Summary: Objective: To determine the prevalence of patellar luxation in dogs in Italy and its relation to signalment, the frequency and the type of postoperative complications and the outcome of treatment, and to compare the findings with those of other studies.Materials and methods: The medical records from four referral clinics were searched for dogs with orthopaedic disorders referred from 2009 to 2014. From these data, the records of dogs with patellar luxation were identified, and the signalment, age and body weight, grade, side and direction of patellar luxation, treatment, postoperative complications, and outcome were retrieved. Univariate and multivariate statistical analyses were used to evaluate the data.Results: Of 8,694 canine orthopaedic cases, fractures not included, patellar luxation was diagnosed in 559 dogs (801 stifles). Mixed breed dogs were most commonly affected (18%), 85% of the luxations were medial, and 52% of the dogs were female. Of the 559 dogs examined, 400 (574 stifles) met the inclusion criteria for treatment evaluation. Minor complications occurred in five percent of the dogs, and major complications in 16%, including recurrence of patellar luxation in seven percent of the dogs. The outcome was good in 88% of stifles, fair in two percent, and poor in 10%.Clinical significance: Although patellar luxation was more common in small breed dogs, it also was diagnosed in a significant number of large breed dogs, which included medial patellar luxation in 73% and lateral patellar luxation in 27% of stifles. Body weight and grade of luxation were the only variables statistically correlated with surgical complications.ORCID iD AV: http://orcid.org/0000-0003-2837-7822
1 January 2010 in Veterinary and Comparative Orthopaedics and Traumatology
Summary: The aim of this study was to evaluate the feasibility of the double pelvic osteotomy (DPO) (osteotomy of the ilium and pubis) to treat clinical cases of hip dyplasia in young dogs instead of performing a triple pelvic osteotomy (TPO) (osteotomy of the ilium, pubis, and ischium). Candidates for DPO were 4.5- to nine-month-old dogs with coxofemoral joint subluxation and laxity, indicative of susceptibility to future development of severe hip dysplasia. The angle of reduction (AR) and angle of subluxation (AS) with Ortolani's sign, Norberg angle (NA), percentage of femoral head (PC) covered by the acetabulum, and the pelvic diameters and their relationships were measured clinically and radiographically before and after surgery. The surgical technique was similar to the TPO technique, but excluded ischiatic osteotomy. A DPO was carried out in 53 joints of 34 dogs AR and AS values immediately postoperatively and at the oneand two-month follow-up examinations were significantly lower than the preoperative values (p <0.01). The complications en-countered were mainly represented by implant failure (3.5%), partial plate pull-out (9.4%), and incomplete fracture of the ischial table (7.5%). Changes in PC and NA values obtained immediately after surgery and at the first and second follow-up examinations were significantly greater (p <0.01 both) than values obtained before surgery. Sufficient acetabular ventroversion was achieved to counteract joint subluxation and the modifications of AR and AS. The NA and PC direct postoperative values reflected a significant improvement in the dorsal acetabular coverage. Clinical relevance: Restoration of normal joint congruity (PC from 50 to 72%) and maintenance of the pelvic geometry without pelvic narrowing were the most intriguing features of DPO. The complications observed were greatly reduced when using dedicated DPO plates. Based on our experience, the morbidity after unilateral and bilateral DPO was lower than after TPO because elimination of the ischiatic osteotomy allowed for increased stability of the pelvis. The surgical technique of DPO was a little more demanding than TPO because of the difficulty in handling and rotating the acetabular iliac segment, but this difficulty was offset by elimination of ischial osteotomy.
