scholarly journals Juvenile pubic symphysiodesis associated with pectineus myectomy for treatment of hip dysplasia in dog

2021 ◽  
Vol 49 ◽  
Author(s):  
Daniel Munhoz Garcia Perez Neto ◽  
Leonardo Augusto Lopes Muzzi ◽  
Fernando Yoiti Kitamura Kawamoto ◽  
Caio Afonso dos Santos Malta ◽  
Laura Lourenço Freitas ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Femoral Head ◽  
Hip Joint ◽  
Hip Dysplasia ◽  
Weight Bearing ◽  
Clinical Signs ◽  
Radiographic Examination ◽  
Acetabular Coverage ◽  
Hip Joints ◽  
Limb Muscles

Background: Hip dysplasia (HD) is the most common non-traumatic orthopedic disease in large breed dogs. Treatment is chosen according to the severity of the condition, the age of the dog and the involvement of osteoarthritis (OA). For puppies up to 20-weeks-old, surgical treatment by the juvenile pubic symphysiodesis (JPS) technique can be performed. This procedure promotes the ventrolateral rotation of the acetabulum over the femoral head, which improves hip joint congruence and stability. The objective of this study is to report the case of a young dog with HD treated with JPS and pectineus myectomy. Clinical and radiographic outcomes were assessed for up to one year after surgery.Case: A 17-week-old Saint Bernard puppy was attended at the University Veterinary Hospital showing abnormal weight bearing and lameness in pelvic limbs, without history of previous trauma. On orthopedic examination, there was a marked hypotrophy of the pelvic limb muscles, severe pain and laxity in the hip joints, and positive feature in the Ortolani test. The hip joint subluxation angle (SA) and reduction angle (RA) were measured. A radiographic study was carried out to evaluate the hip joints and measure the Norberg angle (NA), distraction index (DI), acetabular angle (AA) and dorsal acetabular rim angle (DARA). The 20-week-old dog underwent surgical treatment by JPS technique. A ventral surgical approach to the pubis was performed and the pubic symphysis was cauterized with electrocautery. Partial pectineus myectomy technique was also performed. Drug therapy and restriction of physical activities were indicated in the early postoperative. The dog was evaluated by clinical and radiographic examinations at 4 months and 1 year after the surgical procedure. In the reassessment after 4 months of surgical treatment, the patient showed improvement in clinical signs, with mild lameness and absence of painful sensitivity in the movement of the hip joints. Radiographically, hip joint incongruity was observed, but with progressive improvement in the values of the measured variables. In the clinical examination 1 year after the procedure, the dog showed satisfactory weight bearing with slight lameness in pelvic limbs in the running gait. There was improvement in the thigh muscles and no painful signs were observed in the hip joints, but a positive result was detected in the Ortolani test. In the radiographic examination, bilateral articular incongruity was still observed, however, there was a mild improvement in the coverage of the acetabulum over the femoral head. The measured angles and indices showed favorable results regarding the recovery of hip joint stability and proper development.Discussion: Studies evaluating the JPS technique for the treatment of HD have shown to be a relatively simple and effective procedure, which allows altering the acetabular coverage, reducing the development of HD and the progression of OA. The need for an early diagnosis of this condition is essential, so that the JPS technique can be used in young dogs and offer effective results. In the present report, in the late postoperative period, the dog showed improvement in clinical signs, with favorable weight bearing and ambulation in pelvic limbs, recovery of limb muscles, absence of pain in the hip joints and decrease in RA and SA. Radiographically, the reduction in joint subluxation, improvement in acetabular coverage over femoral heads, increase in NA and AA, reduction in DI and DARA are evidence of the favorable outcome of ventrolateral rotation of the acetabulum after surgical treatment. The surgical technique used was effective, which enabled the dog to recover the functional use of the pelvic limbs and improve the quality of life.Keywords: hip dysplasia, juvenile pubic symphysiodesis, hip joint, osteoarthritis, dog.Título: Sinfisiodese púbica juvenil associada à miectomia do pectíneopara tratamento de displasia coxofemoral em cãoDescritores: displasia coxofemoral, sinfisiodese púbica juvenil, coxofemoral, osteoartrite.

scholarly journals Dysplastic Hip Joint Configuration After Bernese Periacetabular Osteotomy

