home Audience 12 Resection of the femoral head. Treatment of hip dysplasia in dogs

Resection of the femoral head. Treatment of hip dysplasia in dogs

Veterinary clinic "Alisavet" Moscow

Information for pet owners.

Definition. Dislocation hip joint(HB) or dislocation of the femoral head is a pathological displacement of the femur relative to the pelvis, which is accompanied by rupture of the round ligament and overstretching of the joint capsule.
Clinical picture. Animals with damage to the hip joint, as a rule, do not step on the affected limb (floating limb lameness). Depending on the etiology of the dislocation, the position of the limb can be bent and shifted inward or outward. On palpation, pain and crepitus are determined when the joint moves.
Causes. As a rule, the diagnosis of hip joint dislocation is made after an injury (fall, accident, etc.). It occurs quite often in small breeds of dogs (toy terrier, chihuahua, Yorkshire Terrier), as well as in cats. Spontaneous dislocation of the hip joint, which is not preceded by injury, is noted with hip dysplasia. This type of dislocation is typical for dogs of large or giant breeds and is rare.
Diagnosis. X-rays of the hip joint should be performed in two projections. Using X-ray data, you can not only clarify the diagnosis, but also exclude additional pathologies that often occur after injuries. The list of differential diagnoses includes hip subluxation, femoral head fracture, femoral head epiphysiolysis, hip dysplasia, acetabular fracture (Figure 1)

Figure 1. Radiography TBS dogs in direct projection. The red line shows the displacement of the femoral head relative to the glenoid cavity. Dislocation of the hip joint.

Treatment and prognosis. There are two ways to treat a dislocated femoral head. The first, conservative treatment, which is based on closed reduction of the dislocation and wearing immobilizing bandages. I would like to note that the reduction of a dislocation must be carried out under anesthesia. Efficiency conservative method quite low and depends on certain factors (age of the owner, type of dislocation, weight, temperament, breed of animal, etc.)
The surgical method is considered the most effective and the frequency of recurrence of dislocation, after a properly performed operation, is reduced to almost zero. Exist different ways and approaches surgical treatment:
1. Capsulorrhaphy (suturing of the capsule). The essence of the method is to suturing the capsule so that the joint cavity is slightly smaller than after dislocation. The method is performed on large animals. The disadvantage of this method is that the technical capsule can only be sutured dorsolaterally (from above), which does not guarantee recurrence of dislocation.
2. Fixation using Kirschner wires. This method is performed closed and open method. After reducing the dislocation, the wire is inserted through the head of the femur towards the acetabulum. Then the wire is shortened so that it can be easily removed, since the implant is installed temporarily. This method is simple to perform, but repeated dislocations are not uncommon.
3. Transposition of the greater trochanter. A surgical procedure in which stabilization of a dislocation is achieved by stretching the gluteal muscle. To do this, an osteotomy of the greater trochanter is performed and it is secured distally with pins or screws.
4. Round ligament replacement. This method is the most common and highly effective. The essence of the method is to restore the torn round ligament, which is anatomically located inside the joint and prevents the dislocation of the femoral head from the acetabulum (Figure 2).
5. Extracapsular stabilization. This technique is usually performed without opening the joint cavity, by placing retaining sutures between the bones: pelvic and femur.
6. Resection of the femoral head (Arthroplasty). Although it is believed that this method does not ensure the usefulness of the hip joint, it can be performed and recommended for animals with dislocation of the femoral head. The essence of the method is resection (removal) of the head of the femur, after which a connective tissue frame is formed in the joint area. The effectiveness of this operation may be somewhat greater if the animal undergoes postoperative physiotherapy.

The invention is intended for use in veterinary medicine, for resection arthroplasty of the hip joint and can also be used in the surgical treatment of tumors of the head and neck of the femur, Legg-Calvé-Perthes disease, fractures of the head and neck of the femur, dysplasia of the hip joints, coxarthrosis. A method of resection arthroplasty of the hip joint in dogs by means of a linear incision of the skin, cranilateral approach according to Archibald et al., transverse dissection of the cranial part of the joint capsule from the place of attachment to the pelvic bones to the neck of the femur and osteotomy of the head and neck of the femur along the level of the line connecting the big and the lesser trochanter of the femur, followed by layer-by-layer closure of the wound, differs in that a linear skin incision with a craniolateral approach is made over 4-8 cm, the proximal part of the vastus lateralis muscle m is prepared. vastus lateralis over 2-5 cm from the underlying femur, then U-shaped sutures are passed through the caudal part of the joint capsule, the free ends of which are sutured through the proximal part of the vastus lateralis muscle m. vastus lateralis; alternately tightening the U-shaped sutures, transpose the muscle between the pelvic bones and the femur. The proposed method reduces the duration of the operation, reduces its trauma, prevents damage to the sciatic nerve, and shortens the time for recovery of the musculoskeletal function of the limb. 2 ill.

