scholarly journals Effects of pelvis rotation on the projected radiographic position of the femoral head in relationship to the acetabulum

2017 ◽  
Vol 62 (No. 7) ◽  
pp. 377-385 ◽  
Author(s):  
J. Martins ◽  
B. Colaco ◽  
S. Alves-Pimenta ◽  
A. Ferreira ◽  
M. Ginja
Keyword(s):  
Femoral Head ◽  
Hip Dysplasia ◽  
Scoring Systems ◽  
Normal Position ◽  
Pelvis Rotation ◽  
Mean Differences ◽  
The Right ◽  
Extended View ◽  
Norberg Angle

The aim of this study was to describe the influence of pelvis rotation on the projected radiographic position of the femoral head in relationship to the acetabulum in the standard ventrodorsal hip extended view, i.e. Norberg angle, pelvic thickness at the level of the cranial effective acetabular rim, femoral head subluxation index, femoral head subluxation category and femoral head-acetabular distance. Twelve adult dogs of large and giant breeds were radiographed in standard hip extended view and with 2°, 4° and 6° of rotation on the right and left sides. Norberg angle, pelvic thickness, subluxation index, subluxation category and femoral head-acetabular distance were measured on radiographs and analysed comparing a normal position with positions of different degrees of rotation for the dependent and non-dependent side. All the studied parameters showed adequate repeatability. Norberg angle and femoral head-acetabular distance did not show significant mean differences in all degrees of rotated pelvis (P > 0.05). The pelvic thickness showed an increase with the degree of rotation on the dependent side (P < 0.05) and a slight decrease on the non-dependent side (P > 0.05). The subluxation index and subluxation category showed an increase with the degree of rotation on the dependent side and a decrease on the non-dependent side (P < 0.05). As the subluxation index and subluxation category are parameters used in the classification of the main international hip dysplasia scoring systems, pelvic rotation can impair the final hip score, especially in scoring systems that are based on the worst joint.

scholarly journals Femoral rotation and relationship between the femoral head and the acetabulum

2017 ◽  
Vol 62 (No. 11) ◽  
pp. 589-595 ◽  
Author(s):  
J. Martins ◽  
B. Colaco ◽  
S. Alves-Pimenta ◽  
JM Gonzalo Orden ◽  
A. Ferreira ◽  
...  
Keyword(s):  
Femoral Head ◽  
Hip Dysplasia ◽  
External Rotation ◽  
Scoring Systems ◽  
Trochlear Groove ◽  
Femoral Rotation ◽  
Femoral Metaphysis ◽  
Lateral Patella ◽  
Extended View ◽  
Norberg Angle

Canine hip dysplasia is a debilitating hereditary orthopaedic disease with a high prevalence in dogs. The aim of this study was to describe the influence of internal or external rotation of the femur on the projected radiographic position of the patella within the trochlear groove, and on the femoral head in relationship to the acetabulum in the standard ventrodorsal hip extended view, i.e., medial or lateral patella displacement, Norberg angle, femoral head subluxation index and femoral head subluxation category. Eleven adult dog cadavers of large and giant breeds were radiographed in standard ventrodorsal hip extended view and with internal and external femoral rotation. The medial and lateral patella displacement, Norberg angle, subluxation index and subluxation category variables were measured on radiographs, and analysed comparing the normal position with positions of different degrees of internal or external rotation of the femur. In the normal ventrodorsal hip extended view, the patella was centred within the distal femoral metaphysis (P > 0.05). A mean ± SD internal femoral rotation of 16.0 ± 5.9° resulted in a medial patella index displacement of 0.23 ± 0.09, and a mean external femoral rotation of 17.9 ± 6.7° resulted in a lateral patella index displacement of 0.24 ± 0.1. The mean Norberg angle was 105.3 ± 4.3°, 107.7 ± 5.5° and 104.2 ± 4.3° (P < 0.05); the subluxation index was 0.15 ± 0.06, 0.12 ± 0.05 and 0.18 ± 0.06 (P < 0.05); the subluxation category was 1.55 ± 0.6, 1.46 ± 0.7 (P > 0.05) and 1.96 ± 0.65 (P < 0.05) in normal, internal and external femoral rotation ventrodorsal hip extended views, respectively. In conclusion, as the Norberg angle, subluxation index and subluxation category are parameters used for classification in the main international hip dysplasia scoring systems, adequate femoral position with the patella centred in the distal metaphysis is of uppermost importance to ensure the technical quality of radiographs.

