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1.
Objective —To investigate the effect of triple pelvic osteotomy (TPO) on articular contact area and acetabular coverage of dysplastic hip joints in dogs.
Study Design —Articular contact area and femoral head coverage by the acetabulum were computed in vitro in normal and dysplastic canine hips. The effect of TPO on articular contact and coverage was then analyzed in the dysplastic hips.
Sample Population—Five normal and six dysplastic canine cadaver specimens.
Methods —Contact area and coverage of loaded hips were computed using serial computed tomography scan images before and after TPO. Three angles of acetabular ventroversion (AVV) were studied (20°, 30°, and 40°). Using a custom-designed hinge plate, angles of spontaneous hip reduction in dysplastic hips were compared with previously recorded angles of reduction determined by the Ortolani test.
Results —Contact area significantly increased from 0° to 30° of AVV, then remained virtually unchanged. Coverage significantly increased from 0° to 20° of AVV. Both contact and coverage of normal hips were similar, yet significantly smaller than those of dysplastic hips once reduction had occurred. The experimental angles of reduction were significantly smaller and poorly correlated with the angles of reduction determined by the Ortolani test. Although coverage continued to increase with AVV, the actual joint contact area did not significantly vary after relocation of the femoral head.
Conclusions —This study suggests that increasing AVV beyond 20° does not significantly improve the beneficial effects of TPO and therefore should be carefully weighed against increased risks of postoperative complications associated with large angles of AVV.  相似文献   

2.
Objective: To determine which of 3 different plate angles (20°, 25°, 30°) used in double pelvic osteotomy (DPO) would result in the most similar acetabular angle (AA) achieved with a 20° triple pelvic osteotomy (TPO) technique in dogs. Study Design: Experimental anatomic study. Animals: Cadaveric canine pelves (n=8). Methods: Transverse plane computed tomographic images of cadaveric pelves with intact sacroiliac joints, mounted in a custom jig, were made (baseline) and again after DPO (20°, 25°, 30°) and TPO (20°) and pelvic angles measured in 6 transverse planes. Pelvic angles of the 3 DPO techniques were compared with TPO using concordance correlation to determine which DPO angle resulted in an acetabular ventroversion angle closest to TPO. Results: Mean ± SD AAs were 32.89 ± 2.23 (baseline), 47.39 ± 4.39 (20° DPO), 51.43 ± 5.06 (25° DPO), 54.75 ± 4.38 (30° DPO), and 50.20 ± 5.76 (20° TPO). Concordance correlations for the AA compared with 20° TPO were 0.027 (baseline), 0.721 (20° DPO), 0.902 (25° DPO), and 0.593 (30° DPO). A concordance correlation of ≥0.8 indicates good correlation. Conclusions: A 25° DPO is most similar in acetabular ventroversion to 20° TPO (concordance correlation, 0.902).  相似文献   

3.
Triple pelvic osteotomy (TPO) is one of the surgical procedures for use to try to reduce subsequent degenerative joint disease or modify the progress of hip dysplasia in young dogs. Joint force and pressure distribution were changed by this procedure. Therefore, the aim of this study was to find out whether the remodeling of proximal femur exists or not after TPO in dysplastic dogs. Ten femora from five young dysplastic mongrel dogs, treated unilaterally with TPO using 20° canine pelvic osteotomy plates, were used. One year after TPO, neck-proximal shaft angle, femoral head, neck, diaphyseal and mid-shaft diameters, total femoral, femoral neck axis, and intertrochanteric, femoral head offset lengths as well as the lengths from head center to lateral margin of greater trochanter and to proximal femoral axis were measured from the bone. The significant differences between treatment and control side were determined in Norberg angle, neck-proximal shaft angle, neck diameter, diaphyseal diameter, mid-shaft diameter, length from head center to proximal femoral axis and femoral head offset length. In conclusion, although small number of cases was used, it was determined that the aforementioned variables are affected by TPO. So, these variables may be supply additional information about the changes to the joint following TPO in dysplastic dogs.  相似文献   

