of degenerative joint disease were not evident between the affected and the contralateral coxofemoral joint. A decrease in abduction and external rotation and an increase in internal rotation following TPO was noted in the affected coxofemoral joint. Our results establish the utility of this procedure in dysplastic dogs with traumatic coxofemoral luxations.Triple pelvic osteotomy used in the treatment for traumatic coxofemoral luxation in four adult, large breed dogs with hip dysplasia successfully maintained reduction and resulted in satisfactory limb function in all patients.

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