Canine hip dysplasia radiographic screening. Prevalence of rotation of the pelvis along its length axis in 7,012 conventional hip extended radiographs

2007 ◽  
Vol 20 (04) ◽  
pp. 296-298 ◽  
Author(s):  
T. Cachon ◽  
D. Fau ◽  
C. Carozzo ◽  
E. Viguier ◽  
F. Collard ◽  
...  
Keyword(s):  
Femoral Head ◽  
Hip Dysplasia ◽  
Femoral Head Coverage ◽  
Left Hand ◽  
Radiographic Screening ◽  
Pelvis Rotation ◽  
The Right ◽  
Canine Hip Dysplasia

SummaryThe prevalence of rotation of the pelvis along its length axis was noted, as was the number of rotations towards the right or left hand side of the dog, on 7,012 conventional hip extended radiographs, which were sent for official screening. 29.8% of the radiographs showed a rotation the pelvis. The rotation was statistically more frequent towards the left hand side of the dog. The number of rejected radiographs for too important pelvis rotation was only 5.2%. The consequences of the pelvis rotation on the Norberg-Olsson angle, on the dorsal femoral head coverage, and in the aspect of cranial acetabular edge have to be taken into account when scoring the dog for hip dysplasia.

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.

Comparison of the standing tangential radiographic projection of the hip with standard methods of evaluation for hip dysplasia in the dog

2004 ◽  
Vol 17 (01) ◽  
pp. 25-29
Author(s):  
L. J. Armbrust ◽  
W. C. Renberg
Keyword(s):  
Femoral Head ◽  
Hip Dysplasia ◽  
Statistical Significance ◽  
Weight Bearing ◽  
Standard Methods ◽  
Methods Of Evaluation ◽  
Norberg Angle

SummaryThe standing tangential radiographic position (STRP) of the hip is a technique that enables the clinician to visualize the femoral head and acetabulum in an unsedated patient in a weight-bearing stance. This study compared the technique to other radiographic methods of evaluating canine hips for the dysplasia. The methods were compared as to Norberg angle, Distraction Index and by use of novel measures of subluxation and coverage. A statistical significance of correlation was not seen between the STRP technique and other methods. Although a variety of explanations are discussed, the authors do not recommend the use of this technique for the evaluation of hip dysplasia.

Double pelvic osteotomy for the treatment of hip dysplasia in young dogs

2010 ◽  
Vol 23 (06) ◽  
pp. 444-452 ◽  
Author(s):  
A. Vezzoni ◽  
S. Boiocchi ◽  
A. B. Vanelli ◽  
V. Bronzo ◽  
L. Vezzoni
Keyword(s):  
Femoral Head ◽  
Surgical Technique ◽  
Hip Dysplasia ◽  
Pelvic Osteotomy ◽  
Acetabular Coverage ◽  
Pull Out ◽  
Before And After ◽  
Joint Congruity ◽  
Norberg Angle

SummaryThe aim of this study was to evaluate the feasibility of the double pelvic osteotomy (DPO) (osteotomy of the ilium and pubis) to treat clinical cases of hip dyplasia in young dogs instead of performing a triple pelvic osteotomy (TPO) (osteotomy of the ilium, pubis, and ischium). Candidates for DPO were 4.5- to nine-month-old dogs with coxofemoral joint subluxation and laxity, indicative of susceptibility to future development of severe hip dysplasia. The angle of reduction (AR) and angle of subluxation (AS) with Ortolani's sign, Norberg angle (NA), percentage of femoral head (PC) covered by the acetabulum, and the pelvic diameters and their relationships were measured clinically and radiographically before and after surgery. The surgical technique was similar to the TPO technique, but excluded ischiatic osteotomy. A DPO was carried out in 53 joints of 34 dogs AR and AS values immediately postoperatively and at the oneand two-month follow-up examinations were significantly lower than the preoperative values (p <0.01). The complications en-countered were mainly represented by implant failure (3.5%), partial plate pull-out (9.4%), and incomplete fracture of the ischial table (7.5%). Changes in PC and NA values obtained immediately after surgery and at the first and second follow-up examinations were significantly greater (p <0.01 both) than values obtained before surgery. Sufficient acetabular ventroversion was achieved to counteract joint subluxation and the modifications of AR and AS. The NA and PC direct postoperative values reflected a significant improvement in the dorsal acetabular coverage. Clinical relevance: Restoration of normal joint congruity (PC from 50 to 72%) and maintenance of the pelvic geometry without pelvic narrowing were the most intriguing features of DPO. The complications observed were greatly reduced when using dedicated DPO plates. Based on our experience, the morbidity after unilateral and bilateral DPO was lower than after TPO because elimination of the ischiatic osteotomy allowed for increased stability of the pelvis. The surgical technique of DPO was a little more demanding than TPO because of the difficulty in handling and rotating the acetabular iliac segment, but this difficulty was offset by elimination of ischial osteotomy.

scholarly journals Treatment of canine hip dysplasia using triple pelvic osteotomy