The invention relates to veterinary medicine, namely to resection arthroplasty of the hip joint and can be used in the surgical treatment of tumors of the head and neck of the femur, Legg-Calvé-Perthes disease, fractures of the head and neck of the femur, hip dysplasia, coxarthrosis. There are known methods for resection arthroplasty of the hip joint in dogs. Berzon method. The hip joint is approached using a craniolateral approach according to Archibald et al. /Piermattei D.L., Brumm F.R. Zugange zum Skelettsystem von Hund und Katze: Atlas mit Operationsbeschreibung, p.234 - 235. Stuttgart; New York: Schattauer 1996/. An osteotomy of the head and neck of the femur is performed using a chisel or ascillary saw. To reduce pain from friction of the femur on the pelvic bone and speed up the period of restoration of the musculoskeletal function of the hip joint, a muscle flap from m. gluteus profundus. A drill is used to perforate two holes in the femur at the site of the osteotomy of the head and neck. The muscle flap is sutured to the site of osteotomy of the head and neck of the femur, passing the threads through the perforated holes /Berzon, J.L. (1980) A retrospective study of the efficacy of femoral head and neck excision in 94 dogs and cats. Vet. Surg., 9, 88-99/. Disadvantages of this method: muscle flap formed from m. gluteus profundus, is not always able to adequately cover the osteotomy area of the femur and create an adequate layer between the bones, which will subsequently lead to prolonged painful contact and inadequate restoration of limb function. Perforation of two holes in the femur and suturing of a muscle flap to the site of neck osteotomy makes the operation difficult. Method W. Off: A craniolateral approach is performed to the hip joint according to Archibald et al. An osteotomy of the head and neck of the femur is performed using a chisel or ascillary saw. To prevent painful contact between the femur and the acetabulum, the hypertrophied capsule of the hip joint is interposed and the dorsal and ventral parts of the capsule are sutured with interrupted sutures. 1989. Vet. Med. Diss. Munchen/. Disadvantages of this method: It is not always possible to completely cover the pelvic bones with the joint capsule and prevent painful contact between the bones. Complete separation of the joint capsule from the femoral neck leads to increased limb instability, dorsal displacement of the femur, and shortening of the limb. The closest method to the proposed one is the Lippincott method of resection arthroplasty. A craniolateral approach is performed to the hip joint according to Archibald et al. through a skin incision of 14-15 cm. A transverse dissection is made of the cranial part of the joint capsule from the place of attachment to the pelvic bones to the femoral neck. An osteotomy of the head and neck of the femur is performed using a chisel or ascillary saw. The next stage is the formation of a muscle flap from m. biceps femoris and perforation of the caudal part of the joint capsule (Fig. 1a); passing a muscle flap through the caudal part of the joint capsule (interposition of a muscle graft between the pelvic bones and the femur) and suturing it to the cranial part of the joint capsule and m. vastus lateralis with nylon, interrupted sutures (Fig. 1c). /Lippincott, S.L. (1981) Improvement of excision arthroplasty of the femoral head and neck utilizing a biceps femoris muscle sling. J. Am. Anim. Hosp. Assoc., 17, 668-672 - prototype method/. Disadvantages of this method: formation of a muscle flap from m. biceps femoris involves expanding surgical access, increasing surgical trauma and operating time. The duration of the surgical intervention is 60-90 minutes. Perforation of the caudal part of the joint capsule can lead to damage to the sciatic nerve. Complete restoration of the musculoskeletal function of the limb was noted on days 35-40. The proposed method allows us to eliminate these shortcomings of the operating technique and speed up the rehabilitation time of the animal. The essence of the proposal is that in the method of resection arthroplasty of the hip joint in dogs, including a craniolateral approach to the hip joint according to Archibald et al. through a skin incision of 4-8 cm, transverse dissection of the cranial part of the joint capsule and osteotomy of the head and neck of the femur, along the level of the line connecting the greater and lesser trochanters of the femur, the proximal part of the m. vastus lateralis from the underlying femur for 2-5 cm, after which U-shaped sutures are passed through the caudal part of the joint capsule, the free ends of which are stitched through the proximal part of the m. vastus lateralis; alternately tightening the U-shaped sutures, transpose the muscle between the pelvic bones and the femur and suturing it to the caudal part of the joint capsule, followed by suturing the surgical wound. The proposed method is performed as follows. The hip joint is approached using a craniolateral approach according to Archibald et al. , through a skin incision of 4-8 cm. A transverse dissection is made of the cranial part of the joint capsule from the place of attachment to the pelvic bones to the femoral neck. Using a chisel or ascillary saw, an osteotomy of the head and neck of the femur is performed along the level of the line connecting the greater and lesser trochanters of the femur. The next stage is preparation of the proximal part of m. vastus lateralis from the underlying femur for 2-5 cm, then interposition of the proximal part of the m. vastus lateralis dorsocaudally into the cavity of the joint capsule (between the pelvic bones and the femur) and suturing to the caudal part of the joint capsule, with U-shaped sutures, for example nylon (Fig. 2 a; c). Achieved technical result. The operation can be performed through a skin incision that is two times smaller than the prototype method. Minimal surgical trauma and simple surgical technique reduces the operation time to 30-50 minutes. Preservation of the caudal part of the joint capsule prevents damage to the sciatic nerve. The muscle graft provides painless contact between the femur and the acetabulum. The first clinical results show a reduction in the recovery time of musculoskeletal function of the limb by 5-7 days. In not a single clinical case was the primary function of m. vastus lateralis. Examples of specific implementation. Example 1. A dog of the Mastino-Neopalitano breed, male, age 2.5 years, was admitted to the clinic with complaints of severe lameness of the right pelvic limb. After clinical and radiological examination, a diagnosis of severe unilateral dysplasia of the right hip joint was made. The operation was performed under general anesthesia . Through a linear skin incision 8 cm long, a craniolateral approach to the hip joint was performed according to Archibald et al. , the cranial part of the joint capsule was transversely dissected from the place of attachment to the pelvic bones to the femoral neck. The head and neck of the femur were osteotomized using an ascillary saw along the level of the line connecting the greater and lesser trochanters of the femur. The next stage was to prepare the proximal part of m. vastus lateralis from the underlying femur for 4 cm and interposed the proximal part of m. vastus lateralis dorsocaudally into the cavity of the joint capsule (between the pelvic bones and the femur), followed by suturing to the caudal part of the joint capsule with U-shaped sutures. The surgical wound was sutured in layers with nylon using interrupted sutures. The duration of the operation was 50 minutes. Complete restoration of the musculoskeletal function of the limb was noted on the 28th day after surgery. No complications were identified in the early or late postoperative periods. Example 2. A male poodle dog, 8 months old, was admitted to the clinic with complaints of severe lameness of the left pelvic limb. After clinical and radiological examination, a diagnosis of Legg-Calvé-Perthes disease of the left hip joint was made. The operation was performed under general anesthesia. Through a linear skin incision 4 cm long, a craniolateral approach to the hip joint was performed according to Archibald et al., and the cranial part of the joint capsule was transversely dissected from the place of attachment to the pelvic bones to the femoral neck. The head and neck of the femur were osteotomized using an ascillary saw along the level of the line connecting the greater and lesser trochanters of the femur. The next stage was to prepare the proximal part of m. vastus lateralis from the underlying femur for 2 cm and interposed the proximal part of m. vastus lateralis dorsocaudally into the cavity of the joint capsule (between the pelvic bones and the femur), followed by suturing to the caudal part of the joint capsule with U-shaped sutures. The surgical wound was sutured in layers with nylon using interrupted sutures. The duration of the operation was 30 minutes. Complete restoration of the musculoskeletal function of the limb was noted on the 22nd day after surgery. No complications were identified in the early or late postoperative periods. The proposed method was performed at the Experimental Therapy Clinic of the Russian Cancer Research Center named after. N.N. Blokhin RAMS in 15 dogs. The indications for surgery were: chondrosarcoma of the femoral head and neck - 1 dog; hip dysplasia - 10; Legg-Calvé-Perthes disease - 2; fracture of the head and neck of the femur - 2 dogs. The duration of the surgical intervention ranged from 30 to 50 minutes. In general, support on the tips of the fingers of the operated limb was noted on days 6-7. After 14-17 days, the dogs had partial use of the operated limb. Complete restoration of limb function was noted on days 20-28. No complications were noted in this group of animals in the early and late postoperative periods. The animals were tracked for 6 to 18 months.

