Venous drainage of the femoral neck in Legg Perthes disease and in hip dysplasia. A clinical and experimental study in the dog and pig

Three clinical cases of canine avascular femoral head necrosis and 4 cases of hip dysplasia were examined using intraosseus femoral neck venography. The contrast medium passed initio the diaphyseal bone marrow in all cases. Three growing dogs and 7 growing pigs were examined with the same method, before and after experimental ligation of the femoral veins. Before the venous tamponade, no contrast medium was visible in the femoral neck. The venography performed immediately after ligation showed contrast flow into the femoral neck similar to that seen in the clinical cases of Legg Perthes disease or hip dysplasia. However, a collateral circulation developed within 7 weeks. No more contrast-flow into the diaphysis was observed after that time.Although osteomedullography shows that both in Perthes disease and in hip dysplasia venous drainage has failed, venous tamponade may not induce the onset of the disease.Key words: hip dysplasia, Legg Perthes disease, osteomedullography     

A radiographic stress technique for evaluation of coxofemoral joint laxity in dogs

OBJECTIVE: To develop a radiographic stress technique to quantify hip joint laxity in dogs. STUDY DESIGN: Prospective study on client-owned dogs presented for hip dysplasia screening. ANIMAL POPULATION: 302 nonselected dogs (63 breeds). METHODS: Dogs were sedated and placed in dorsal recumbency. During pelvic radiography, the femoral heads were displaced manually in a craniodorsal direction. On these stress radiographs, the degree of lateral displacement of the femoral heads was assessed in terms of a subluxation index (SI) and compared with the degree of femoral head subluxation and the severity of hip dysplasia found on conventional extended hindlimb radiographs. RESULTS: The degree of subluxation on stress radiographs was significantly greater than on conventional radiographs. Correlation between the severity of canine hip dysplasia (CHD), graded according to conventional techniques, and the degree of subluxation, induced by radiographic stress technique, was positive (r = .57; P<.0001). Two critical SI values were noted. Of the dogs with an SI value of 0.3 or less, 99% were classified as CHD grade normal, borderline, or mildly dysplastic. In dogs with an SI value between 0.3 and 0.5, CHD grading ranged from normal to severely dysplastic. Of the dogs with an SI value greater than 0.5, 95% had dysplastic hip joints. CONCLUSIONS: Hip joint laxity cannot be quantified precisely on standard position radiographs. The proposed stress technique yields significantly higher degrees of femoral head subluxation than the standard position.     

Estimation of genetic population variables for six radiographic criteria of hip dysplasia in a colony of Labrador Retrievers

OBJECTIVE: To estimate genetic population variables for 6 radiographic criteria of canine hip dysplasia (CHD). ANIMALS: 664 full- and half-siblings from a colony of Labrador Retrievers. PROCEDURE: Heritability estimates and genetic correlations were calculated for 6 radiographic criteria of CHD. Two evaluation protocols were compared: the grade of the most severely affected hip joint and the sum of the scores for both hip joints. The predictive performance of estimated breeding values was also evaluated. RESULTS: The overall prevalence of CHD (Federation Cynologique Internationale grades C, D, and E) was 29.6%. Median age at radiographic examination was 377 days. Heritability for the total CHD grade, Norberg angle (NA), coverage of the femoral head (COV), craniodorsal acetabular rim (ACR), subchondral bone sclerosis (SUBCH), shape of the femoral head and neck (FHN), and osteoarthritic changes at the insertion site of the joint capsule (JC) was estimated as follows: 0.44, 0.43, 0.46, 0.37, 0.32, 0.21, and 0.05, respectively. Heritability estimates were slightly higher for the sum of the scores for both hip joints. If NA and COV were included as fixed effects in the model for the dependent variables ACR, SUBCH, FHN, and JC , then heritability of these traits significantly decreased (0.08 to 0.15). High scores of NA and COV lead to a significant increase of the scores of the remaining criteria. CONCLUSIONS AND CLINICAL RELEVANCE: Canine hip dysplasia is heritable to a moderate degree. Signs of subluxation revealed the highest heritability estimates. The criteria ACR, SUBCH, FHN, and JC were strongly influenced by NA and COV.     

