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Articles prepublished January 27, 2012

Canine hip dysplasia treated by juvenile pubic symphysiodesis

Journal:Veterinary and Comparative Orthopaedics and Traumatology (VCOT)
ISSN:0932-0814
DOI:http://dx.doi.org/10.3415/VCOT-09-04-0045
Issue:2010: Issue 5 2010
Pages:306-317

Canine hip dysplasia treated by juvenile pubic symphysiodesis

Part I: Two year results of computed tomography and distraction index

Online Supplementary Material

R. T. Dueland (1), W. M. Adams (1), A. J. Patricelli (2), K. A. Linn (3), P. M. Crump (4)

(1) Department of Surgical Sciences, University of Wisconsin, Madison, Wisconsin, USA; (2) Breckenridge Animal Clinic Surgical Services, Breckenridge Colorado, USA; (3) University of Saskatchewan, Saskatoon, Canada; (4) Department of Computing & Biometry, University of Wisconsin-Madison, Madison, Wisconsin, USA

Summary

Objectives: To measure one and two year effects of juvenile pubic symphysiodesis (JPS) in puppies defined as ‘at-risk’ for canine hip dysplasia (CHD) using the following objective hip conformation criteria: Acetabular angle (AA), dorsal acetabular rim angle (DARA) and hip laxity (PennHIP© distraction index (DI). Design: Controlled clinical case study. Animals: Thirty-nine dysplastic puppies (six controls). Procedures: The dogs were anaesthetised and acetabular angle, DARA, and DI values were obtained by computed tomography and radiography preoperatively. Electro-cautery fusion of the pubic symphysis was performed between 12 – 24 weeks of age. The imaging was repeated at one and two years of age. Results: Significant hip improvements were seen at the two-year follow-up appointments for: AA (JPS dogs 31% increase, control 3%), DARA (JPS 38% decrease, control 15%) and DI (JPS 41% decrease in laxity, controls 20%) for all postoperative versus preoperative values. Pubic fusion occurred with minor morbidity. Conclusion: Juvenile pubic symphysiodesis resulted in significant improvements in hip conformation (AA and DARA), especially in mild to moderately lax hips (DI = 0.40–0.69). Most dogs with DI≥0.70 increased in osteoarthritis grade by two years of age. Clinical relevance: Juvenile pubic symphysiodesis surgery at 12–24 weeks of age significantly improved hip conformation and decreased laxity in at-risk CHD dogs. Early-age (12 to 16 week) recognition of hip laxity offered greater JPS benefits than surgery performed at 19- to 24-weeks-old. Dogs with severe laxity (DI≥0.70) continued to increase in osteoarthritis. An early (12–16 weeks) positive laxity test (Ortolani) should alert one to obtain objective laxity determinations (PennHIP© DI).

Keywords

canine, Hip dysplasia, juvenile pubic symphysiodesis

DOI

http://dx.doi.org/10.3415/VCOT-09-04-0045

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