2021 ◽  
Author(s):  
Kamil Kołodziejczyk ◽  
Adam Czwojdziński ◽  
Andrzej Sionek ◽  
Jarosław Czubak
Keyword(s):  
Surgical Treatment ◽  
Femoral Head ◽  
Normal Distribution ◽  
Hip Joint ◽  
Hip Dysplasia ◽  
Periacetabular Osteotomy ◽  
Hip Joints ◽  
Radiological Parameters ◽  
Significant Difference ◽  
Dysplastic Hip

Abstract Background: Residual hip dysplasia is one of the factors contributing to early hip joint osteoarthritis. The main problems caused by residual dysplasia are pain and instability of the hip joint caused by the lack of sufficient bony covering of the femoral head. The aim of this work was to radiologically assess the configuration change of a dysplastic hip joint after surgical treatment using the Bernese periacetabular osteotomy procedure.Methods: We assessed the radiological parameters of patients with hip dysplasia treated by Bernense periacetabular osteotomy by performing a digital antero-posterior pelvis X-ray: central edge angle and femoral head coverage, medialization, distalization and ilio-ischial angle parameters. For normally distributed parameters, we used Student’s t-test; for parameters without a normal distribution, we used the Wilcoxon signed-rank test. Correlations were assessed according to a normal distribution using the Pearson and Spearman method.Results: For all parameters, we observed statistically significant differences in the measurements of dysplastic hip joints before and after the surgery. We also observed a statistically significant difference between the structure of dysplastic hip joints prior to the surgery and healthy hip joints from the control group based on all radiological parameters. The resulting medialization was 2.68 mm, distalization was 3.65 mm, and the ilio-ischial angle was changed by 2.62°. There was also an improvement in the femoral head bony covering: CEA by 17.61° and FHC by 16.46%.Conclusions: Based on all the radiological parameters, we presented the difference between healthy and dysplastic hip joints. Learning the parameter values that are used to describe dysplastic hip joints will allow us to improve the imaging of the condition and will also allow for better planning and proper qualification of patients for surgical treatment of hip joint dysplasia.Trial registration: Consent of the bioethics commission Medical Centre of Postgraduate Education 83/PB/2015 18.11.2015 Warsaw

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.

Asymmetrical lumbosacral transitional vertebrae in dogs may promote asymmetrical hip joint development

2017 ◽  
Vol 30 (02) ◽  
pp. 137-142 ◽  
Author(s):  
Frank Steffen ◽  
Michael Hässig ◽  
Joseph Morgan ◽  
Mark Flückiger
Keyword(s):  
Femoral Head ◽  
Hip Joint ◽  
Hip Dysplasia ◽  
Transverse Process ◽  
Hip Joints ◽  
Secondary Osteoarthritis ◽  
Pelvic Rotation ◽  
Lumbosacral Transitional Vertebra ◽  
Lumbosacral Transitional Vertebrae ◽  
Canine Hip Dysplasia

Summary Objectives: This study examines the relationship between the morphology of the lumbosacral transitional vertebra (LTV) and asymmetrical development of the hip joints in dogs. Methods: A total of 4000 dogs which had been consecutively scored for canine hip dysplasia were checked for the presence of a LTV. A LTV was noted in 138 dogs and classified depending on the morphology of the transverse processes and the degree of contact with the ilium. Results: In dogs with an asymmetrical LTV, the hip joint was significantly more predis-posed to subluxation and malformation on the side of the intermediate or sacral-like transverse process (p <0.01), on the side of the elevated pelvis (p <0.01), or when an asymmetrical LTV resulted in pelvic rotation on its long axis (p <0.01), whereas hip joint conformation was less affected on the side featuring a free transverse process (p <0.01). Clinical significance: The results support our hypothesis that an asymmetrical LTV favours pelvic rotation over its long axis, resulting in inadequate femoral head coverage by the acetabulum on one side. Inadequate coverage of the femoral head favours subluxation, malformation of the hip joint, and secondary osteoarthritis. Asymmetrical hip conformation may therefore be the sequela of a LTV and mask or aggravate genetically induced canine hip dysplasia.