Dog hip dysplasia is one of the pathologies in veterinary medicine, which originates from the stages of animal domestication. Wolves or wild dogs that had this pathology, could not move and hunt in full and therefore died as a result of natural selection of nature. During the process of domestication, dogs had a serious function in human life: hunting, guarding, etc., so weak and unviable dogs were clearly discarded from breeding.

In modern times, we regard a dog primarily as a family member, a pet, or simply a companion for life, and therefore the criteria for strict selection of the working qualities of animals fade into the background. Most often, people evaluate dogs from the point of view of character and appearance and often forget about such an important part as health. Therefore, in today's veterinary medicine, doctors encounter pathologies in animals that were not previously widespread and did not pose a serious problem for veterinary specialists, breeders and simply dog lovers.

Veterinary orthopedic specialists not only in our country, but throughout the world are doing a great deal of work to prevent this disease, developing various tactics for conservative and surgical methods of treating hip dysplasia, and maintaining statistics on the methods of treatment used and the outcome of the disease.

Hip dysplasia occurs in all dog breeds, but dogs are most susceptible large breeds: Rottweiler, Labrador, German and East European Shepherds, Alabai, Moscow Watchdog. Among small breeds canine hip dysplasia occurs in pugs.

Hip dysplasia is a pathology characterized by certain anatomical inconsistencies, which will be discussed below. To better understand these discrepancies, you need to have a good understanding of the structure and function of the dog's hip joint.

The structure of the dog's hip joint

The dog's hip joint is not complex. This is a ball-and-socket joint consisting of the acetabulum of the pelvis and the head of the femur entering into it. The ligamentous apparatus of the joint is represented by the articular capsule and the round ligament, which is located at the bottom of the acetabulum of the pelvis. The round ligament connects the head of the femur and the acetabulum, providing stability to the joint. The acetabulum, except for the attachment point of the round ligament, and the femoral head are lined with cartilaginous tissue. The joint cavity contains synovial fluid. Movements in the hip joint can be performed in different planes. This is primarily due to its anatomical structure in the form of a ball-and-socket joint. Its mobility is controlled by several components: the round ligament, the articular capsule and the special shape of the surface of the acetabulum.