4.
OBJECTIVE: To compare long-term outcomes of juvenile pubic symphysiodesis (JPS) and triple pelvic osteotomy (TPO) in dogs with hip dysplasia. DESIGN: Prospective clinical trial. ANIMALS: 18 dogs with hip dysplasia (ie, distraction index > or = 0.5 in at least 1 hip joint and no, mild, or moderate radiographic evidence of degenerative joint disease [DJD]). PROCEDURES: Dogs between 4 and 5.5 months old at enrollment were assigned to undergo JPS, and dogs between 5 and 12 months old were assigned to undergo TPO. All dogs were reexamined at 2 years of age. RESULTS: At 2 years of age, there were no significant differences between groups in regard to lameness scores, angle of extension of the hip joints, distraction index, peak vertical force, acetabular angle, radiographic DJD score, or owner-assigned scores of clinical function. Dorsal acetabular rim angle was significantly higher in dogs that underwent JPS than in dogs that underwent TPO. For dogs that underwent TPO, dorsal acetabular rim angle was significantly decreased and acetabular angle was significantly increased at 2 years of age, compared with values obtained prior to surgery. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that JPS and TPO have similar effects on hip joint conformation in dogs with moderate to severe hip dysplasia but that neither procedure eliminates the hip joint laxity characteristic of hip dysplasia or the progression of degenerative changes.  相似文献   

5.
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6.
We describe the case of a Simmental calf with congenital unilateral hip dysplasia. In the initial physical exam, the calf was able to stand unsteady when helped and showed severe swinging lameness in the left hind limb. Unilateral hip laxity and a positive Ortolani sign indicated subluxation of the femur within the hip joint. This finding was further confirmed by radiographic examination which also showed malformation of the left femoral head and acetabulum. After a short period of clinical improvement the calf's health deteriorated and it was euthanized due to signs of severe coxarthrosis. Pathological examination of the affected hip joint revealed a severe acetabular and femoral dysplasia with an incomplete formation of the epiphysis of the femoral head and a chronic granulating coxarthritis without evidence of primary infectious events.  相似文献   

7.
An accurate method for guiding injections into the canine hip would facilitate diagnostic localization of lameness and targeted treatments. Ultrasound‐guided hip injections are commonly used in humans and large animals. Aims of this prospective study were to describe ultrasound (US) anatomy of the adult canine hip and determine the feasibility and accuracy of intra‐articular placement of injectate using US‐guidance. Seven adult dogs were used to describe US anatomy, five dog cadavers were used to assess the feasibility of the injection technique and 11 dog cadavers were used to assess accuracy of injections. For the accuracy test, 22 joints were injected with iodinated contrast medium by three operators with different experience. With dogs in lateral recumbency, the hyperechoic femoral head surface was identified by following the femoral neck from the greater trochanter or the acetabular rim was localized by following caudally the ilium from the iliac wing.  An anechoic gap between the femoral head and acetabular surface represented the joint. The capsule was visible as a triangular echoic structure and the femoral head articular cartilage appeared as an anechoic band. The needle was inserted axial to the greater trochanter and directed in a dorsolateral–ventromedial direction toward the joint space and then pushed through the capsule. Based on postinjection radiography, accuracy was 81.8% at first attempt and 100% at second attempt. This study indicated that US‐guided injection is a feasible and accurate technique for injecting the adult canine hip. Future studies in live dogs are needed to assess safety and efficacy.  相似文献   

8.
OBJECTIVE: To assess the effect of rotating the acetabulum 20 degrees and 30 degrees on percent coverage (PC) of the femoral head by the acetabulum and Norberg angle (NA) after triple pelvic osteotomy (TPO). STUDY DESIGN: Retrospective study. ANIMAL POPULATION: Fifty-six client-owned dogs. METHODS: PC and NA were measured from preoperative, immediate postoperative, first recheck, and second recheck radiographs to compare the effects of 20 degrees and 30 degrees of rotation of the acetabulum after TPO for treatment of hip dysplasia. RESULTS: Within the 20 degrees rotation group, PC and NA values were significantly greater at each subsequent evaluation time starting at the preoperative measurement except for NA between the first and second recheck times. Within the 30 degrees rotation group, PC and NA values were significantly greater at each subsequent evaluation time starting at the preoperative measurement except for PC and NA between the first and second recheck times. No significant differences between the 20 degrees and 30 degrees rotation groups were found at any corresponding times for either PC or NA. CONCLUSIONS: Acetabular rotation of 20 degrees provided the same degree of improvement in acetabular femoral head coverage as 30 degrees of rotation after TPO at the immediate postoperative, first recheck, and second recheck evaluation times. CLINICAL RELEVANCE: Based on PC and NA, 20 degrees rotation of the acetabulum provides as much benefit as 30 degrees of acetabular rotation when performing a TPO.  相似文献   

