Diagnostic and Operative Arthroscopy of the Coxofemoral Joint in Horses

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.     

Diagnostic and Surgical Arthroscopy of the Equine Shoulder Joint

An arthroscopic technique for examination and surgical treatment of conditions of the shoulder joint was evaluated in eight normal horses and two horses with osteochondrosis lesions. A single arthroscope entry point caudal to the infraspinatus tendon allowed inspection of the cranial, lateral, and caudal surfaces of the shoulder joint. With the humeral head and glenoid cavity distracted by a curved forceps, the entire cartilage surface of the shoulder could be examined. The caudomedial portion of the humeral head was seen better with a 70 degree angled arthroscope. Instruments for intra-articular manipulation were introduced through a separate skin incision 2 to 4 cm caudal to the arthroscope entry point. Two horses with osteochondrosis lesions of the shoulder were examined arthroscopically and debrided with instrument triangulation. Five normal horses and both horses with osteochondrosis lesions were euthanized immediately after the procedure and a necropsy was performed. Minor iatrogenic damage to the cartilage surfaces and joint capsule resulted from the technique. Three horses recovered from anesthesia and were killed 3, 30, or 60 days after surgery. Subcutaneous fluid that accumulated during surgery had resorbed by 3 days and lameness was evident for 12 to 24 hours. Gross examination and histopathologic findings of specimens collected at 30 and 60 days showed several small nonhealing partial-thickness cartilage defects attributed to instrument insertion. Arthroscopy is a satisfactory method to examine the joint surfaces and to evaluate and treat osteochondrosis lesions of the shoulder joint in horses.     

Coxofemoral dislocations

Extract

Sir,—The article by A. N. Bruere on “The Treatment of Coxofemoral Dislocations in the Dog” (N Z. vct. J., 9 : 70) is of great interest. I myself find that the easiest way to diagnose dislocation of this joint in the dog is to palpate the gap between the trochanter major and tuber ischii on each side and compare the two. This is done preferably in the standing position but may also be done in laterat recumbency.     

Prosthetic Coxofemoral Joint Repiacement in the Goose (Anser Sp.): I. Preliminary Results

In order to study failure modes of fixation of artificial hip joints in man, an animal model was needed that had similar loading conditions concerning the hip joint and a life expectancy long enough to allow for fixation failures to occur. Femoral components of a hip joint were implanted into domestic geese ( Anser sp.) to evaluate their suitability for long-term in vivo studies of femoral implants. A prosthesis was developed. It was implanted into mature geese under general anesthesia using a lateral surgical approach. The animals were sacrificed 5 to 11 months after implantation. The results indicate that prosthetic hip joints could be implanted and that joint function was restored in all cases. There was no postoperative morbidity or mortality. Prosthetic loosening was observed in three out of the nine implants.     

Coxofemoral luxations in cats

In a retrospective study, 79 untreated luxations of the coxofemoral joint in cats were recorded over a 12-year period. Twenty-nine of these cases were available for follow-up, of which 13 were re-examined clinically and radiologically. It was found that the maximum incidence of the injury occurred from one to three years of age. Follow-up radiographs showed that the cats had developed nearthroses of various degrees located dorsally on the ilium. The degree of nearthrosis formation was not consistently correlated with the length of the observation time. Radiological signs of decreased bone density of the proximal femur may be caused by reduced weightbearing related to changes in biomechanical function and altered blood supply in the luxated limb. Almost two-thirds of the re-examined animals presented some kind of locomotor dysfunction on clinical examination. Limb function improved with time. The best clinical results appeared to be in cats that were immature at the time of injury and developed nearthrosis similar to a normal coxofemoral joint. All the cats available to this study showed acceptable functional results and had a normal level of activity according to the owners.     

Changes in the Proximal Femur and Coxofemoral Joint Following Intramedullary Pinning of Diaphyseal Fractures in Young Dogs

We report radiographic changes and clinical results seen in the proximal femur and coxofemoral joint of 7 young dogs following intramedullary pinning. Changes seen radiographically included coxa valga, a small malformed femoral head, a short thin femoral neck, and coxofemoral subluxation. Epiphyseal trauma, ischemia, and mechanical impairment of normal femoral neck growth due to presence of the intramedullary pin are discussed as possible etiologic factors.     