To perform its function normally, the joint must also be stable. Stability is ensured by the ligamentous apparatus (articular capsule, round ligament, muscles around the joint), as well as clear comparability of the articular surfaces - the presence of congruence. To reduce friction of the articular surfaces, the joint contains synovial or articular fluid. In addition to reducing friction, synovial fluid serves as a nutrition for cartilage cells on the articular surfaces.

For the proper functioning of the hip joint, the following aspects are important:

anatomical structure of the acetabulum (take into account its size, depth and shape);
anatomical structure of the femoral head (take into account its shape and size);
congruence and degree of mobility between articular surfaces;
angle of inclination and length of the femoral neck;
hip joint capsule strength;
structure and function of tendons and muscles.

What does dysplasia mean in dogs?

The name of the disease - dysplasia - has its own functional justification and, when translated from Greek, means “pathological growth”. According to many data from foreign veterinary specialists, hip dysplasia is a hereditary disease that manifests itself during the dog’s growth period. Initially, a dog may be born with healthy hip joints, but later in the process of growth, weakness of the ligamentous apparatus of the hip joint appears and the process of disease development will begin. In puppies, changes in the load on the surface of the acetabulum or any other anatomical disturbances during the period active growth can irreversibly change the shape of the articular surfaces and also lead to joint subluxation. This will greatly affect the functioning of the joint and leads to pathological stress on them. Over time, it develops to remodeling of the hip joint and the development of deforming arthrosis.

The cause of pathological weakness of the ligamentous apparatus of the hip joint in puppies is still not clear. According to some sources, it is believed that this is caused by a violation of the development of the head of the femur and acetabulum initially, according to others - by changes in the ligamentous apparatus of the joint itself.

In modern veterinary medicine, it is believed that the probable causes of the development of hip dysplasia in dogs are:

changes in the anatomy of the hip joint: flattening of the acetabulum, changes in the neck-diaphyseal angle;
changes in the anatomy of other joints of the pelvic limb;
genetic factor;
underdevelopment of muscle mass;
obesity or too rapid growth of the dog;
hormonal disorders of the reproductive system;
neuromuscular diseases;
lack of vitamin C.

In any case, regardless of the causes of dysplasia, the disease leads to overstretching of the joint capsule and subluxation. There is an excessive load on the joint capsule and it becomes damaged and inflamed. Swelling and subluxation lead to impaired joint mobility, irritation of nerve endings occurs and severe pain develops.

Clinical signs of hip dysplasia in dogs

Clinical signs of hip dysplasia depend on the age of the animal and the degree of dysplasia. In puppies, clinical signs develop gradually as the problem progresses. They become more noticeable from 4-9 months of age. Initially, when examining a puppy, signs of hip instability will not be noticeable even to the most experienced veterinarian. As you get older, the subluxation of the hip joint will increase, the joint capsule will begin to stretch and become inflamed, resulting in pain. Such puppies become inactive, have difficulty standing up, and pain may occur when the affected limb is abducted. In cases where the instability is significant, a click may occur in the hip joint.

Also, at the initial stage of the disease, puppies will have a noticeable “wobbly gait.” This strange gait is the result of instability of the hip joint along the transverse axis. The dog tries to walk normally, but due to the pain, it compensates for the stress on the joints by rocking its back from side to side. This helps the dog move forward without increasing the range of motion in the hip joint.

By reducing mobility in the hip joint, the dog also reduces the range of motion in the knee and hock joints, placing its paws at right angles. As a result, the dog walks on its paws extended at the joints.

In cases where the instability of the hip joint is severe enough, you can feel a click when you put your hand on the dog's hip joint while walking.

If pain manifests itself, atrophy of the muscles of the pelvic limbs will appear after at least 1-1.5 months. Visually, such a dog has a more massive front part of the body than the back. This occurs due to the transfer of body weight when moving to the thoracic limbs due to pain.

In dogs with dysplasia, the process of remodeling of the hip joint occurs. The peak occurs after about a year, when the dog’s body stops growing. The remodeling process is the body’s natural response to instability and consists of many mechanisms.

The final stage of the remodeling process is damage to the cartilage of the articular surfaces, stretching or rupture of the ligamentous apparatus of the hip joint, the formation of incongruence of the articular surfaces, the formation bone growths in the area of the edges of the acetabulum, and the final stage is the development of deforming arthritis of the hip joint.

In adult dogs, clinical signs will be observed as a result of degenerative changes in the hip joint. During the process of remodeling, the joint undergoes irreversible changes. As a rule, the joint becomes stable, but the articular surfaces will be irreversibly changed and susceptible to arthrosis. Such dogs experience pain, especially when getting up, and often such dogs refuse to get up. Upon examination, a decrease in the amplitude of mobility in the joint may be observed as a result of deforming arthrosis. Atrophy of the muscles of the pelvic limbs is also observed. As a result of the inability to move normally, these dogs are often overweight. An overweight dog with dysplasia practically cannot tolerate physical activity.