2012 ◽  
Vol 48 (No. 1 - 2) ◽  
pp. 41-46
Author(s):  
K. Altunatmaz ◽  
R. Yucel ◽  
Y. Devecioglu ◽  
M. Saroglu ◽  
S. Ozsoy
Keyword(s):  
Femoral Head ◽  
Hip Dysplasia ◽  
Pelvic Osteotomy ◽  
Hereditary Disease ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Hip Joints ◽  
Mild Dysplasia ◽  
Canine Hip Dysplasia ◽  
Norberg Angle

In this study, triple pelvic osteotomy (TPO) was carried out in a total of 22 dysplastic dogs, of which 9 were treated bilaterally and 13 unilaterally, and the position of the acetabulum was changed in a total of 31 hip joints using a special plate. It was established that, of the treated hip joints, 16 had severe, 12 medium and 3 mild dysplasia, the Norberg angle was between 70&ndash;92&deg; and that the covering rate of the acetabulum over the femoral head changed between 5&ndash;42&deg;. In the radiographs taken immediately after the operation, the covering rate of the acetabulum over the femoral head was determined to be very good in 25 hip joints (75% and over) and good in 6 joints (60&ndash;75%). In 5 cases, some of the screws holding the plate in place were seen to loosen in radiographs. However, this did not have any effect on the angle given to the acetabulum. In radiographs obtained 6&ndash;48 months later, degenerative joint disease was not encountered in 29 cases, with the exception of 2 cases. It was concluded that hip dysplasia, which is a hereditary disease, can be treated reasonably successfully in young dogs with TPO carried out before degenerative changes begin to occur in the joint.

Relation of the Norberg angle and position of the femoral head centre to the dorsal acetabular edge in evaluation of canine hip dysplasia

2010 ◽  
Vol 23 (06) ◽  
pp. 433-438 ◽  
Author(s):  
L. Skurková ◽  
M. Hluchý ◽  
M. Lacková ◽  
M. Mihalová ◽  
V. Ledecký
Keyword(s):  
Femoral Head ◽  
Scoring System ◽  
Hip Dysplasia ◽  
Diagnostic Process ◽  
Radiographic Examination ◽  
Screening Programs ◽  
Ultrasound Diagnostics ◽  
Two Parameters ◽  
Canine Hip Dysplasia ◽  
Norberg Angle

SummaryCanine hip dysplasia (CHD) is a locomotive-system disease in dogs, which in many countries is the target of screening programs aimed at reducing the prevalence of CHD among descendants of predisposed dog breeds. Despite the efforts to apply genetic testing or ultrasound diagnostics in diagnosing CHD (as is common in human medicine), the main diagnostic process in veterinary medicine is by radiographic examination. The main two parameters which are used in diagnosing HD are the Norberg angle (NA) and the position of femoral head centre to the dorsal acetabular edge (FHC/DAE). We examined the relationship between these two parameters in the process of the determination of CHD degree by evaluating 225 randomly selected radiographs which were made during the period from 1993 to 2008. The aim of our study was to examine the validity of these two parameters in CHD classification as used in three different classification programs. Using Pearson’s correlation coefficient, the value of which was 0.85 (p <0.05), we observed a positive correlation. Comparing the three scoring systems for CHD evaluation, we found that the final degree of CHD was similar for 78% to 85% of cases using Flückiger’s scoring system versus a modified scoring system of 5 parameters without FHC/DAE. Results were significant.

Awareness and Decision Making in Professional Ethics

2000 ◽  
Vol 5 (1) ◽  
pp. 19-27 ◽  
Author(s):  
Ronny Swain
Keyword(s):  
Decision Making ◽  
Professional Ethics ◽  
Ethical Decision Making ◽  
Code Of Ethics ◽  
Professional Autonomy ◽  
Ethical Awareness ◽  
Ethical Decisions ◽  
The Right ◽  
Aid Decision

The paper describes the development of the 1998 revision of the Psychological Society of Ireland's Code of Professional Ethics. The Code incorporates the European Meta-Code of Ethics and an ethical decision-making procedure borrowed from the Canadian Psychological Association. An example using the procedure is presented. To aid decision making, a classification of different kinds of stakeholder (i.e., interested party) affected by ethical decisions is offered. The author contends (1) that psychologists should assert the right, which is an important aspect of professional autonomy, to make discretionary judgments, (2) that to be justified in doing so they need to educate themselves in sound and deliberative judgment, and (3) that the process is facilitated by a code such as the Irish one, which emphasizes ethical awareness and decision making. The need for awareness and judgment is underlined by the variability in the ethical codes of different organizations and different European states: in such a context, codes should be used as broad yardsticks, rather than precise templates.

