Long-term results of transarticular pinning for surgical stabilisation of coxofemoral luxation in 20 cats

O bjectives : The objective of this study was to describe initial and long-term results of open reduction and transarticular pinning for treatment of coxofemoral luxations in cats.
M ethods : Cats were treated by open reduction and transarticular pinning for coxofemoral luxation over a five year period at two institutions. Follow-up assessment included orthopaedic examination, radiography and owner questionnaires.
R esults : Twenty cats were included in the study (14 males and six females). One cat was affected bilaterally. Mean time to follow-up was 21 months. Seventeen joints were stabilised with a 1·6 mm pin, three with 2·0 mm pins and a 1·2 mm pin was used in the remaining joint. An Ehmer sling was not utilised in any case. All transarticular pins except one were removed (mean 3·5 weeks), with all hips still in reduction The overall success rate was 77 per cent, with two reluxations and one resorbed femoral head noted on radiographs of 13 joints followed long term. All 20 owners reported good to excellent long-term functional outcome for their cats.
C linical S ignificance : Results from this study indicate that transarticular pinning for stabilisation of coxofemoral luxation in cats can provide a good long-term outcome without sacrificing the integrity of the coxofemoral joint.     

Treatment of a coxofemoral luxation in a pony using a prosthetic capsule technique

Objective: To report open reduction and joint stabilization using a prosthetic capsule technique for treatment of a craniodorsal coxofemoral luxation in a lightweight pony. Study Design: Clinical report. Animals: Pony stallion (8 years old, 113 kg). Methods: A craniodorsal approach to the coxofemoral joint was performed under general anesthesia. After open reduction, a prosthetic capsule technique was used. Four 3.5 mm self‐tapping cortical anchor screws were implanted: 2 screws were inserted above the cranial aspect of the dorsal acetabular rim, and 2 screws were inserted into the femoral neck. Subsequently, a #5 USP ultra‐high molecular weight polyethylene suture was placed through these anchor screws in figure‐8 fashion to serve as a prosthetic capsule. Routine closure and a medial patellar desmotomy completed the surgical procedure. Postoperatively, the pony was cross tied for 4 weeks to prevent it from lying down. Results: Neither short‐term nor long‐term complications occurred and the pony was sound at the follow‐up examination performed 15 months postoperatively. Conclusions: A prosthetic capsule technique can be used successfully to stabilize the coxofemoral joint after open reduction of a craniodorsal luxation in a lightweight pony.     

Toggle-pin technique for management of coxofemoral luxation in an alpaca

Objective: To report repair of a coxofemoral joint luxation in an Alpaca using a toggle‐pin technique. Study Design: Case report. Animals: An 11‐month intact male Alpaca with luxation of the right coxofemoral joint. Methods: The Alpaca was anesthetized and an open repair and reduction of the luxation was performed using a toggle‐pin technique. Results: The luxation was successfully reduced. An Ehmer sling was used for the initial 3 days after surgery and the Alpaca was discharged 7 days postoperatively without complications. Follow‐up examinations confirmed maintained reduction of the coxofemoral joint, as well as no evidence of lameness or muscle atrophy. Conclusions: Coxofemoral joint luxations in Alpacas can be successfully repaired using a toggle‐pin technique alone, without the need for other techniques such as capsular reconstruction or greater trochanter transposition. Use of an Ehmer sling for the immediate postoperative period provided additional protection to the repair and was tolerated well.     

Feline talocrural luxation: a cadaveric study of repair using ligament prostheses