Diagnosis of hip dysplasia in dogs

Diagnosis of hip dysplasia in dogs consists of different research methods, since it is very important to determine the type of dysplasia and make the right decision about treating the animal. Owners, how important is an early visit to a veterinarian, even if a strange gait occurs or simply for prevention. When diagnosing dysplasia in early age the effect of treatment is achieved better than in advanced stages of the disease. Also early diagnosis will allow you to avoid expensive and quite traumatic operations.

Diagnosis of hip dysplasia consists of examining the animal, performing specific diagnostic tests for the hip joints, x-rays and, in some cases, a CT scan.

During the examination, the veterinarian will collect anamnesis, assess the degree of mobility of the hip joint, determine the presence or absence of pain in the joint, lameness or atrophy of the muscles of the pelvic limbs. In some cases, when the instability of the hip joint is significant, upon examination you can feel the moment of subluxation or dislocation.

A competent general examination will help in making a diagnosis, but only special tests and specialized research methods will help make it definitively. Special diagnostic tests in dogs are recommended to be carried out under sedation so that tension does not interfere. The essence of these tests is to determine whether there is instability of the hip joint (dislocation or subluxation) and to determine a special Barlow angle for further surgical treatment.

There are two common tests for hip dysplasia:

The essence of the Ortolani test is to create a subluxation in the hip joint. This test is carried out in supine position on the side. Veterinarian hands creates pressure on the knee joint, this leads to its subluxation. Without reducing the pressure, the veterinarian moves the dog's limb laterally and the hip joint snaps into place. A click is felt in the joint, which means the test is positive. Normally, pressure on the knee joint does not cause subluxation of the hip joint.

Bardens test

The essence of the Bardens test is also to achieve subluxation of the hip joint. This test is carried out in a lateral position. The veterinarian holds his fingers simultaneously on the ischial tuberosity and the greater trochanter of the femur, while with the other hand he shifts the femur to the mediolateral side, as if shifting the femoral head from the acetabulum downwards. With subluxation of the hip joint, a shift of the greater trochanter to the lateral side is felt. This symptom is positive.

For full diagnostics X-ray examination is performed to detect hip dysplasia. A prerequisite for this procedure is the use of sedation.

Radiographs take into account all the signs of hip dysplasia, namely:

identify all signs of instability of the hip joint by displacement of the femoral head from the acetabulum:
-- Rhodes Jenny index - measurement of the lowest and highest points of the acetabulum;
-- Norberg-Olsson angle: determine the center of the femoral head using a stencil with marked circles and draw a line between them, then measure the angle formed by this line and a line drawn through the upper bony edge of the acetabulum. The norm is 105 degrees.
The structure of the hip joint is assessed by the femoral head and acetabulum.
identify signs degenerative disease hip joint with dysplasia.

Sometimes Penn stress films can be done for hip dysplasia. At this method joints are assessed under load. The assessment is based on hip instability only.

CT scans of the hip joints can be used in similar ways to x-rays, such as measuring angles and detecting instability. If we compare X-ray diagnostics and CT, then X-ray diagnostics is cheaper and no less informative method research.

After a diagnosis such as hip dysplasia is made, its type is determined.

Hip dysplasia is divided into two types:

Acetabular dysplasia (Dysplasiaacetabula).
This type of dysplasia is caused by a normal neck-shaft angle (135 degrees) and weakness of the ligamentous apparatus.
Cervical-diaphyseal dysplasia (Coxavalgaantetorta).
This type of dysplasia is characterized by a change in the neck-shaft angle and the presence of a normal acetabulum. The angle for this pathology is more than 150 degrees.

Understanding the differences between types of dysplasia is very important when deciding whether to undergo surgical treatment.

To determine the degree of dysplasia, a special classification was created. It may differ in different countries, but the essence remains the same. In Russia, it is customary to classify dysplasia as A, B, C, D, E:

A - Normal joint;
B - Joint within acceptable limits;
C - Dysplasia mild degree;
D - Moderate dysplasia;
E - Severe dysplasia.

Methods for controlling hip dysplasia in dogs

Hip dysplasia control methods should be implemented by breeders and owners of dog breeds at risk. At the moment, X-ray examination for dysplasia is carried out from the age of 12 months, when the dog has already grown. If such a diagnosis is confirmed, the dog should be discarded from breeding and sterilized.

If hip dysplasia is suspected, it is better to conduct an X-ray examination from 2-16 weeks of age. Research at an early age will significantly affect the dog’s recovery process and will help avoid radical surgical interventions.

Treatment of hip dysplasia in dogs

There are two types of treatment for hip dysplasia - conservative and surgical treatment.

Conservative treatment aimed at reducing the load on the joint, especially in young animals. The dog's weight should be seriously monitored with balanced diet to avoid increased stress on the sore joint. It is also important to monitor your dog's physical activity in terms of frequency, duration and type. It is important that a dog suffering from dysplasia has a good muscular frame to provide support for the diseased joint. The best exercise is slow walking on a leash. For dogs with severe dysplasia, walking starts at 5 minutes a day, then increases by 5 minutes. If the lameness intensifies, then no time is added. If pain occurs, especially in older dogs with secondary signs of arthrosis deformans, non-steroidal anti-inflammatory drugs are prescribed for a long course.