PUPPY LINE, METAPHYSEAL SCLEROSIS, AND CAUDOLATERAL CURVILINEAR AND CIRCUMFERENTIAL FEMORAL HEAD OSTEOPHYTES IN EARLY DETECTION OF CANINE HIP DYSPLASIA

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.     

COMPARATIVE STRUCTURAL ANALYSIS OF THE CANINE FEMORAL HEAD IN LEGG-CALVÉ-PERTHES DISEASE

The goal of this study was to examine the microarchitecture of the trabecular bone of the canine femoral head using microcomputed tomography (micro-CT) technology. Specifically, we assessed changes seen in the femoral head in dogs with Legg-Calvé-Perthes disease and compared this with changes seen in dogs with hip dysplasia and coxofemoral luxation. Femoral heads from healthy animals were examined as a control. In total, 38 femoral heads were studied. Rules for defining spherical volumes (region of interest) for determination of the structural parameters within the trabecular structure were established using micro-CT images. The following parameters were determined directly in three dimensions: bone volume fraction, surface volume fraction, trabecula thickness, trabecular count, trabecular spacing, and connectivity. Characteristic femoral head changes were found for each condition. An unexpected result was found that contradicts the prevailing understanding of Legg-Calvé-Perthes disease. Instead of observing a thickening of the bone trabeculae caused by layering of new bone matrix on top of necrotic trabeculae, we observed an increase in trabecular count and a smaller trabecular thickness. From this it may be concluded that trabecular regeneration is more prominent or prevails over the characteristically described layering processes in the revascularization and repair processes occurring in this illness.     

Quantitative genetics of traits associated with hip dysplasia in a canine pedigree constructed by mating dysplastic Labrador Retrievers with unaffected Greyhounds

OBJECTIVE: To determine the genetic influence on expression of traits associated with canine hip dysplasia. ANIMALS: 193 dogs from an experimental canine pedigree. PROCEDURE: An experimental canine pedigree was developed for linkage analysis of hip dysplasia by mating dysplastic Labrador Retrievers with nondysplastic Greyhounds. A statistical model was designed to test the effects of Labrador Retriever and Greyhound alleles on age at detection of femoral capital epiphyseal ossification, 8-month distraction index, and 8-month dorsolateral subluxation score. RESULTS: The additive effect was significant for age at detection of femoral capital epiphyseal ossification. Restricted maximum likelihood estimates (+/-SD) for this trait were 6.4+/-1.95, 10.2+/-2.0, 10.8+/-3.1, 11.4+/-2.1, and 13.6+/-4.6 days of age for Greyhounds, Greyhound backcross dogs, F1 dogs, Labrador Retriever backcross dogs, and Labrador Retrievers, respectively. The additive effect was also significant for the distraction index. Estimates for this trait were 0.21+/-0.07, 0.29+/-0.15, 0.44+/-0.12, 0.52+/-0.18, and 0.6+/-0.17 for the same groups, respectively. For the dorsolateral subluxation score, additive and dominance effects were significant. Estimates for this trait were 73.5+/-4.1, 71.3+/-6.5, 69.1+/-6.0, 50.6+/-12.9, and 48.4+/-7.7%, respectively, for the same groups. CONCLUSIONS: In this canine pedigree, traits associated with canine hip dysplasia are heritable. Phenotypic differences exist among founder dogs of each breed and their crosses. This pedigree should be useful for identification of quantitative trait loci underlying the dysplastic phenotype.     

The pathogenesis and diagnosis of canine hip dysplasia: a review.