9.
The effects on femoral remodeling of medullary reaming and insertion of a porous endopros-thesis in uncemented hip arthroplasty (UHA) were measured. A unilateral hip hemiarthroplasty (HA) was performed in 12 dogs, with six dogs receiving full-sized and six dogs receiving undersized femoral endoprostheses. A prosthetic head and neck, or acetabular cup, was not implanted. A control group of six dogs underwent femoral head and neck excision (FHNE) only. All dogs were killed 4 weeks after the surgical procedure. Porosity, vascularity, and bone formation were quantified in each femur of the dogs that had been operated on and in each femur of two unoperated dogs. Full-sized did not differ from undersized HA bones in vascularity, porosity, or bone formation. Femurs in which hemiarthroplasties had been performed (full-sized and undersized) had a three-fold increase in porosity, vascularity, and bone formation compared to the contralateral and the FHNE femurs. Changes in porosity and vascularity were greatest (p < .05) at the metaphyseal level and in the medial and caudal quadrants. There was a strong correlation (R2 0.77 to 0.93, and p − .0001) between the increase in porosity and vascularity. These results support the hypothesis that medullary reaming followed by uncemented prosthetic stem implantation contribute to remodeling of the proximal portion of the femur after UHA.  相似文献   

10.
Arthroscopic examination of the hip joint was performed in mature and juvenile horses, using a lateral approach and standard or long instruments depending on body weight. Nine hip joints were examined in three cadavers and four anesthetized horses. The lateral, cranial, and caudal regions of the femoral head and acetabulum were accessible, and, after distraction of the limb, the ligament of the head of the femur and the acetabular notch were also visible. In small horses, the medial regions of the hip joint were visible but were inaccessible in larger horses. Iatrogenic injury to the sciatic nerve or periarticular vasculature was not evident at necropsy examination. Six horses with lameness localized to the hip joint were examined arthroscopically. At surgery, two horses had tearing of the ligament of the head of the femur, two horses had osteochondrosis of the femoral head or acetabulum, and two horses had degenerative joint disease, one associated with a rim fracture of the caudal aspect of the acetabulum and the other of indeterminant origin. Improvement after debridement occurred in one of the horses with partial disruption of the ligament of the head of the femur and in both horses with osteochondrosis. Diagnostic and surgical arthroscopy of the hip can be accomplished in foals and weanlings using standard equipment, but, in adults weighing more than 300 kg, longer instruments are required and the ease of access and the visible extent of the hip joint is considerably reduced.  相似文献   

11.
Changes in cardiopulmonary function and platelet count were determined in 22 dogs of various breeds that underwent total hip replacement with cemented femoral prostheses. In 11 dogs (group I) polymethylmethacrylate (PMMA) was inserted without venting the reamed and lavaged femoral canal. In a second group of 11 dogs (group II) a urethral catheter (ID: approximately 2.7 mm) was placed into the medullary cavity before the insertion of PMMA. The application of PMMA resulted in a decrease in end-tidal carbon dioxide tension (PETco2) until 5 minutes after insertion of bone cement. Increases in arterial to end-tidal pCO2 gradient [P(a-ET)co2] and physiological dead space (VD/VT) were recorded between 2 minutes before and 5 minutes after insertion of PMMA in 12 dogs. A significant decrease in platelet count occurred in both groups of dogs. Decreases in arterial pO2 (Pao2), arterial/alveolar oxygen tension ratio (Pao2/PAo2), and percent O2 saturation of hemoglobin in arterial blood (Sao2) were not statistically significant. No significant differences could be detected between data obtained from both groups of dogs. An increase in femoral intramedullary pressure caused by the insertion of PMMA and subsequent pulmonary microembolism by medullary contents has been considered the most likely cause for changes in pulmonary function. The lack of statistically significant differences in cardiopulmonary variables and platelet count between the two groups of dogs could have been related to inefficient pressure reduction by the method used.  相似文献   

12.
Ventrodorsal extended hip radiographs were analyzed from Foxhounds, Irish setters, Greyhounds, and Labrador retrievers radiographed four to seven times between 8 and 110 weeks of age. Occurrence in these 91 dogs of a puppy line, an ill-defined zone of proximal femoral metaphyseal sclerosis, a femoral neck linear sclerosis, or circumferential linear femoral head osteophytosis at 15–17 weeks of age were compared with hip joint laxity, as measured by distraction index, and to later findings of caudal curvilinear femoral neck osteophytes, circumferential femoral head osteophytes, hip incongruity consistent with hip dysplasia and degenerative joint disease by 52 weeks of age. A puppy line and/or femoral metaphyseal sclerosis was common at 15–17 weeks of age for dogs at mimimal risk (Greyhounds) and high risk (Foxhounds) of developing early degenerative joint disease associated with canine hip dysplasia. Though 44% of Greyhound hips had puppy lines and 28% had femoral metaphyseal sclerosis at 15–17 weeks of age, no Greyhound had a caudolateral curvilinear osteophyte or circumferential femoral head osteophyte at 24–27 or 52 weeks of age. No significant relationship was found between occurrence of a puppy line, a circumferential femoral head osteophyte or femoral metaphyseal sclerosis at 15–17 weeks and canine hip dysplasia or degenerative joint disease incidence at 42–52 weeks. Presence of a caudolateral curvilinear osteophyte in at least one hip at 24–27 weeks was significantly related to the diagnosis of canine hip dysplasia by 42–52 weeks. When both a caudolateral curvilinear osteophyte and a circumferential femoral head osteophyte were present in a hip at 24–27 weeks, degenerative joint disease was evident in all such hips by 42–52 weeks of age.  相似文献   