The Associations of Plasma/Serum Carotenoids with Alzheimer’s Disease: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 1-12
Author(s):  
Mingyue Qu ◽  
Hanxu Shi ◽  
Kai Wang ◽  
Xinggang Wang ◽  
Nan Yu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Meta Analysis ◽  
Scoring Systems ◽  
Serum Levels ◽  
Epidemiological Studies ◽  
Pooled Analysis ◽  
Protective Effects ◽  
Mean Differences

Background: Multiple lines of evidence indicate protective effects of carotenoids in Alzheimer’s disease (AD). However, previous epidemiological studies reported inconsistent results regarding the associations between carotenoids levels and the risk of AD. Objective: Our study aims to evaluate the associations of six major members of carotenoids with the occurrence of AD by conducting a systematic review and meta-analysis. Methods: Following PRISMA guidelines, a comprehensive literature search of PubMed, Web of Science, Ebsco, and PsycINFO databases was conducted, and the quality of each included studies was evaluated by a validated scoring systems. Standardized mean differences (SMD) with 95%confidence intervals (CI) were determined by using a random effects model. Heterogeneity was evaluated by I2 statistics. Publication bias was detected using funnel plots and Egger’s test. Results: Sixteen studies, with 10,633 participants were included. Pooled analysis showed significantly lower plasma/serum levels of lutein (SMD = –0.86, 95%CI: –1.67 to –0.05, p = 0.04) and zeaxanthin (SMD = –0.59; 95%CI: –1.12 to –0.06, p = 0.03) in patients with AD versus cognitively intact controls, while α-carotene (SMD = 0.21, 95%CI: –0.68 to 0.26, p = 0.39), β-carotene (SMD = 0.04, 95%CI: –0.57 to 0.65, p = 0.9), lycopene (SMD = –0.12, 95%CI: –0.96 to 0.72, p = 0.78), and β-cryptoxanthin (SMD = –0.09, 95%CI: –0.83 to 0.65, p = 0.81) did not achieve significant differences. Conclusion: Of six major members of carotenoids, only lutein and zeaxanthin concentrations in plasma/serum were inversely related to the risk of AD. More high-quality longitudinal studies are needed to verify these findings.

scholarly journals Reliability of the classification of cartilage and labral injuries during hip arthroscopy

2020 ◽  
Vol 7 (3) ◽  
pp. 448-457
Author(s):  
Stephanie W Mayer ◽  
Tobias R Fauser ◽  
Robert G Marx ◽  
Anil S Ranawat ◽  
Bryan T Kelly ◽  
...  
Keyword(s):  
Femoral Head ◽  
Transition Zone ◽  
Central Compartment ◽  
Classification Systems ◽  
Cartilage Injury ◽  
Intraobserver Agreement ◽  
Acetabular Cartilage ◽  
Femoral Head Cartilage ◽  
Labral Tears

Abstract To determine interobserver and intraobserver reliabilities of the combination of classification systems, including the Beck and acetabular labral articular disruption (ALAD) systems for transition zone cartilage, the Outerbridge system for acetabular and femoral head cartilage, and the Beck system for labral tears. Additionally, we sought to determine interobserver and intraobserver agreements in the location of injury to labrum and cartilage. Three fellowship trained surgeons reviewed 30 standardized videos of the central compartment with one surgeon re-evaluating the videos. Labral pathology, transition zone cartilage and acetabular cartilage were classified using the Beck, Beck and ALAD systems, and Outerbridge system, respectively. The location of labral tears and transition zone cartilage injury was assessed using a clock face system, and acetabular cartilage injury using a five-zone system. Intra- and interobserver reliabilities are reported as Gwet’s agreement coefficients. Interobserver and intraobserver agreement on the location of acetabular cartilage lesions was highest in superior and anterior zones (0.814–0.914). Outerbridge interobserver and intraobserver agreement was &gt;0.90 in most zones of the acetabular cartilage. Interobserver and intraobserver agreement on location of transition zone lesions was 0.844–0.944. The Beck and ALAD classifications showed similar interobserver and intraobserver agreement for transition zone cartilage injury. The Beck classification of labral tears was 0.745 and 0.562 for interobserver and intraobserver agreements, respectively. The Outerbridge classification had almost perfect interobserver and intraobserver agreement in classifying chondral injury of the true acetabular cartilage and femoral head. The Beck and ALAD classifications both showed moderate to substantial interobserver and intraobserver reliabilities for transition zone cartilage injury. The Beck system for classification of labral tears showed substantial agreement among observers and moderate intraobserver agreement. Interobserver agreement on location of labral tears was highest in the region where most tears occur and became lower at the anterior and posterior extents of this region. The available classification systems can be used for documentation regarding intra-articular pathology. However, continued development of a concise and highly reproducible classification system would improve communication.

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