Surgery Hip dysplasia depends on the type of dysplasia and the age of the animal.

This is the simplest surgical technique to prevent the occurrence of hip dysplasia. With coagulation of the pubic fusion of the pelvis, the growth of the pubic bone slows down, and the pelvis begins to grow in width. With this growth, the acetabulum rotates to cover the femoral head and make the joints stable. This surgical intervention is not painful for the dog and makes it possible to walk immediately in full. This procedure is performed on dogs up to 20 weeks of age. The most best time This technique takes up to 16 weeks.

Pelvic osteotomies (double and triple)

This type of surgical treatment is performed on dogs from 6-7 months of age for acetabular dysplasia, when juvenile symphysiodesis is no longer advisable. Also this type The operation is not suitable for dogs with damage to the dorsal edge of the acetabulum and signs of arthrosis of the hip joint. Although pelvic osteotomy is sufficient complex operations, but are used quite often in veterinary practice. The essence of the operation is to rotate part of the pelvis so as to rotate the acetabulum and cover the femoral head, as a result of which the joint becomes stable. After surgery, a mandatory rule is to limit the dog’s mobility for the period of pelvic fusion. The advantage of this operation is the preservation of the joint.

Intertrochanteric osteotomy

This type of surgery is performed on dogs with an irregular neck-shaft angle greater than 150 degrees. The operation is performed on the femur. The essence of the method is to change the angle and immerse the femoral head into the acetabulum.

Resection arthroplasty of the hip joint

This type of surgery consists of removing the femoral head and forming a pseudarthrosis. The use of this technique is possible only when the hip joint is destroyed as a result of deforming arthrosis. The operation is performed primarily to relieve pain.

Hip replacement

This is a total hip replacement in dogs - a technique that gives good results, but is expensive.

In conclusion of this article, I would like to say about the problems of breeding in our country. When purchasing a puppy of a breed prone to hip dysplasia, you must look at documents confirming that the dog's parents have been tested for hip dysplasia. If you already have a dog and you notice a change in gait and other signs of dysplasia listed above, then do not delay in visiting a veterinarian. Remember! The sooner the disease is diagnosed, the easier it will be to treat your pet.

Clinical case of treatment of hip dysplasia in a dog

Hosts German Spitz nicknamed Ulli (6 years old) contacted GVOTS Pride with complaints that she had stopped stepping on her right pelvic limb. After an X-ray examination and examination by an orthopedic traumatologist, a diagnosis was made of pathological dislocation of the hip joint on the right as a result of hip dysplasia with developed arthrosis.

Hip dysplasia in dogs is a disorder of the development of the joint, its structures from bones to ligaments. If the dog is older than 10 months and has already developed secondary osteoarthritis, then resection arthroplasty is performed for this disease. After this operation, the function of the joint will be restored and there will be no pain.

Ulli underwent a preoperative examination and underwent resection arthroplasty, after which she emerged from anesthesia in the clinic under the supervision of doctors and went home.

Within a few days, Ulli began to use her operated paw.

Veterinary surgeon, specialist in traumatology, orthopedics and neurology Maslova E.S.
Veterinary anesthesiologist Smirnova O.V.

Use: veterinary medicine. The essence of the invention: the method is a reconstructive surgery of the hip joint in dogs with dysplasia, namely total arthroplasty of the dysplastic joint. The method includes resection of the femoral head, deep arthrosis of the acetabulum, implantation of an artificial ligament and myoplasty of the joint capsule. The method allows you to achieve full recovery functions of the operated joint and the limb as a whole.