1 March 2021 in Veterinary Clinics of North America: Small Animal Practice
Objectives: To evaluate the efficacy of juvenile pubic symphysiodesis (JPS) in a clinical setting for the early treatment of canine hip dysplasia (CHD), and to identify its indications and contraindications. Methods: The final degree of CHD using the FCI (Fédération Cynologique Internationale) CHD classification in 5 Grades (A, B, C, D, E) was assessed at skeletal maturity in two homogeneous groups of dogs assessed at the age of 14 to 22 weeks and selected according to their susceptibility to CHD; one group was treated with JPS and one group was conservatively managed. Two hundred seventeen puppies completed the study; 81 were treated with JPS (group 1) and 76 were conservatively managed (group 2). A third group of 60 puppies with normal hips was followed as a negative control group. Results: In group 1, 43.2% of the puppies had regression or a lack of progression of the disease in the final evaluation (Grade A & B), 25.9% had mild CHD (Grade C) and 30.9% had moderate and severe CHD (Grade D & E). In group 2, 23.6% of the puppies did not show any development of the disease (Grade A & B), 21.1% had mild CHD (Grade C) and 55.3% developed moderate to severe CHD (Grade D & E). Further investigation was done by comparing the severity of early signs of susceptibility to CHD with the final FCI Grades at adulthood in both groups. Clinical significance: The JPS procedure increased the odds of arresting or limiting the progression of CHD in mild to moderate grades of CHD, while it was less effective or ineffective in more severe forms.
Objective: To report outcomes and complications associated with total hip replacements (THR) using a multiuser canine hip registry (CHR) and owner‐administered questionnaire.Study design: Prospective longitudinal clinical study.Animals: Dogs (n = 1852).Methods: Total hip replacement cases submitted to a CHR were reviewed. An online questionnaire including an adapted “Liverpool Osteoarthritis in Dogs” (LOAD) score was e‐mailed to owners. Data were analyzed to determine associations between clinical variables and the agreement by veterinary surgeons and owners for complications.Results: A group of 1329 (72%) dogs had unilateral THRs and another group of 523 (28%) dogs had bilateral THRs, resulting in 2375 THRs. Indications included hip dysplasia and osteoarthritis (n = 2028/2375, 85%). Implants were manufactured by Kyon (n = 1087, 46%), BioMedtrix CFX (n = 514, 22%), BioMedtrix hybrid (n = 264, 11%), BioMedtrix BFX (n = 221, 9%), and Helica (n = 107, 4.5%). Median veterinary surgeon and owner follow up were 1328 and 900 days respectively. Postoperative LOAD scores (21 ± 9) reported by 461 owners improved compared to preoperative scores (11 ± 9) (P < .001). Veterinary surgeons reported complications in 201/2375 (8.5%) THRs and owners in 107/461 (23%) THRs, with moderate agreement (weighted kappa = 0.44). No associations were identified between complications and weight, age, sex, or breed. BioMedtrix BFX and Helica implants were associated with increased complications (P = .031) when used for revisions of femoral head and neck excisions.Conclusion: Excellent outcomes, including improved canine mobility, were reported after THRs. Complications were underreported by veterinary surgeons compared to owners in this first multiuser CHR.Clinical significance: Canine THRs are safe, effective procedures but THR implants should be carefully selected when revising femoral head and neck excisions.
26 December 2017 in Veterinary and Comparative Orthopaedics and Traumatology
Summary: Objectives: To evaluate the use of Kirschner wires for treatment of fractures of the lateral aspect of the humeral condyle in growing dogs.Methods: Retrospective analysis of 35 elbow fractures (33 dogs) of the lateral aspect of the humeral condyle treated by insertion of multiple transcondylar and one anti-rotational Kirschner wires. Radiographic and clinical re-evaluations were carried out immediately after surgery, at four weeks and, when required, at eight weeks postoperatively. Long-term follow-up was planned after a minimum of six months. The relationship between different implant configurations and clinical outcome was analysed statistically.Results: Complete functional recovery was seen in 31 elbows (30 dogs), three elbows (2 dogs) had reduction in the range of motion, and one elbow (1 dog) had persistent grade 1 lameness two months postoperatively. Major complications occurred in eight elbows (8 dogs) and all were resolved by implant removal. Implant configuration did not affect outcome. Long-term evaluation in 12 cases with a mean follow-up of four years showed absence of lameness, normal function and no or mild radiographic evidence of osteoarthritis in 11 cases.Clinical significance: Fracture of the lateral aspect of the humeral condyle in growing dogs can be successfully treated by multiple transcondylar convergent or parallel Kirschner wires, resulting in adequate fracture healing.