Hip dysplasia is a common developmental problem affecting the canine population. Despite extensive research into the condition, many questions remain unanswered and numerous misconceptions are present among the general public. The purpose of this paper is to review the current knowledge on the development of hip dysplasia, factors modifying its development, and current diagnostic techniques. A computerized literature search was conducted for the period of January 1983 to April 1985 using the MEDLINE and CAB databases, and the keywords hip dysplasia, hip, dog, and canine. Other articles, wherever possible original research articles, published before 1983 were also reviewed. Animals affected by hip dysplasia are born with normal hips, but quickly develop subluxation of the femoral head. Degenerative joint disease follows. Hip dysplasia is a complex, inherited, polygenic trait. Selective breeding of only normal dogs with normal littermates, parents, and grandparents is the recommended method of reducing the incidence in the general population. Gene expression in affected individuals may be modified by a number of environmental factors. These factors do not cause hip dysplasia, but they alter manifestations of the trait and its severity. Nutrition is a major environmental factor. Excess energy consumption increases the frequency and severity of hip dysplasia in genetically predisposed dogs. Food intake should be regulated to maintain a slender figure with the ribs and dorsal vertebral spines easily palpable, but not visible. Excess dietary calcium and vitamin D contribute to hip dysplasia in genetically predisposed individuals and should be avoided. High dose vitamin C supplementation in growing puppies does not prevent hip dysplasia, and this practice should be discontinued.(ABSTRACT TRUNCATED AT 250 WORDS)     

Effect of triple pelvic osteotomy on the proximal femoral geometry in dysplastic dogs

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.     

Results of single-session bilateral triple pelvic osteotomy with an eight-hole iliac bone plate in dogs: 95 cases (1996-1999)

OBJECTIVE: To evaluate feasibility of single-session bilateral triple pelvic osteotomy with 8-hole iliac bone plates in dogs with bilateral hip dysplasia. DESIGN: Retrospective study. ANIMALS: 95 dogs with bilateral hip dysplasia. PROCEDURE: Medical records were reviewed, and information was obtained on signalment; body weight; angles of subluxation and reduction prior to surgery; durations of surgery and hospitalization; postoperative mobility; severity of lameness, radiographic grade of hip dysplasia, Norberg angle, and femoral head coverage before and after surgery; time required for radiographic evidence of iliac healing; change in pelvic diameter; implant integrity; and complications. RESULTS: Mean age at the time of surgery was 10.8 months, and mean weight was 35.2 kg (77.4 lb). Prior to surgery, mean angles of subluxation were 2.2 degrees on the right and 2.6 degrees on the left; mean angles of reduction were 25.9 degrees on the right and 27.3 degrees on the left. Mean surgical time was 95 minutes. All but 1 dog were able to walk on their own by the fourth day after surgery. Mean hospitalization time was 7.5 days. Clinical signs of lameness and radiographic grade of hip dysplasia were significantly improved during follow-up examinations. Mean time for radiographic iliac healing was 8 weeks. None of the plates and only 7 of the 1,520 (0.5%) screws loosened after surgery. Nineteen dogs had complications, but all complications were minor. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that single-session bilateral triple pelvic osteotomy with 8-hole iliac bone plates is effective for treatment of dogs with bilateral hip dysplasia.     

Radiographic Criteria for Evaluation of Uncemented Total Hip Replacement in Dogs

A zonal analysis system and corresponding nomenclature were developed to describe the location and nature of radiographic changes in canine uncemented total hip arthroplasties. Criteria to assess prosthetic component alignment, percentage of femoral canal fill, resorptive and formative bony changes, and alterations in the bone at the implant-bone interface were derived by studying serial radiographs of 100 consecutive canine uncemented total hip arthroplasties for up to 30 months after surgery.     

A case of congenital unilateral hip dysplasia in a newborn calf

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.     

Segmentation of the canine population in different femoral morphological groups

ObjectiveThe incidence of femoral traumatology and hip dysplasia shows the need to design canine specific femoral implants in veterinary surgery. A good knowledge of femoral morphology, and particularly of intra-species variability, is required to develop a well-adapted canine femoral intramedullary implant. The aim of this study is to evaluate the morphological variability of the canine femur and to propose a segmentation of this population.ProcedureThis study proposes different possibilities for the segmentation of a canine population of 103 dogs of various common breeds in relation to their femoral morphology. These segmentations were obtained with a statistical methodology, which takes into account 24 measured and calculated morphological parameters of 206 canine femurs.ResultsThe segmentation of this canine population into four or six homogeneous groups related to the femoral morphology were the two most relevant solutions. The total length of the femur and the femoral head diameter were the best discriminant parameters for this segmentation.ConclusionKnowledge of the variability of the femoral morphology in the canine species and the possibility of splitting the canine population into homogeneous morphological groups are useful for the design of specific canine femoral implants. The femoral morphological profiles of each group constitute an essential database for fitting the best orthopedic implant to the bone.     

