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1.
OBJECTIVE--To determine the long-term effects of juvenile pubic symphysiodesis (JPS) in dysplastic puppies. STUDY DESIGN--Prospective, randomized, clinical trial. ANIMALS--Seven dysplastic Chesapeake Bay retrievers and 2 beagle-crosses (BX1 and 2). METHODS--Five puppies had JPS performed with electrocauterization at 12, 16, 20, 22, and 24 weeks of age, respectively. Two puppies served as controls. BX1 and BX2 were used to obtain biopsies of the symphysis. Hips were evaluated for: pelvic development (transverse computerized tomography for acetabular angle [AA] and dorsal acetabular rim angle [DARA]); laxity [hip extended and stress radiography [distraction index (DI)]); Ortolani maneuver with reduction angles; acetabular coverage (Norberg angles); and function (coxofemoral range of motion, hip pain, and gait analysis by force-plate technique at 44 and 137 weeks of age). RESULTS--The pubis fused prematurely in every puppy that was operated on with the JPS technique. Greater acetabular responses were related to younger ages at surgery. The final mean AA in dogs that had JPS was 25 degrees greater than preoperative values; 40% increased over control. The DARA final mean was 10 degrees, 52% less than preoperative values and 46% less than control. The final mean DI in dogs having JPS was 0.28, 47% improved over preoperative values and 58% better than control. Mean pelvic dimensions in dogs that had JPS were 18% less than control. Gait analyses were normal for all dogs at 137 weeks. No urinary or bowel complications occurred. CONCLUSIONS--Significant ventrolateral acetabular rotation, increased hip coverage, diminished hip laxity, normal pain-free gait, and insignificantly reduced pelvic size occurred after JPS. CLINICAL SIGNIFICANCE--Dysplastic hips in young dogs were significantly improved by JPS.  相似文献   

2.
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   

3.
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   

4.
OBJECTIVE: To examine the effects of juvenile pubic symphysiodesis (JPS) on hip joint conformation, hip laxity, gait, and the development of degenerative joint disease (DJD) in dysplastic puppies operated at 15 and 20 weeks of age. STUDY DESIGN: Randomized controlled prospective study. ANIMALS-Eighteen female hound puppies with increased hip laxity. METHODS: Puppies were randomized to 1 of 4 treatment groups: JPS at 15 weeks of age (n = 6), sham-operated control at 15 weeks of age (n = 3), JPS at 20 weeks of age (n = 6), and sham-operated control at 20 weeks of age (n = 3). Hip extension with pain scoring, Ortolani palpation, hip reduction angle measurement (HRA), PennHIP radiography (University of Pennsylvania) with measurement of distraction index, Norberg angle measurement, and transverse computed tomographic imaging to measure acetabular angle (AA) and dorsal acetabular rim angle (DARA), were tested preoperatively, and at 1 and 2 years of age. RESULTS: JPS resulted in significant changes in AA, HRA, DARA, and conversion to Ortolani negative status. Larger and more rapid changes in hip conformation were seen when surgery was performed at 15 weeks of age. No significant changes were identified in control dogs. Twenty-five percent of JPS dogs developed DJD whereas 83% of control dogs developed DJD. CONCLUSIONS: JPS resulted in significant improvements in hip joint conformation and hip laxity in dysplastic puppies treated at 15 and 20 weeks of age. Improvements in conformation were significantly greater when surgery was performed at 15 weeks of age. CLINICAL RELEVANCE: JPS appears to be a promising treatment for hip dysplasia and is a safe and technically simple procedure to perform.  相似文献   

