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.

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.

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.

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.

scholarly journals Endoscopically controlled surgery with open hemilaminectomy for the treatment of intradural extramedullary tumors: an operative technique and short-term outcomes of 20 consecutive cases

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Xiaorong Yan ◽  
Huiqing Wang ◽  
Cai Li ◽  
Yuanxiang Lin ◽  
Lin Lin ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Spinal Deformity ◽  
Tumor Recurrence ◽  
Clinical Symptoms ◽  
Short Term ◽  
Before And After ◽  
Intradural Extramedullary ◽  
Controlled Surgery

Abstract Background To present a surgical technique for the treatment of intradural extramedullary (IDEM) tumors by using endoscopically controlled surgery with open hemilaminectomy technique. Methods In this study, 20 patients with 22 IDEM tumors were enrolled. An endoscopically controlled surgery with open hemilaminectomy was employed to remove the tumors. Data related to clinical symptoms and medical images before and after surgery were collected for perioperative evaluation and follow-up analysis. Results All the tumors in 20 patients were well removed. The clinical symptoms were significantly reduced in all the patients as well. The short-term follow-up data showed that there was no tumor recurrence or spinal deformity. Conclusion The endoscopically controlled surgery with open hemilaminectomy technique provided favorable exposure and satisfactory resection to the IDEM tumors. It may be an effective surgical method for treating IDEM tumors. Larger samples and longer follow-up data are needed to verify its long-term effectiveness.

scholarly journals Endoscopically-controlled surgery with open hemi-laminectomy for the treatment of intradural extramedullary tumors: An operative technique and short-term outcomes of 20 consecutive cases

2020 ◽  
Author(s):  
Xiaorong Yan ◽  
Huiqing Wang ◽  
Cai Li ◽  
Yuanxiang Lin ◽  
Lin Lin ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Spinal Deformity ◽  
Tumor Recurrence ◽  
Clinical Symptoms ◽  
Short Term ◽  
Before And After ◽  
Intradural Extramedullary ◽  
Controlled Surgery

Abstract Background To present a surgical technique for the treatment of intradural extramedullary (IDEM) tumors by using endoscopically-controlled surgery with open hemi-laminectomy technique. Methods In this study, 20 patients with 22 IDEM tumors were enrolled. An endoscopically-controlled surgery with open hemi-laminectomy was employed to remove the tumors. Data related to clinical symptoms and medical images before and after surgery were collected for perioperative evaluation and follow-up analysis. Results All the tumors in 20 patients were well removed. The clinical symptoms were significantly reduced in all the patients as well. The short term follow-up data showed that there was no tumor recurrence or spinal deformity. Conclusion The endoscopically-controlled surgery with open hemi-laminectomy technique provided favorable exposure and satisfactory resection to the IDEM tumors. It may be an effective surgical method for treating IDEM tumors. Larger samples and longer follow-up data are needed to verify its long-term effectiveness.

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 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 &gt; 0.05). The pelvic thickness showed an increase with the degree of rotation on the dependent side (P &lt; 0.05) and a slight decrease on the non-dependent side (P &gt; 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 &lt; 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 Partial resection of the posterior wall for hip dislocation in severe acetabular protrusio

2020 ◽  
Vol 1 (7) ◽  
pp. 431-437
Author(s):  
Hugo A. Rodriguez ◽  
Felipe Viña ◽  
Meilyn A. Muskus
Keyword(s):  
Femoral Head ◽  
Surgical Technique ◽  
Hip Arthroplasty ◽  
Hip Dislocation ◽  
Posterior Wall ◽  
Partial Resection ◽  
Hip Arthroplasties ◽  
Acetabular Protrusio

Aims In elderly patients with osteoarthritis and protrusio who require arthroplasty, dislocation of the hip is difficult due to migration of the femoral head. Traditionally, neck osteotomy is performed in situ, so this is not always achieved. Therefore, the purpose of this study is to describe a partial resection of the posterior wall in severe protrusio. Methods This is a descriptive observational study, which describes the surgical technique of the partial resection of the posterior wall during hip arthroplasty in patients with severe acetabular protrusio operated on between January 2007 and February 2017. Results In all, 49 hip arthroplasties were performed. The average age of patients was 60 years, and idiopathic was the most frequent aetiology of protrusio. All patients were treated with femoral head autograft and no intra- or postoperative complications were reported. No patients required revision surgery. Conclusion Partial resection of the posterior wall demonstrated to be a safe surgical technique with 100% survival in a follow-up to ten years in total hip arthroplasty due to severe acetabular protrusio. Cite this article: Bone Joint Open 2020;1-7:431–437.

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.

The influence of epidural anaesthesia on femoral overlap and Norberg angle in the hip joint of young dysplastic dogs

2003 ◽  
Vol 16 (03) ◽  
pp. 127-131 ◽  
Author(s):  
L. A. A. Janssens ◽  
B. C. W. Ballieu ◽  
P. M. F. P. Vandekerckhove
Keyword(s):  
Retrospective Study ◽  
Hip Joint ◽  
Epidural Anaesthesia ◽  
Pelvic Osteotomy ◽  
Before And After ◽  
Norberg Angle

SummaryA retrospective study of 61 dogs that underwent triple pelvic osteotomy evaluated the effect of the epidural anaesthesia on the hip laxity as measured by the femoral overlap and Norberg angle before and after epidural anaesthesia. Both the femoral overlap and the Norberg angle measured on the non-operated hip decreased significantly after epidural anaesthesia. (p < 0.0001 and p < 0.001, respectively).

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