Relationship of peroxidation indicators and hemograms in children with hip joint pathology

2021 ◽  
Vol 66 (2) ◽  
pp. 104-109
Author(s):  
M. P. Teplen’kiy ◽  
E. L. Matveeva ◽  
E. S. Spirkina ◽  
A. G. Gasanova
Keyword(s):  
Lipid Peroxidation ◽  
Femoral Head ◽  
Hip Joint ◽  
Hip Dysplasia ◽  
Stage Ii ◽  
Perthes Disease ◽  
Antioxidant Protection ◽  
Aseptic Necrosis ◽  
Joint Pathology ◽  
Group I

The increase in the number of patients with hip pathologies among children of different ages makes the diagnosis and treatment of these diseases one of the most actually existing problems in modern orthopedics. The aim of the work was to determine the features of the lipid peroxidation system - antioxidant protection and hemogram indices in children with various forms of hip joint pathology. The results of a preoperative examination of 47 patients aged 6-15 years (average age 10.3 years) who were treated at the clinic “FSBI NICC“ TO ”named after academician G. A. Ilizarova, Ministry of Health of the Russian Federation. There were 25 boys and 20 girls. Given nosology, patients were divided into five groups. The diagnosis was established on the basis of a clinical and radiological examination. Group I consisted of 8 male patients with stage II Perthes disease (mean age 8.75 + 1.63). Group II includes 16 patients (8 boys, 7 girls) with stage III Perthes disease. (average age 11.80 + 0.89). Group III included 12 patients (6 boys, 6 girls) with aseptic necrosis of the femoral head (average age 14.7 + 2.35). Group IV consisted of 4 patients (1 boy, 3 girls) with epiphyseal dysplasia. (average age 10.25 + 1.36). Group V includes 7 patients with hip dysplasia complicated by aseptic necrosis of the femoral head (mean age 8.33 + 2.11). The norm is the data that was obtained after examining 10 healthy male adolescents (age 13-14) and 5 female adolescents (age 8-14 years). Changes in lipid peroxidation rates and antioxidant activity are unidirectional in different forms of pathology of the hip joints in children, and the content of peroxidation products reliably correlates with hemogram values in stage II osteochondropathy and complicated hip dysplasia. In the complex of diagnostic measures for children with dystrophic lesions of the hip joint, to clarify the nature and stage of the pathological process, as additional criteria, hemogram indicators and lipid peroxidation systems - antioxidant protection can be used.

Early Diagnosis of Hip Dysplasia – A Stress-Radiographic Study

1995 ◽  
Vol 08 (02) ◽  
pp. 114-117 ◽  
Author(s):  
J. S. Madsen ◽  
E. Svalastoga
Keyword(s):  
Femoral Head ◽  
Early Diagnosis ◽  
Hip Dysplasia ◽  
Radiographic Examination ◽  
Radiographic Evaluation ◽  
Radiographic Study ◽  
German Shepherd ◽  
Lateral Dislocation ◽  
The Future ◽  
Maximal Reduction

SummaryPresently, the diagnosis of hip dysplasia is based on a single pelvic radiographic examination of the dog at the age of 12 to 24 months. However, by this method, only a static appearance of the coxofemoral joint is evaluated. The purpose of our study was to diagnose hip dysplasia in young dogs and consequently, we included a radiographic evaluation of the dynamic appearance of the coxofemoral joint.A stress-radiographic examination was applied to 23 German Shepherd Dogs at the age of six and 12 months to obtain maximal reduction and maximal dislocation of the coxofemoral joint. Finally, at the age of 12 months, the hips were examined radiographically using the conventional criteria for hip dysplasia.At the age of six months, dogs with hip dysplasia showed significantly greater joint laxity and lateral dislocation of the femoral head than normal dogs. However, some predysplastic dogs, with lateral dislocation of the femoral head, developed normal hips and would be approved for breeding. Based on these findings, we conclude that stress-radiographic examinations of young dogs provide important, hitherto unrecognized, information of relevance in the future screening programmes to reduce the incidence of hip dysplasia.A stress-radiographic examination of young dogs provides important, hitherto unrecognized, information of relevance in the future screening programmes to reduce the incidence of hip dysplasia.

scholarly journals Management of osteonecrosis of the femoral head in children with sickle cell disease: results of conservative and operative treatments at skeletal maturity

2018 ◽  
Vol 12 (1) ◽  
pp. 47-54
Author(s):  
C. Mallet ◽  
A. Abitan ◽  
C. Vidal ◽  
L. Holvoet ◽  
K. Mazda ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Femoral Head ◽  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Skeletal Maturity ◽  
Weight Bearing ◽  
Long Term Results ◽  
Harris Hip Score ◽  
Cell Disease ◽  
Femoral Head Osteonecrosis