13.
犬猫单纯的股骨头颈部骨折临床上较少,其发病原因是骨盆或股骨受到直接或间接的外力导致,也常继发于髋关节发育不良导致的骨质疏松,轻微的外力就可造成动物的股骨头颈部骨折。介绍了猫股骨头颈部骨折的临床症状、诊断及治疗过程,以供参考。  相似文献   

14.
Triple osteotomy of the pelvis with transplantation of the greater trochanter was performed in 41 immature dogs (77 hips) with hip dysplasia. Before surgery, all hips were moderately to severely subluxated and unstable on palpation. The juxta-acetabular location of the ilial, ischial, and pubic osteotomies allowed repositioning of the acetabulum over the femoral head even when subluxation was severe. The acetabular fragment was rotated 70 degrees to 90 degrees in all hips. After surgery, craniodorsal coverage of the femoral head was increased and each hip was stable on palpation. Bilateral procedures were performed 4 to 7 weeks apart. The functional status of the limb was assessed and physical examination and radiography were performed in 71% (55) of the hips 1.0 to 5.5 years (mean, 2.7 years) after surgery. Functional ability was considered satisfactory in 93% (51) of the limbs, though few dogs had a normal gait. On palpation, all hips were stable and all but one were evaluated as nonpainful. In most instances, contact between the femoral neck and the repositioned acetabular rim resulted in a variable amount of crepitus and restriction of motion when the hip was abducted and rotated externally and internally. Eighty-two percent (45) of the hips had little or no evidence of degenerative joint disease. A satisfactory functional, physical, and radiographic result was obtained in 73% (40) of the hips.  相似文献   

15.
The dorsal acetabular rim (DAR) view of the hip joint can be used to assess the weightbearing portion of the acetabulum and the acetabular coverage, providing an adjunct to the conventional ventrodorsal (VD) view in the radiographic evaluation of hip dysplasia in the dog. A quantitative index of acetabular coverage in the DAR view, the acetabular slope (AS) angle, was originally proposed in 1990. The aim of the present study was to make a prospective, comparative assessment of a new parameter, the centre-edge (CE) angle, with the AS angle, for the evaluation of the acetabular coverage of the femoral head in the DAR view. The reliability and repeatability of the two parameters was assessed using the r(I) value of intraclass correlation coefficient (ICC) in a prospective study of 208 hip joints in large and giant breed dogs. An estimation of the added value of using the DAR view, compared with that of the VD standard view alone, was also assessed. The CE angle showed a higher r(I) value compared with the AS angle; in 26 per cent of hips of FCI classes A, B and C, the DAR view provided additional diagnostic information compared with the VD view, with respect to lateralisation and/or initial changes to the dorsal rim. It is concluded that the CE angle is more reliable than the AS angle in the evaluation of acetabular coverage, and that the DAR view provides valuable data compared with the VD view alone in the early stages of canine hip dysplasia.  相似文献   

16.
OBJECTIVE: To report use of ultrasonographic examination of the coxofemoral joint, a surgical technique for repair of craniodorsal coxofemoral dislocation, and outcome. STUDY DESIGN: Clinical case reports. ANIMALS: Calves (n=4) with coxofemoral luxation. METHODS: Craniodorsal coxofemoral luxation was diagnosed by physical examination, radiographic, and ultrasonographic findings. Open surgical reduction of the femoral head was performed using a modified caudal approach. RESULTS: Craniodorsal luxation of the femoral head and the presence of an intact femoral neck were confirmed by ultrasonography. All luxations were successfully reduced and reluxation did not occur. At follow-up, 1 heifer had calved and 1 was 5 months pregnant. One calf died of bronchopneumonia 6 days after surgery. One calf had severe coxofemoral degenerative joint disease diagnosed (ultrasonography, radiography, and arthrocentesis) 3 months after surgery and confirmed by necropsy. CONCLUSION: Ultrasonography proved to be a simple and effective non-invasive technique for diagnosis of coxofemoral luxation. Immediate surgical intervention in hip dislocation in calves is necessary to avoid unnecessary trauma to subchondral structures. In calves, open instead of closed surgical reduction appears preferable because it allows access to the acetabular cavity for removal of debris. CLINICAL RELEVANCE: Ultrasonography should be considered a supplementary but not an alternative to radiographic examination for diagnosis of coxofemoral luxation and for follow-up examinations after reduction.  相似文献   