5.
OBJECTIVES--To determine thermal necrosis zone and the maximal temperature achieved with various electrocautery doses applied to the pubic symphysis of immature dogs, and to establish the minimal electrocautery dose needed to affect thermal necrosis of the germinal chondrocytes of the immature canine pubis. STUDY DESIGN--A randomized, controlled, prospective study. ANIMALS--Twelve puppies, 15 to 17 weeks of age. METHODS--Each treated puppy was randomly selected to receive 3 of 33 possible doses of electrical current applied at uniform intervals along the pelvic symphysis. Three treatment sites were sham-operated controls. All treatment zones were biopsied 7 days after application of electrocautery. Confocal laser microscopy with calcein green and ethidium homodimer red stains were used to determine cell type and viability within treatment and control zones. The physeal diameter and thermal necrosis zone were measured. Thermal necrosis zone and dose, and temperature and dose were compared using regression analysis. Prediction equation analysis was used to establish dose recommendations. RESULTS--Doses of 40 W produced a highly significant linear relationship (R(2) =.88, P <.01) with thermal necrosis zone, and a significant linear relationship (R(2) =.76, P <.02) with maximal temperature. CONCLUSIONS--The thermal necrosis zone within the pelvic symphysis and maximal temperature achieved can be reliably predicted using electrocautery doses of 40 W. For application of electrocautery to induce pubic symphysiodesis, doses should be chosen based on measured or estimated physeal size. Using prediction equation analysis, the surgeon can plan mean thermal necrosis zone with acceptable variance. CLINICAL RELEVANCE--Unipolar needle electrocautery can be used to reliably achieve symphyseal necrosis. Prediction equation analysis can be used to determine 40-W doses.  相似文献   

6.
Objective— Compare the biomechanical characteristics of screw and wire fixation with and without polymethylmethacrylate (PMMA) re-enforcement for acetabular osteotomy stabilization in dogs. Animals— Pelves removed from 8 adult mixed breed dogs weighing between 25 and 30 kg. Procedure— The pubic symphysis of each pelvis was split and a central transverse acetabular osteotomy was performed. One hemipelvis from each dog was stabilized with the composite fixation (interfragmentary Kirschner wire, two screws and a figure-of-eight orthopedic wire with PMMA). The contralateral hemipelves was stabilized with an interfragmentary Kirschner wire, two screws, and a figure-of-eight orthopedic wire without PMMA. All hemipelves were tested in bending by using a materials testing machine at a cross head speed of 5 mm/min. An extensometer was placed on the dorsomedial surface of the hemipelves centered over acetabular osteotomy to record distraction of the osteotomy during loading. A load/deformation curve and a load/distraction curve was produced for each hemipelvis. The slope for the initial linear portion of the load/deformation curve and the load/distraction curve, yield load and maximum load sustained were compared between repair groups using a paired t-test with P < .05 considered significant. Results— The slope of the load/deformation curve was significantly greater (P= .001 ) for hemipelves stabilized with the composite fixation (mean ± SD: 69 ± 18 N/mm) compared with hemipelves stabilized without PMMA (mean ± SD: 39 ± 8 N/mm). There was no significant difference (P= .593 ) between repair groups in the slope of the load/distraction curves as measured on the extensometer. Yield load was significantly greater (P= .0002 ) for hemipelves stabilized with the composite fixation (mean ± SD: 184 ± 25 N) compared to hemipelves stabilized without PMMA (mean ± SD: 74 ± 12 N). Maximum load sustained was also significantly greater (P= .013 ) for hemipelves stabilized with the composite fixation (mean ± SD: 396 ± 71 N) compared to hemipelves stabilized without PMMA (mean ± SD: 265 ± 94 N). Failure of hemipelves stabilized with the composite fixation occurred primarily by ventrolateral bending of the cranial and caudal pelvic segments at the osteotomy site. Failure of hemipelves stabilized without PMMA occurred by ventrolateral bending of the cranial and caudal pelvic segments at the osteotomy site with pronounced concurrent ventrolateral rotation of the cranial pelvic segment. Conclusion— PMMA improves the mechanical characteristics of acetabular fracture fixation, at least in part by neutralization of rotational forces. The results of this study justify use of PMMA as a component of the composite fixation when repairing acetabular fractures.  相似文献   

7.
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   

8.
Acetabular angles (AAs) and dorsal acetabular rim angles acquired by computed tomographic (CT) imaging have been used to assess patient response to juvenile pubic symphysiodesis surgery. The purpose of this study was to evaluate the effects of patient positioning and slice selection on these angles, and an attempt was made to devise a repeatable method of measuring these angles that would eliminate positioning effects. We found significant variation in AAs with small differences in pelvic tilt and slice selection. Dorsal acetabular rim angles were not affected. As a result of positioning differences from one CT study to the next, every attempt should be made to standardize pelvic tilt, or eliminate its effect on AAs by standardizing gantry angle in relation to an anatomic landmark that will not change over time. The floor of the sacral vertebral canal may be a reasonable landmark for this purpose and deserves further study.  相似文献   