Purpose Sickle cell disease (SCD) is the most common cause of femoral head osteonecrosis (ONFH) during childhood with an overall prevalence of 10%. In children, spontaneous revascularization can occur, as in Legg-Calve-Perthes disease. Consequently, the aim of treatment is to restore proper hip containment to prevent joint arthritis. This is the first study reporting long-term results at skeletal maturity of non-operative and surgical treatments for ONFH in SCD children. Methods All children with ONFH due to SCD were retrospectively reviewed. At initial evaluation, extension of osteonecrosis was radiographically defined using Catterall, lateral pillar Herring and Ficat classifications. Subluxation of the femoral head with Reimers migration index > 30% required surgical treatment including femoral varus osteotomy and/or pelvic osteotomies. Conservative treatment including non-weight bearing and physiotherapy was performed in the remaining cases. Outcomes were assessed at skeletal maturity using the Harris Hip Score (HHS) and the Stulberg classification. Total hip arthroplasty and Stulberg 5 were defined as failures. Results A total of 25 hips in 17 patients were included (mean follow-up 7.5 years SD 3.4). Mean age at diagnosis was 11.4 years SD 2.9. In all, 15 hips (60%) were classified Catterall 3 and 4 and Herring B and C. A total of 13 patients (52%) underwent surgical treatment. At skeletal maturity, mean HHS was good (81 SD 17), 12 hips (48%) were classified Stulberg 1 and 2, seven hips (28%) were classified Stulberg 3 and 4. Conclusion Both treatments led to good functional results with 75% of congruent hips at skeletal maturity. Level of Evidence IV

scholarly journals Transposition of the great trochanter: A look at the problem

2021 ◽  
Vol 9 (2) ◽  
pp. 195-202
Author(s):  
Ivan Y. Pozdnikin ◽  
Pavel I. Bortulev ◽  
Dmitry B. Barsukov ◽  
Vladimir E. Baskov
Keyword(s):  
Surgical Treatment ◽  
Femoral Neck ◽  
Range Of Motion ◽  
Hip Joint ◽  
Proximal Femur ◽  
Great Trochanter ◽  
Clinical Parameters ◽  
Greater Trochanter ◽  
Hip Joints ◽  
High Position

BACKGROUND: Multiplanar deformity of the proximal femur with a high position of the greater trochanter is one of the most common residual deformities of the hip joint. The VeauLamy transposition of the greater trochanter does not fully treat the mutual trauma of the components of the hip joint, as it only brings down the greater trochanter to provide tension for the gluteal muscles. AIM: This study aimed to share the experience of performing transposition of the greater trochanter according to our proposed technique. MATERIALS AND METHODS: The study included 15 patients (15 hip joints) aged 916 years with a high position of the greater trochanter of the femur, who underwent surgical treatment in the period from 2018 to 2019. In addition to the actual transposition of the greater trochanter, the intervention provided a modeling resection of the base (bed) of the greater trochanter and the formation of an offset of the femoral neck. RESULTS: Patients were followed up for period of up to 30 months. All patients showed positive changes after surgical treatment with improvement of radiological and clinical parameters. CONCLUSIONS: The proposed intervention allows restoration of the function of the gluteal muscles, improves the range of motion in the hip joint, and prevents and treats extra-articular impingement syndrome.

scholarly journals Dysfunction in the hip joints in children with Charcot-Marie-Tooth syndrome (literature review)

2015 ◽  
Vol 3 (3) ◽  
pp. 52-56
Author(s):  
Ivan Yurievich Pozdnikin
Keyword(s):  
Early Diagnosis ◽  
Hip Joint ◽  
Clinical Signs ◽  
Sensory Neuropathy ◽  
Disease Diagnosis ◽  
Lower Limbs ◽  
Foot Deformities ◽  
Hip Joints ◽  
Charcot Marie Tooth ◽  
Reconstructive Operations