Hip dysplasia is a polygenically inherited disease characterized by loss of conformity between the articular surfaces and leading to dislocation or arthrosis in the joint. Among service breeds Dog dysplasia is widespread, and in the absence of measures to combat it, the frequency of its occurrence can reach 60-70% (Belov A.D. et al. 1994). The hereditary factor of joint underdevelopment is the trigger point for the occurrence of congenital dislocation hip or dysplasia. Hip dysplasia is a malformation of all parts of the joint (acetabulum, head of the femur, adjacent muscles, ligamentous apparatus), as well as damage or underdevelopment of its individual elements. If left untreated, hip dysplasia can lead to serious degenerative changes articular surfaces, bursa-ligamentous apparatus and, as a consequence, persistent dysfunction of the affected limb, manifested, as a rule, in the animal’s uncertain gait, weakness of the limbs or complete refusal move. Due to dysplasia, deforming arthrosis can occur (Korzh A.A. et al. 1987), osteochondropathy, varus curvature of the femoral neck, etc. (Kutsenok Ya.B. et al. 1992). Known methods surgical treatment dysplasia of the hip joints in dogs by: shortening step osteotomy of the femur (Mitin V.N. 1984), intertrochanteric wedge-shaped osteotomies, allowing to change the angle of entry of the femoral head into the acetabulum, followed by osteosynthesis Prieur W. D. Scartazzini R. 1980; Prieur W.D. 1990), supraacetabular pelvic osteotomy according to K. Chiare (1955) with the creation of the roof of the acetabulum and increasing the area of the loaded surfaces of the femoral head and acetabulum (Bohler N. et.al. 1985; Kruger K. 1991), triple pelvic osteotomy (David T. 1986; Schrader S.C. 1986; David T. Kasper M. 1991; etc.), total arthroplasty with complete replacement of the maternal joint with an artificial one (Parker R.B. et. al. 1984; Perot F. 1985, etc.). All of these methods of surgical treatment, including endoprosthetics, do not always give good results (Bennett J.T. Mac Even S.D. 1989, Markov Yu.A. et al. 1990). The prototype of the invention is a method for surgical treatment of hip dysplasia in dogs by resection of the femoral head. The method includes resection of the femoral head through a craniolateral approach. The head is cut off with a chisel. The wound is stitched up. After two weeks, massage is recommended. I haven't found a way yet wide application due to a number of residual pathological symptoms (lifelong instability and external rotation in the hock joint in dogs; lack of complete restoration of limb function. Considering the above, it was possible to develop a new method of reconstructive surgery, which avoided complications characteristic of already known methods of surgical treatment, and also allowed to restore the functional suitability of the affected joint and the limb as a whole. The method is carried out as follows. An incision is made along the outer surface of the thigh in the skin and subcutaneous tissue in the form of a semicircle 5-7 cm long, encircling the greater trochanter. The deeper layers are separated along the fibers using a blunt and sharp method muscles (superficial, middle and deep gluteal, piriformis muscle). Next, the joint capsule is dissected, if it is preserved. A Gigli saw is passed under the greater trochanter, encircling the femoral neck, and the head is resected. A prerequisite for this stage of arthroplasty is the treatment of the femoral neck stump with a rasp. The resected head is removed out. The second stage of the operation is the excision of soft tissue growths on the acetabulum and deep arthrosis (reaming) with a ball-shaped cutter, thereby creating a “roof” covering for the future femoral head. The third stage of the operation consists of implanting an artificial ligament of the hip joint, which is usually absent in cases of dysplasia. For this purpose, three strands of chrome catgut p4 are woven like a woman’s braid and fixed transsocally to the greater trochanter and the upper arch of the acetabulum through pre-drilled channels in the bone. The implanted artificial ligament is given optimal physiological tension, which is controlled by abduction and adduction movements, as well as flexion-extension and rotational movements of the limb. The final, fourth stage of the proposed method is myoplasty of the joint capsule. For this purpose, a purse-string suture is applied to the joint capsule and adjacent muscles, tightening it in the area of the femoral neck stump. The surgical wound is sutured tightly in layers. In the postoperative period, a complex is carried out rehabilitation measures, allowing to achieve complete restoration of the function of the operated joint and the limb as a whole. According to the conducted morphological studies, a new full-fledged joint is formed in place of the former dysplastic joint. Reparative regeneration occurs according to the type of neoarthrosis formation. Thus, the method includes four successive stages, which are its integral parts. Only a competent combination of the above four stages makes it possible to achieve complete restoration of the function of the diseased limb. After several months, the implanted artificial ligament grows with connective tissue, and in its place a powerful scar is formed, reliably fixing the proximal epiphysis of the femur in the area of the acetabulum. Implantation of an artificial ligament, as well as myoplasty of the joint capsule, prevents the occurrence of instability and external rotation in the hock joint, which was noted by the authors (Chwilezynski M. 1975; Ormond A.N. 1961), who used known methods surgical treatment of hip dysplasia in dogs. Arthrosis of the acetabulum eliminates the likelihood of pain when loading the limb and the formation of scratches and other damage to the cartilage during movement of the proximal epiphysis, which, in turn, prevents inflammatory processes cartilage tissue acetabulum. Thus, the proposed method allows Sanatio anatomica et restitutio functionalis to achieve anatomically correct treatment and the most complete functional restoration.

Claim

METHOD FOR SURGICAL TREATMENT OF HIP JOINT DYSPLASIA IN DOGS, including resection of the femoral head and treatment of the femoral neck stump, characterized in that after treatment of the femoral neck stump, arthrosis of the acetabulum, implantation of an artificial ligament and myoplasty of the hip joint capsule are performed.

Similar patents:

The invention relates to agricultural microbiology, namely to phage preparations and their use to combat salmonellosis

The invention relates to genetic engineering of animals, experimental and molecular biology, biotechnology, and can be used in experimental medicine, veterinary medicine and livestock breeding

Results of clinical examination, radiography and motion analysis. Department of Surgery, Faculty of Veterinary Medicine, Ludwig Maximilian University, Munich, Germany.

VetCompOrthopTraumatol 2010; 23: 297-305

Original source: Off W, Matis U. ResektionsarthroplastikdesHüftgelenkesbeiHundenundKatzen.

Klinische, röntgenologische und ganganalytische Erhebungen an der Chirurgischen Tierklinik der Ludwig-Maximilians-Universität München. Tierärztl Prax 1997; 25: 379–387.