Currently recommended surgical techniques to treat severe biaxial feline talocrural soft-tissue injuries commonly lead to unsatisfactory outcome. Data relating to canine talocrural stabilisation may not be useful in cats due to major differences in tarsal anatomy between the species. This experimental biomechanical cadaveric study used specimens (n = 10) prepared from the distal pelvic limbs of five adult cats. The aim was to design a technique for treating talocrural luxation using suture prostheses and bone tunnels, and to investigate its suitability for use in clinical cases. Four prosthetic ligaments were placed through a series of five 1.5 mm bone tunnels. Two prostheses, the caudoproximal pair, were taut in talocrural flexion and two prostheses, the craniodistal pair, were taut in extension. The intact specimens had their range-of-motion (ROM) and stability tested, after which they were transected at the talocrural joint (simulated luxation) and repaired using the technique described. The ROM and stability of the repaired specimens were tested and compared to the intact specimens. The repaired specimens had comparable stability to the intact specimens, although the ROM was different (p <0.05) in six of 16 positions (p <0.003125). These corresponded to the positions where the lateral prostheses were taut. The repair technique described may be useful in the treatment of talocrural luxation, as it is low-profile in an area of limited soft-tissue cover, allows anatomic reduction, restores normal talocrural joint stability and near-normal tarsal ROM.     

An open reduction technique for chronic coxofemoral luxation in the dog

Extract

Coxofemoral luxation in the dog is an all too common condition encountered in rural practice in New Zealand. The treatments described for the reduction of this condition are many, which is a fair indication that none of them is particularly satisfactory. This may be owing, in part, to the fact that luxation of this joint is usually the result of an accident in which considerable force is exerted on the joint, which suffers severe trauma.     

Comparison of a suture anchor and a toggle rod for use in toggle pin fixation of coxofemoral luxations

The mechanical characteristics of toggle rods and Bone Biter anchors inserted through the medial acetabular wall for toggle pin repair of coxofemoral luxations were compared in 16 canine cadaver pelves. No differences were detected in maximum load to failure, displacement at failure, or energy to failure between the two constructs. Toggle rod constructs failed primarily by breakage of the suture at the rod eyelet. All of the Bone Biter anchor constructs failed when the anchors pulled through the medial acetabular wall.     

Closed reduction of coxofemoral luxation in a goat: case report

Hip luxations have been reported in many ruminants, and several treatments have been described for them. However, successful closed reduction of hip joint luxation has not been reported in goats to date. This case report describes the closed reduction of coxofemoral luxation in a three-month-old male Saanen dairy goat. The goat showed non-weightbearing lameness and abnormal mobility of the proximal right hindlimb. Luxation of the right coxofemoral joint in craniodorsal direction was diagnosed by radiography. The femoral head was repositioned under sedation, and physiotherapy including non-weightbearing hindlimb movement and supported walking exercise was performed. Fifteen days after closed reduction the animal was discharged from the clinic. At that time the animal was sound at a slow walk but lameness was still present at faster gaits. Follow-up examinations revealed normal development of the animal, which subsequently showed no lameness and served successfully as a breeding goat.     

Minimally invasive approach to lumbosacral decompression in a cadaveric canine model

AIMS: To determine efficacy of a minimally invasive (MI) surgical approach using a human MI lumbar retractor for canine lumbosacral dorsal laminectomy and partial discectomy and to compare this technique to the standard open surgical (OS) approach.

METHODS: Lumbosacral dorsal laminectomy and partial discectomy was performed on 16 large-breed canine cadavers using either a standard OS (n=8) or MI (n=8) approach. Skin and fascial incision length, procedure time, and intraoperative complications were recorded. Postoperatively specimens were evaluated for laminectomy and discectomy dimensions, and visible damage to the cauda equina and exiting nerve roots.

RESULTS: Median length of skin and fascial incisions in the OS group were longer than in the MI group (p<0.001). Median laminectomy length was similar between both approaches (p=0.234) but width was greater for the MI than OS approach (p=0.002). Both approaches achieved similar partial discectomy width (p=0.279). Overall surgical time was longer for MI approaches compared to OS, with a median of 18.5 (min 15.5, max 21.8) minutes for MI compared to 14.6 (min 13.1, max 16.9) minutes for OS (p=0.001).

CONCLUSIONS: The MI approach reduced incision lengths while retaining comparable laminectomy and discectomy dimensions. For this in vitro model the MI approach required more time to complete, but this difference may not be relevant in clinical cases.

CLINICAL RELEVANCE: Dogs undergoing lumbosacral dorsal laminectomy are commonly large-breed dogs. The traditional open approach requires a large skin incision and soft tissue dissection, especially in overweight animals. A MI approach accomplishing the same surgical result while minimising soft tissue trauma could reduce post-operative pain and recovery time, and may lower wound-related complications. Clinical studies are needed to confirm postoperative benefit and assess operating times in vivo.     