9.
Hip dysplasia is a common orthopaedic developmental disorder of dogs. This paper reviews the treatment options available for management of the condition in the skeletally immature and adult dog.  相似文献   

10.
Objective: To report and evaluate use of external skeletal fixation (ESF) for repair of isolated (fibula intact) diaphyseal tibia fractures in skeletally immature dogs.
Study Design: Case series.
Animals: Skeletally immature (mean age, 17 weeks; range, 12–23 weeks) dogs (n=5) with isolated diaphyseal tibial fractures.
Methods: Medical records (2006–2007) of 5 dogs with isolated diaphyseal tibial fractures treated with Type 1a ESF were reviewed and outcome assessed by clinical examination and telephone interviews.
Results: Dogs were evaluated ∼2 and 4 weeks after surgery. Limb function, muscle mass, and comfort level remained very good to excellent throughout healing. Bony union was confirmed radiographically and the ESF removed ∼4 weeks after surgery (mean, 31.4 days; range, 28–37 days). Owner satisfaction was high when contacted a minimum of 4 weeks after ESF removal.
Conclusions: Use of Type Ia ESF with positive profile threaded pins is a practical and biologic method for treatment of isolated tibial fractures in skeletally immature dogs
Clinical Relevance: ESF is an effective alternative treatment to external coaptation and internal fixation for isolated diaphyseal tibial fractures in skeletally immature dogs.  相似文献   

11.
OBJECTIVE: To evaluate changes in canine hip joint characteristics during growth via computed tomography (CT) and compare CT features of hip joints with and without laxity in young dogs placed in 2 imaging positions. ANIMALS: 21 dogs (42 hip joints). PROCEDURES: From 2 to 12 months after birth, CT examinations of the acetabulum of each hip joint in simulated normal standing and simulated weight-bearing positions were performed monthly for all dogs. Acetabular angle, dorsal acetabular rim angle (DARA), and femoral head diameter (FHd) were analyzed as skeletal variables; the lateral center edge angle (LCEA), dorsolateral subluxation (DLS) score, and center distance (CD) index were analyzed as joint laxity variables. At 12 months, all dogs underwent the Ortolani test to as-sess hip joint laxity. RESULTS: Hip joint laxity was detected in 5 dogs (10 joints) at 12 months of age; from 2 months, the acetabular angle and FHd increased and DARA decreased significantly until 5 months and the LCEA and DLS score increased significantly until 6 months. In nonlax hip joints in both positions, the CD index decreased significantly until 4 months of age and be-came stable thereafter. In lax hip joints, the CD index increased from 4 through 12 months; between 8 and 12 months, these changes were significantly greater in the weight-bearing position than in the standing position. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that CT-detected abnormalities in the DARA and CD index during body weight loading might be useful indicators of hip dysplasia in 2- to 6-month-old dogs.  相似文献   

12.
Objectives— (1) To compare short‐term outcome of juvenile pubic symphysiodesis (JPS) in puppies aged 12–17 weeks with lax hips (group JPS1), in puppies aged 18–22 weeks (group JPS2), and control (group C) puppies; and (2) to document outcome of bilateral pectineus myotomy (PM) associated with JPS in 18–22‐week‐old puppies (group JPS–PM). Study Design— Prospective study. Methods— Puppies (12–22 weeks) from large and giant breed dogs with a combination of a positive Ortolani sign, poor acetabular coverage (Norberg angle [NA]≤100°), and a subluxation index (SI) >0.5 for one or both hips were selected. Puppies aged <18 weeks were randomly assigned to group JPS1 or C. Puppies aged 18–22 weeks were randomly assigned to group JPS2, JPS–PM, or C. Three to 4 months later, surgery was considered successful in pain‐free dogs with negative Ortolani sign, normalized acetabular coverage (NA≥105°), and SI>0.5. Success rates were compared using Fisher's exact tests: JPS1 versus JPS2 versus C; JPS2 versus JPS–PM. Significance was set at P<.05. Results— All dysplastic hips from nonoperated (C) groups were dysplastic at follow‐up, meaning that our criteria for case selection were accurate. JPS1 had significantly better success rate than JPS2 (85 versus 17.8%, respectively). JPS–PM dysplastic hips failed to demonstrate a better outcome than JPS2 hips. Clinical Relevance— This study confirms, on a large series of dysplastic hips, the age‐dependent effects of JPS, with better results if performed before 18 weeks of age. There is no benefit of adding PM to the procedure in candidates >18 weeks at surgery.  相似文献   