A review of the literature on the treatment of children with dysfunction in the hip joints in motor-sensory neuropathy Charcot-Marie-Tooth is presented. Peculiarities of disease diagnosis and the approach used in the treatment of patients are described. The Charcot-Marie-Tooth syndrome is a hereditary neuromuscular disease characterized by progressive atrophy of the distal muscle group of the lower limbs. According to international authors, the incidence of hip joint dysfunction in this condition is at least 10%, ranking second only to foot deformities. In the Russian literature, the problem has not been adequately interpreted. Early diagnosis of dysfunction in the hip joints during Charcot-Marie-Tooth syndrome is complicated by the child's age and is characterized by progression. Conflicting clinical signs and trivial symptoms of the disease also confuse diagnosis, until it becomes clearer in adolescence or the second or third decade of life. Surgical reconstructive operations on the hip joint often occur too late, and they are accompanied by a greater frequency of neurological complications. Practitioner awareness coupled with an early diagnosis of hip subluxation and decentration and complex orthopedic and neurological examinations of children with the disease of Charcot-Marie-Tooth should result in more favorable outcomes.

scholarly journals Orthopaedic and Neurologic Aspects of Early Coxarthrosis Development in Children with Hip Dysplasia

2016 ◽  
Vol 23 (1) ◽  
pp. 55-61
Author(s):  
N. Kh Bakhteeva ◽  
G. A Korshunova ◽  
V. V Zotkin ◽  
I. A Norkin
Keyword(s):  
Spinal Cord ◽  
Surgical Treatment ◽  
Motor Neurons ◽  
Functional Activity ◽  
Peripheral Nerves ◽  
Hip Dysplasia ◽  
Clinical Course ◽  
Healthy Children ◽  
Hip Joints ◽  
Conservative And Surgical Treatment

Comparison of clinical-roentgenologic and electroneuromyographic data was performed for 29 patients, aged 3 - 16 years, at different stages of conservative and surgical treatment for hip joints dysplasia. First group included 18 patients with complicated clinical course; second - 11 patients with favorable process of joint formation. Functional activity of motor neurons, spinal cord and peripheral nerves conductivity was assessed. It was shown that in patients from the 1st group the ENMG indices were statistically significantly lower than in healthy children ( р

scholarly journals Surgical Treatment of Severe Idiopathic Flexible Flatfoot by Evans–Mosca Technique in Adolescent Patients: A Long-Term Follow-Up Study

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Vincenzo De Luna ◽  
Fernando De Maio ◽  
Alessandro Caterini ◽  
Martina Marsiolo ◽  
Lidio Petrungaro ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Weight Bearing ◽  
Radiographic Examination ◽  
Radiographic Evaluation ◽  
Foot And Ankle ◽  
Flexible Flatfoot ◽  
Adolescent Patients ◽  
The Mean

Flexible idiopathic flatfoot is very common in growing age and rarely causes pain or disability. Surgery is indicated only in severe symptomatic cases that are resistant to conservative treatment, and numerous surgical procedures have been proposed. Lateral column calcaneal lengthening as described by Evans and modified by Mosca is a widely used surgical technique for the correction of severe symptomatic flexible flatfoot. In the present study, we report the long-term clinical and radiographic results in 14 adolescent patients (mean age: 12.8 years) affected by severe symptomatic flexible flatfoot, surgically treated by Evans–Mosca procedure, for a total of 26 treated feet (12 cases bilateral and 2 unilateral). In all cases, surgery was indicated for the presence of significant symptoms resistant to nonsurgical management. Clinical evaluation was made according to the American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale, the Foot and Ankle Disability Index (FADI) Score, and Yoo et al.’s criteria. Radiographic evaluation was made using anteroposterior and lateral weight-bearing radiographs of the feet to evaluate Meary’s angle and Costa–Bertani’s angle and to evaluate possible osteoarthritic changes in the midtarsal joints. At follow-up (mean: 7 years and 7 months), we observed a satisfactory result in all patients. The mean average score of the AOFAS Ankle-Hindfoot Scale improved from 60.03 points to 95.26; the mean FADI score improved from 71.41 to 97.44; and according to Yoo et al.’s criteria, the average clinical outcome score was 10.96. At radiographic examination, nonunion of the calcaneal osteotomy was never observed. Meary’s angle improved from an average preoperative value of 25° to 1.38° at follow-up; Costa–Bertani’s angle improved from an average preoperative value of 154.2° to 130.9° at follow-up. In no case, significant radiographic signs of midtarsal joint arthritis were observed. According to our results, we believe that Evans–Mosca technique is a valid option of surgical treatment for severe idiopathic flexible flatfoot and allows a satisfactory correction of the deformity with a low rate of complications.

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