Segmentation of the canine population in different femoral morphological groups

ObjectiveThe incidence of femoral traumatology and hip dysplasia shows the need to design canine specific femoral implants in veterinary surgery. A good knowledge of femoral morphology, and particularly of intra-species variability, is required to develop a well-adapted canine femoral intramedullary implant. The aim of this study is to evaluate the morphological variability of the canine femur and to propose a segmentation of this population.ProcedureThis study proposes different possibilities for the segmentation of a canine population of 103 dogs of various common breeds in relation to their femoral morphology. These segmentations were obtained with a statistical methodology, which takes into account 24 measured and calculated morphological parameters of 206 canine femurs.ResultsThe segmentation of this canine population into four or six homogeneous groups related to the femoral morphology were the two most relevant solutions. The total length of the femur and the femoral head diameter were the best discriminant parameters for this segmentation.ConclusionKnowledge of the variability of the femoral morphology in the canine species and the possibility of splitting the canine population into homogeneous morphological groups are useful for the design of specific canine femoral implants. The femoral morphological profiles of each group constitute an essential database for fitting the best orthopedic implant to the bone.     

Effects of limited food consumption on the incidence of hip dysplasia in growing dogs.

Forty-eight 8-week-old Labrador Retrievers were allotted to 2 groups of 24 dogs each; 1 group was fed ad libitum and the other group was given 25% less of the same feed until the dogs were 2 years old. Radiography of the hip joints was done when the dogs were 30, 42, 54, 78, and 104 weeks old. Subluxation was measured by the Norberg angle on radiographs made with the dog in the standard (extended limb) position. Independent of age at which the radiography was done, there was less subluxation of the femoral heads in the limit-fed dogs. Using the Swedish method of hip joint evaluation on the same radiographs, it was found that fewer dogs on limited food intake had signs of hip dysplasia. Radiographs done when dogs were 2 years old, for all the methods used (Norberg angle in standard and frog-limb position, the Orthopedic Foundation for Animals [OFA] score, and the Swedish score), revealed less hip dysplasia (less joint subluxation and less degenerative joint disease) in the limit-fed dogs. Using the OFA method, 7 of the 24 limit-fed dogs and 16 of the 24 ad libitum-fed dogs were diagnosed as having hip dysplasia. Similarly, using the Swedish method, 5 of the 24 limit-fed dogs and 18 of the 24 ad libitum-fed dogs were diagnosed as having hip dysplasia. The food-intake-related differences were significant both for the OFA score and for the Swedish score.(ABSTRACT TRUNCATED AT 250 WORDS)     

Influence of femoral head and neck conformation on hip dysplasia in the German Shepherd dog.

We investigated the prevalence of an anatomic variant of the proximal femur, termed the broomstick-like femoral head and neck formation, and its influence on the Féderation Cynologique Internationale (FCI) hip dysplasia score in 294 German Shepherd dogs. One-hundred and eighty (61%) of the 294 dogs in our study had this anatomic variant. The calculated area of the femoral heads in dogs with a broomstick-like conformation was 4.5 +/- 0.6 cm2 on the hip-extended view. In dogs with a normal femoral head, the calculated area of the femoral head was significantly larger at 4.8 +/- 0.6 cm2 (P < 0.05). In the frog-leg view, there was no significant difference in femoral head area between dogs with the broomstick-like conformation and normal dogs. There was no difference in the antetorsion angle between dogs with broomstick-like conformation and normal dogs. There was also no difference in the distraction ratio between the two phenotypes. The official FCI hip score was similar in dogs with and without the broomstick-like conformation. The average heritability of the broomstick-like conformation was 0.3 +/- 0.1, suggesting heritable influence. We conclude that the broomstick-like conformation is a common finding in the German shepherd dog and has genetic base. The broomstick-like conformation does not appear to be associated with the presence of canine hip dysplasia and it can therefore be assumed to be a normal anatomic variant.     