13.
The effect of a triple pelvic osteotomy (TPO) procedure on the forces acting about the hip joint was examined in five dysplastic canine hips using a previously described theoretical analysis. Hip reaction force (Fh) and its angle of application (θh) were calculated from radiographic measurements made before and after TPO procedures which sequentially increased acetabular ventroversion from 0° to 20°, 30°, and 40°. The results of the in vitro study showed that Fh decreased with increasing acetabular ventroversion reaching an asymptotic value between 30° and 40°. The decrease in Fh corresponded to an increase in θh toward the vertical, with statistical significance found in both Fh and θh between 0° and 20°. The changes observed in Fh and θh after TPO were attributed to the medialization of the femoral head resulting from the reduction of the subluxated head. The results of this study suggest that the noted reduction in the magnitude of the forces acting on the hip joint may act in concert with increased coverage of the femoral head to effect the beneficial clinical results observed with the TPO procedure.  相似文献   

14.
A radiographic study of the anatomy of the canine acetabulum was performed. The relationship between the area of dorsal acetabular rim that is subject to early damage in dogs with coxofemoral joint laxity, and the "DAR point" identified on dorsal acetabular rim (DAR) radiographic views was examined. Radiographs and digital photographs were made of the pelvis harvested from each of six skeletally mature dogs. Through analysis of these images, it was determined that in the standing animal, the DAR point is located 4–6 mm (or approximately 37°) caudal to the dorsal acetabular rim area that is prone to early damage in dogs with coxofemoral joint laxity. This study suggests that the DAR radiographic view may under-represent changes to the dorsal acetabular rim in dogs with coxofemoral laxity.  相似文献   

15.
The authors reviewed pelvic radiographs of 891 dogs in a retrospective study, to determine the incidence of Unilateral Canine Hip Dysplasia (UCHD). Results show that 149 (16.7%) dogs had UCHD. Comparing dogs affected uni- and bilaterally, results show a maximum of 37.6% with UCHD in dogs less than 12 month old, 22.8% in dogs between 12-24 months of age, 25.5% in dogs between 25-72 months and 14.1% in dogs older than 73 months.  相似文献   

16.
17.
OBJECTIVE: To determine prevalence of a radiographic caudolateral curvilinear osteophyte (CCO) on the femoral neck in various breeds and age groups of dogs and to evaluate its contemporaneous relationship with degenerative joint disease (DJD) and distraction index (DI). DESIGN: Cross-sectional prevalence study. ANIMALS: 25,968 dogs, including 3,729 German Shepherd Dogs, 4,545 Golden Retrievers, 6,277 Labrador Retrievers, and 1,191 Rottweilers. PROCEDURE: Data from the University of Pennsylvania Hip Improvement Program database were analyzed, including ventrodorsal hip-extended, compression, and distraction radiographs. The CCO and radiographic signs of DJD were considered independent events and were interpreted as either present or absent. Statistical methods were used to evaluate the CCO as a possible risk factor for DJD and assess its association with DI, as measured by use of distraction radiography. RESULTS: When all breeds were pooled, DJD was detected in 8.6% of dogs, and the CCO was detected in 21.6% of dogs. Among dogs with a CCO, 25.1% had radiographic evidence of DJD. Among dogs without a CCO, only 4% had DJD. Dogs with a CCO were 7.9 times as likely to have DJD as were those without a CCO. Additionally, DI, weight, and age were significant risk factors for the CCO. CONCLUSION AND CLINICAL RELEVANCE: Results confirm the contemporaneous association between the CCO and DJD and that passive hip laxity, as measured by use of the DI, is associated with both the CCO and DJD.  相似文献   