Evaluation of a Joint Distractor to Facilitate Arthroscopy of the Canine Stifle

Objectives— To assess a novel technique for arthroscopic evaluation of the canine stifle avoiding the need for fat pad debridement.
Study Design— Prospective study.
Sample Population— Cadaveric canine stifles (n=10); Client-owned dogs (15).
Methods— In cadaveric stifles, the femoropatellar space was assessed before placement of a joint distractor and examination of the femorotibial joint. Time to complete evaluation of the femoropatellar space, to observe the cruciate ligaments, and to completion of examination of the femorotibial joint were recorded. Distractor-assisted arthroscopy was then performed in 15 consecutive clinical cases. Clinical information, time to complete joint evaluation, and ability to perform any additional arthroscopic surgery were recorded.
Results— Observation and palpation of intra-articular structures were possible in all cadaveric stifles. Mean time to evaluate the femoropatellar space was 3.2 minutes (range, 2–4 minutes); to observe the cruciate ligaments, 5.8 minutes (range, 3–8 minutes); and to completion of joint inspection, 9.1 minutes (range 6–13 minutes). In the clinical cases, observation of intra-articular structures was also possible in all stifles. Mean time to complete joint inspection was 21 minutes (range, 10–40 minutes). Partial meniscectomy was performed successfully in 5 stifles.
Conclusions— Use of a joint distractor allowed arthroscopic observation of all relevant structures. Partial meniscectomy was readily performed.
Clinical Relevance— Use of a joint distractor may simplify arthroscopic assessment of the canine stifle and avoid potential morbidity associated with fat pad debridement.     

Evaluation of Lameness Associated with Arthroscopy and Arthrotomy of the Normal Canine Cubital Joint

OBJECTIVE: To evaluate gait, range of motion (ROM), and lameness in normal dogs after arthroscopy or arthrotomy of the cubital joint. STUDY DESIGN: Experimental study. ANIMALS: Fourteen mature, healthy dogs. METHODS: Dogs were randomly assigned to treatment groups. Seven underwent arthrotomy and 7 underwent arthroscopy of the left cubital joint. Dogs were evaluated using kinetic gait assessment, subjective evaluation scores, and cubital joint ROM. Evaluations were performed before and on days 2, 4, 7, 15, 22, and 29 after surgery. Radiographs made before and after the surgical procedures were evaluated. RESULTS: Significant differences in peak vertical force and vertical impulse force were not observed between surgery groups (P =.88 and.49, respectively). Joint ROM was not significantly different between groups (P =.09 for flexion and.91 for extension). For all dogs, joint ROM and radiographic evaluations remained normal throughout the study period. Significant differences in subjective lameness scores, weight bearing, or pain were not observed between groups (P >/ or =.19 for all variables). CONCLUSIONS: In this study population, significant differences between dogs undergoing arthroscopy or arthrotomy of the cubital joint with respect to postoperative pain, weight bearing, joint ROM, or temporal improvement of ground reaction forces were not observed. CLINICAL RELEVANCE: The results of this study suggest that postoperative morbidity should not be a factor when making a decision to perform either arthroscopy or arthrotomy for exploration of the medial compartment of the canine cubital joint.     

Coxofemoral Luxation in the Dog and Cat

The medical records from 95 cases of coxofemoral luxation in dogs and cats were reviewed. Unilateral craniodorsal luxation was most common, (78.1% of dogs, 72.7% of cats). Trauma from being struck by an automobile was the most frequent cause (59.0%). Treatment was closed (manual) or open (surgical) reduction. The failure rate following single closed reduction was 64.8%. The surgical reduction procedure included capsular repair (capsulorrhaphy) via a craniolateral approach to the hip or via trochanteric osteotomy or gluteal tenotomy. The success rate following reduction via the craniolateral approach was 82%; no failure was recorded with trochanteric transposition, but reluxa-tion followed the single gluteal tenotomy. The Ehmer sling was the most common external fixation and was kept in place an average of 12.5 days. Thirty-three animals were available for follow-up, and no difference was recorded in limb function between the two groups of animals treated by closed vs surgical reduction. Patients with degenerative joint disease at the time of luxation were less likely to be successfully reduced; 64.3% of these animals were eventually treated by femoral head and neck excision. Thirty-eight patients had associated major injuries. Long-term follow-up results were better in those patients with concomitant orthopedic injuries than in those without other injuries.     