RADIOGRAPHIC EVALUATION OF TOTAL HIP REPLACEMENT IN THE DOG

The radiographic signs associated with implanted canine total hip prostheses include: (1) a 1 mm-or-less wide static lucent zone at the acetabular and femoral bone-cement interfaces, and (2) periosteal bone proliferation surrounding the stem of the femoral prosthesis. The radiographic signs associated with total hip replacement complications are dislocation of the femoral component, bone changes suggestive of infection involving the acetabular and femoral components, and loosening of the acetabular component. Arthrography is beneficial in determining the presence of a loose prosthesis with or without infection.     

犬髋关节发育异常的研究进展

犬髋关节发育异常是一种常发于4～10月龄大型品种幼犬,由遗传和其它因素所致的复合性进行性疾病。典型临床特征为疼痛,跛行,主要病理变化为髋臼变浅,股骨头变形,髋关节不同程度的松弛,不完全脱位或全脱位,甚至发展为严重的退行性关节炎。从首次发现本病至今,对本病的遗传特点、诊断方法标准和各种治疗手段都有大量的研究。作者综述了犬髋关节发育异常的发病因素,常用的诊断和防控措施,从而为全面认识本病,并进行深入研究提供参考。     

Effects of intramuscular administration of glycosaminoglycan polysulfates on signs of incipient hip dysplasia in growing pups.

We tested the hypothesis that treatment of growing, susceptible (to hip dysplasia) pups by IM administration of glycosaminoglycan polysulfates would mitigate the signs of incipient hip dysplasia. In 1 experiment, 7 pups, selected at random from 2 litters, were administered glycosaminoglycan polysulfates (2.5 mg/kg of body weight, IM) twice weekly, and 7 control pups from the same litters were given sterile buffered 0.9% saline solution from the age of 6 weeks to 8 months. Hip joints were examined by radiography, with pups in the standard, limbs-extended position. At 8 months of age, all pups in this experiment did not manifest femoral head subluxation radiographically. The Norberg angle, a measure of coxofemoral congruity, improved from a mean +/- SEM value of 102 degrees +/- 1 degrees in controls to 106 degrees +/- 1 degrees in treated pups (P = 0.008). Pups were not subjected to necropsy. In the second experiment, 8 pups were selected at random from 2 litters and were administered 5 mg of glycosaminoglycan polysulfates/kg, IM, twice weekly from 6 weeks to 8 months of age. Similarly, 8 control pups were administered saline solution. At 8 months of age, hip joints were examined by radiography with pups in the standard position; at necropsy, intra-articular tissues were evaluated macroscopically and biochemically. Of 8 treated pups, none had subluxation radiographically, whereas 4 of 8 control dogs had femoral head subluxation. Mean Norberg angle on the radiographs was 109.7 degrees +/- 1.6 degrees for the treated group and was 101.5 degrees +/- 1.6 degrees for controls, representing a mean improvement in coxofemoral congruity of 8.2 degrees in the treated pups.(ABSTRACT TRUNCATED AT 250 WORDS)     

The pathogenesis of canine hip dysplasia.

Dogs with CHD are born with normal hips that subsequently undergo varying degrees of subluxation of the coxofemoral joint. Although the etiology of CHD is multifactorial, the pathogenesis or stages of change within the affected coxofemoral joint(s) are similar regardless of cause. With the onset of the disease, there are progressive structural changes including joint laxity and femoral head subluxation; swelling, stretching, fraying, and eventual rupture of the teres ligament; a shallow, flattened acetabulum, deformity of the head; erosion of articular cartilage, eburnation of subchondral bone, DJD; and periarticular osteophyte formation.