18.
OBJECTIVE: To detect early screw loosening in triple pelvic osteotomy (TPO) and to evaluate the efficacy of retightening using fluoroscopic guidance and minimally invasive surgery to maintain acetabular alignment and achieve bone healing. STUDY DESIGN: Prospective clinical study. SAMPLE POPULATION: Sixteen dogs that had TPO. METHODS: Dogs (16) had TPO (21) by using pre-angled plates secured with 3.5 and 4.0 mm screws, with ischiatic or iliac cerclage, for osteosynthesis. In all but 1 TPO at least 1 screw was inserted into the sacral body (43 screws). The mean radiographic screw length inserted in the sacrum was 10.2 mm, and the mean percent sacral engagement was 22%. Dogs were examined clinically and radiographically immediately postoperatively, and at 10, 30, 60, and 90 days to evaluate screw position. Loose screws were retightened through stab incisions using fluoroscopy to locate the screw. RESULTS: TPO was performed without operative complications. At 10 days, 12 TPOs (57%; 11 dogs) had loose screws primarily located in the cranial aspect of the plate. This represented 20% (25) of the inserted screws. In 5 dogs, screw loosening resulted in medial rotation of the acetabular segment. All loose screws were retightened; 3 screws loosened again in 2 dogs and were detected at 60 days. However, the osteotomies healed with the planned acetabular rotation without further intervention. Screw tightening corrected the acetabular segment displacement. Screws correctly seated at 10 days did not subsequently loosen. Clinical and radiographic outcome was judged excellent in all dogs. CONCLUSION: Loose screws in TPO plates can be identified by 10 days postoperatively and retightened using fluoroscopic guidance to achieve acetabular realignment and healing without need for further surgery. CLINICAL RELEVANCE: Postoperative radiographic evaluation of screw position at 10 days after TPO is recommended to detect loose screws. Retightening loose screws should be considered as an alternative to TPO revision or confinement, especially in immature dogs.  相似文献   

19.
Hip palpation has been used to provide semiquantitative information regarding passive joint laxity and susceptibility to hip dysplasia. The purpose of this study was to: (1) evaluate the intra- and inter-examiner repeatability of the hip reduction angle measured at 4 months of age by three examiners using manual goniometry and an electromagnetic tracking system; (2) compare the hip reduction angle measured with manual goniometry to the hip reduction angle measured with the electromagnetic tracking system; and (3) evaluate the hip reduction angle, distraction index and Ortolani manoeuvre at 4 months of age as predictors of the development of hip osteoarthritis at 12 months of age in 11 Labrador Retriever dogs. Intra- and inter-examiner repeatability was demonstrated for both the manual and electromagnetic goniometric measurement of the hip reduction angle (coefficient of variation < 4.3% and < 6.1%; and P = 0.163 and P = 0.836 respectively). The hip reduction angle measured by manual goniometry was moderately correlated to the hip reduction angle measured by the electromagnetic tracking system (r = 0.603, P < 0.0000). The hip reduction angle measured by manual and electromagnetic goniometry was a poor predictor of osteoarthritis at 12 months of age (r = 0.231, P < 0.062, and r = 0.321, P < 0.01). The distraction index was moderately correlated with the development of osteoarthritis by 12 months of age (r = 0.493, P < 0.0000). The Ortolani sign was sensitive (100%) but not specific (41%) for the development of osteoarthritis at 12 months of age. The hip reduction angle did not further quantify the Ortolani manoeuvre as a predictor of osteoarthritis in Labrador Retrievers.  相似文献   

20.
Unilateral triple pelvic osteotomy was performed with three variations in technique on canine cadaver pelves. The following variables were studied: the angle of the ilial osteotomy (perpendicular to the long axis of the ilium and 10d?, 20d?, and 30d? off perpendicular); the degree of axial rotation (20d?, 30d?, and 45d?); and the type of fixation (canine pelvic osteotomy plate [CPOP] or a 2.7-mm dynamic compression plate [DCP]). Structural changes measured were the pelvic inlet and acetabular area, interischiatic tuberosity distance, and degree of acetabular version. Means and standard error of the means were determined for all pelvic measurements and were analyzed by three-way analysis of variance (P < .05). As the axial rotation increased from 20d? to 45d? an ilial osteotomy angled 10d?, 20d?, or 30d? resulted in a significantly greater decrease in the pelvic inlet area and significantly less deviation of the interischiatic tuberosity distance and degree of acetabular version from normal than an osteotomy directed perpendicular to the long axis of the ilium. Compared with the CPOP, as the axial rotation increased from 20d? to 45d?, the DCP resulted in a significantly greater decrease in the pelvic inlet area, an increase in the interischiatic tuberosity distance and degree of acetabular version, and less of an increase in the acetabular area. The results of this study suggest that to maximize dorsal acetabular coverage, while minimizing disruption of normal pelvic architecture, a CPOP and an ilial osteotomy angled 10d? to 30d? are preferred for all degrees of axial rotation.  相似文献   

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