Experimental Coxofemoral Replacement Hemiarthroplasty in the Pony

For the in vivo evaluation of hip joint prostheses that are developed for man, the suitability of the pony as an animal model has been studied. Human and custom made prostheses were implanted into 1 femur in each of 7 ponies to replace the femoral head. The surgical approach was through a caudolateral incision. The prosthesis was fixed in the femur with bone cement. Because of errors in the implantation technique and resulting lack of sufficient fixation 2 ponies as well as 1 control animal with an excision arthroplasty were unwilling or unable to stand. Rigid fixation of the implant was achieved in 3 ponies. They were returned to pasture after 8 days. A full return to a normal gait did not occur within an observation period of up to 3 months. All 3 ponies developed a dorsolateral coxofemoral luxation and pseudarthrosis within the first 10 days. A mismatch between the equine anatomy and human prosthesis geometry was thought to be the cause. We, therefore, believe that the pony does not provide a suitable model for the testing of human femoral joint implants. The results, however, indicate that coxofemoral surgery can be performed in the adult pony. For clinical reconstruction of joint function, a custom made total artificial hip joint might provide better results.     

Prosthetic Coxofemoral Joint Replacement in the Goose (Anser Sp.): II. Histologic and Mechanical Interface Evaluations

The interfacial tissue-implant healing reactions have been investigated in the goose to evaluate its suitability as an animal model for joint replacement implant studies. After various implantation periods, geese with one coxofemoral replacement hemiarthroplasty were evaluated for their gait performance and then sacrificed. The implantation sites and femora with implants were subjected to histologic studies, and the interfacial shear strength between the bone and implant was measured. The results were compared with findings reported in the literature on dog and man. Direct bone apposition was found in two geese with a firmly fixed implant. A connective tissue capsule surrounded those seven implant stems that were found to sit loosely in the femoral canal. Whereas the histologic findings were comparable to findings in dog and man, the interfacial shear stress was somewhat lower in the goose. Because of the histopathologically comparable findings of interfacial healing, the goose appears to present a suitable model to study bone implant tissue reactions. Further studies are necessary to determine seasonal-, age-, and sex-related bone tissue differences in the goose.     

Coxofemoral joint radiography in standing cattle

The objective of this study was to establish a technique for radiographic examination of the coxofemoral joint and adjacent bony structures in standing cattle. Left (or right) 30° dorsal-right (or left) ventral radiographic views of the coxofemoral joint region of standing cattle (n = 10) with hind limb lameness were evaluated retrospectively. In addition, an experimental study of oblique laterolateral views of the coxofemoral joint region of a bovine skeleton at angles of 15-45° was carried out to determine the optimal position for visualization of the hip region. In the 10 clinical patients, the bodies of the ilium and ischium, the acetabulum and proximal third of the femur could be assessed. Six of these cattle had fractures of the body of the ilium and body of the ischium, five with and one without involvement of the acetabulum, two had craniodorsal and one caudoventral luxation of the femur and one had a femoral neck fracture. The described laterodorsal-lateroventral radiographs of the hip region in standing cattle were suitable for assessing the coxofemoral joint, the proximal aspect of the femur and parts of the ischium, ilium and pubis. After testing the optimal angle on the skeleton, it was seen that distortion and superimposition were minimized by positioning the X-ray beam at an angle of 25° to the horizontal plane. It can be concluded that the described technique improves the evaluation of injuries of the coxofemoral region in cattle. With the appropriate angle, the technique can also be applied in recumbent cattle.     

Idiopathic Hypocalcemia in Foals

Five thoroughbred foals (4 fillies and 1 colt), all in good to excellent body condition, ranging in age from 4 days to 5 weeks at the time of onset of signs, were presented to 2 Kentucky equine hospitals from 1992 through 1996. All 5 foals presented with tachycardia, hyperhidrosis, diarrhea or a recent history of diarrhea, and muscle rigidity or stiff gait. Four of the 5 foals presented for recumbency, seizure-like activity with opisthotonos, or pronounced extensor muscle rigidity. All 5 foals were hypocalcemic. All foals either died or had euthanasia performed. None responded to oral calcium supplementation. The cause of the hypocalcemia was unknown. Different idiopathic hypocalcemia syndromes may exist in foals.