Stifle joint luxation in the cat: treatment using transarticular external skeletal fixation

Extra-articular suturing techniques and transarticular external skeletal fixators were used to repair traumatic luxation of the stifle joint in four cats. Rupture of the cranial cruciate, caudal cruciate and medial collateral ligaments, together with injury to one or both menisci, were the most common injuries observed. The method of stifle repair was successful in all cases, but serious complications occurred when cats with transarticular external fixators were not kept confined indoors. Complications consisted of pin loosening and disruption of the fixator, or fractures through proximal or distal pins. Transarticular external skeletal fixation was considered to be a simple and effective method of maintaining short-term joint stability to allow healing of injured soft tissue structures. The apparatus facilitated early weightbearing and, on removal, allowed for the return of near-normal stifle function. Careful pin insertion and owner compliance in enforcing confinement are essential in minimising complications associated with immobilising the stifle joint using transarticular external skeletal fixation.     

Open reduction and stabilisation of coxofemoral joint luxation in dogs and cats, using a stainless steel rope inserted via a ventral approach to the hip joint

Open reduction and stabilisation of coxofemoral joint luxation was made via a ventral approach to the hip joint in dogs and cats, using a transarticular stainless steel rope. A feature of the procedure is transarticular penetration of the rope from the pelvic cavity to the femoral neck by guidance with a guide wire which was previously inserted from the femoral neck into the pelvic cavity and by detection of the guide wire in the pelvic cavity by use of forceps connected to an alarm-ohmmeter. Forty-seven animals (37 dogs and 10 cats) with acute and simple coxofemoral luxation were treated and postoperatively maintained in cage rest without external fixation. Most of the animals regained an almost normal gait within several days.     

Surgical correction of a coxofemoral luxation in a European Honey buzzard (Pernis apivorus) by incorporating a toggle-pin technique: A case report

A 2-year-old female European Honey buzzard (Pernis apivorus) was diagnosed with a coxofemoral luxation (craniodorsal) of the right leg. Modified toggle pin technique was performed to replace the ruptured ligament of head of femur with an artificial ligament. An anchor was tied to a monofilament-type nonabsorbable suture and placed into the buzzard's acetabular hole through the drilled femoral canal. The buzzard gradually regained full activity by 13 weeks following surgery, displaying a slight lameness but otherwise a completely normal range of motion without relapse or complication. In this specific case, the procedure was uneventful and the buzzard recovered over several months without relapse or complications. Further clinical reports including a larger number of animals are needed in order to determine whether this technique is safe and which surgical technique is more effective in birds with coxofemoral luxation.     

Vertebral stabilisation for cervical spondylopathy using a screw and washer technique

A transvertebral screw and interbody washer technique was used to stabilise the vertebrae and maintain the intervertebral space in 34 adult dobermann pinschers with cervical spondylopathy. The long term success of the procedure was 50 per cent. Pre-operatively three dogs were considered mildly ataxic, 16 moderately ataxic, 13 severely ataxic and two non-ambulatory. Thirty dogs had radiographic changes of calcified disc, vertebral malalignment or narrow intervertebral disc space and all dogs had myelographic abnormalities in the caudal cervical spine. Vertebral malalignment and narrow intervertebral space correlated closely with myelographic cord compression. However, compressive lesions were not identified in 11 cases on plain films. Follow-up was available on 30 dogs of which 25 showed neurological improvement. This was temporary in 10 cases which were destroyed two weeks to three years following surgery.     

Temporary transarticular stabilization with a locking plate for medial shoulder luxation in a dog.

This report describes the temporary fixation of a traumatic shoulder luxation in a large-breed dog using a 3.5-mm Locking Round-Hole Reconstruction Plate (LRHRP) to provide stable internal splinting, allowing healing of the injured ligaments, joint capsule, glenohumeral ligaments, tendons, and muscles for restoration of joint stability. The use of a temporary plate with a locking system should be considered as an option in the treatment of canine shoulder joint luxations with severe tissue damage.