17.
OBJECTIVE: To determine the practicality and clinical outcome of miniature total hip replacement (THR) in dogs. STUDY DESIGN: Retrospective study. Sample Population- Seventeen client-owned dogs that had miniature THR. METHODS: Patient data surveyed included signalment, body weight, diagnosis, implant size, surgical technique, and intraoperative and postoperative complications. Radiographic evaluation included angle of lateral opening of the acetabular component, implant positioning, cement mantle quality, and femoral displacement measurement and ratio. Client questionnaire and orthopedic examination were used to obtain long-term follow-up information. RESULTS: Miniature THR was performed to address hip dysplasia and secondary osteoarthritis. In 1 dog, a staged bilateral procedure was performed. Mean body weight was 19 kg (range, 12 to 25 kg). Penetration or fissure of the femoral cortex was the most common intraoperative complication and occurred in 3 dogs. In 3 dogs, there was excessive coxofemoral laxity after reduction of the prosthesis. This instability was addressed specifically in 2 dogs by capsulorrhaphy or capsular prosthesis. Postoperative convalescent complications (craniodorsal luxation, 2 dogs; acetabular cup displacement, 1 dog) were related to surgical errors. Aseptic loosening of the femoral implant was diagnosed in 1 dog at 18 months. Mean follow-up time was 17 months (range, 4 to 42 months). Fifteen of 18 (83%) miniature THRs had good or excellent outcomes. CONCLUSIONS: Miniature THR should be considered a satisfactory alternative to femoral head and neck ostectomy in medium-size dogs affected by hip dysplasia and secondary osteoarthritis. The population of medium-size dogs that might derive more benefit from THR than FHO has yet to be defined. CLINICAL RELEVANCE: Miniature THR is a viable treatment option in medium-size dogs with hip dysplasia.  相似文献   

18.
Objectives: To evaluate the acetabular ventroversion obtained with a modified triple pelvic osteotomy (2.5 PO) compared with that resulting from standard double pelvic osteo-tomy (DPO). Study design: Ex vivo study. Animals: Seven pelves obtained from skeletally mature dogs with a total body weight ranging from 26-41 kg were used. Methods: Unilateral DPO technique and dorsal ischial mono-cortical osteotomy were performed on every right hemipelvis. Angular ventral rotation was measured by determining the relative orientation of two Kirschner wires placed in the ilial wing and in the dorsal acetabular rim. Results: The mean angle of ventroversion was 9.5 ± 5.2 degrees for the DPO group (range 2.1-18.1) and 10.9 ± 4.8 degrees for the 2.5 PO group (range 4.1-19.5). The mean difference between the 2.5 PO and DPO was 1.5 ± 0.6 degrees (range 0.5-2.1). Conclusions: The 2.5 PO technique increased acetabular ventroversion versus DPO.  相似文献   

19.
双峰驼髋关节解剖特征   总被引：2，自引：0，他引：2  
运用大体解剖学方法,结合活体Ｘ射线透视及光学摄影术,观察了双峰驼的髋关节。与马、牛、羊、猪、犬及人的对等器官比,双峰驼的髋关节囊纤维层增厚,形成髂股、坐股及耻股３条韧带,分别类似于人的同名韧带;关节囊纤维层有少量弓形及半环形纤维,但未形成轮匝带;股骨头韧带始于髋臼切迹及髋臼窝,与人（始于髋臼横韧带及髋臼切迹两侧）、马（始于近髋臼切迹的耻骨下沟）均不同;髋关节无副韧带（与牛同）。  相似文献   

20.
Handling traumatic hip dislocation is a routine procedure in emergency clinics. Many cases are successfully managed with closed reduction and supportive bandage. However, when surgery is needed the techniques commonly in use are hampered with the lack of visualisation and may result in excessive joint trauma. This paper describes a new surgical method for stabilising the hip joint. The technique is called prearticular stabilisation. The principle is to avoid reluxation by limiting the range of rotatory movement of the femoral head by the use of heavy double mattress sutures tied between the tendons of insertion of the psoas minor and the gluteus medius muscles. The results of the first 11 cases are reported and long term as well as short term results are encouraging.  相似文献   

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