Summary

From 1978 to 1989 At the Department of Veterinary Surgery of the Ludwig Maximilian University, Munich, Germany, 132 femoral head and neck osteotomies were performed in dogs and 51 in cats. Eighty-one (44%) animals underwent follow-up clinical examination and radiography at an average of 4 years postoperatively, with 17 animals also undergoing motion analysis. Functional results were rated as good in 38% of cases, satisfactory in 20% and unsatisfactory in 42% of cases. However, 96% of owners were satisfied with the results of the operation. As shown by kinetic and kinematic measurements, despite the relief of pain after resection of the head and neck of the femur, as a result of the operation appeared functional disorders in both small and large dogs. These disturbances were not noticeable during fast gaits.

Introduction

Osteotomy of the femoral head and neck (FCH) – relatively simple procedure, which has become the subject of many studies (1, 2, 4–8, 10–12, 18–24). Techniques and surgical approach vary, as do the results of the procedure. Some researchers have relied solely on owner assessment of outcome by completing questionnaires.

This study was conducted to evaluate the effectiveness of OGBC according to clinical examination and radiography of patients after surgery, performed at the Department of Veterinary Surgery, Ludwig Maximilian University, Munich, Germany. Some dogs were also analyzed for kinetics and kinematics, since the human eye is not able to correctly evaluate the full movement of a four-legged animal.

Materials and methods

Between 1978 and 1989, 132 dogs and 51 cats underwent OGBC surgery. This procedure was used in cases where joint preservation was not feasible or practical (Fig. 1). The most common indication in dogs was avascular necrosis of the femoral head due to Legg-Calvé-Perthes disease; most animals suffering from this disease weighed

In all cases, a craniolateral approach to the hip joint was used. After bending the joint capsule and cutting the round ligament, the limb was rotated 90° outward. An osteotome or vibrating saw was used to perform osteotomy of the femoral head. Sometimes the lesser trochanter was also cut off. To completely remove the caudal edge of the femoral neck, the osteotome or saw was held perpendicular to the long axis of the femoral neck (Fig. 3). The goal of this intervention was to create a smooth resection plane without bony protrusions. In most cases, the joint capsule was closed to create a layer of tissue between the acetabulum and the cutting surface of the femur after removal of the head and neck (Fig. 4) (17). Toward the end of the study, some animals received two additional sutures of durable, slowly absorbable material to secure the gluteal tendons to the insertion of the rectus femoris muscle to prevent caudodorsal displacement of the femur. The wound was sutured in the usual way. Immediately after surgery, photographs were taken in the ventrodorsal projection to determine the osteotomy plane.

Follow-up examinations of 81 animals (66 dogs and 15 cats) were carried out 7 months to 10 years after surgery (average 4 years) in our clinic.

Rice. 1. Indications for osteotomy of the femoral head and neck in 132 dogs and 51 cats.

Rice. 2. Weight distribution of 132 dogs and 51 cats who underwent osteotomy of the femoral head and neck (the weight of 5 dogs is unknown).

Rice. 3. Orientation of the osteotome during femoral neck osteotomy.

Rice. 4. The joint capsule was positioned between the osteotomy site and the acetabulum to avoid pain due to contact of the two bony surfaces.

a) view of the hip joint in the transverse plane before resection;

b) view after removal of the head and neck of the femur;

c) closing the joint capsule;

d) ventral view of the acetabulum after closure of the joint capsule.

Clinical parameters assessed included lameness, muscle atrophy, pain with passive movement, crepitus, caudodorsal displacement of the femur, and range of motion. These objective variables were supplemented by the owners' assessment of the following indicators:

duration postoperative symptoms;
duration of the postoperative recovery period;
leaning on the affected limb during slow gait, fast gait, after strenuous physical activity and in cold or damp weather;
subjective assessment of the success of surgical intervention.

Scores were assigned as follows:

good: no lameness, the animal fully relies on the limb at all gaits;
satisfactory: slight lameness, sometimes stiffness, sometimes lameness without support of the limb;
unsatisfactory: mild to severe persistent lameness, the animal often does not support the limb, lameness after exercise, lameness when trotting and/or galloping, lameness associated with weather.

In 67 cases (55 dogs and 12 cats), radiographs were taken immediately after surgery to assess the completeness of resection of the femoral neck with or without removal of the lesser trochanter and to ensure that there were no sharp bone edges along the osteotomy line. 17 dogs were also studied in a movement assessment laboratory (18, 19). Using a treadmill with four built-in load plates, the following kinetic parameters were assessed:

duration of the support phase (ms);
peak vertical support load (% of body weight);
slope of the support load curve (% of body weight/sec);
integral (% of body weight x sec).

Kinematic data were obtained using reflective markers placed on the iliac crest, greater trochanter, lateral femoral condyle, malleolus of the fibula, and tarsus during movement.

results

Postoperative assessment showed shortening of the limb in 68 animals (84%) (caudodorsal displacement of the femur), muscle atrophy in 61 (75%) animals, a decrease in the range of motion during extension and abduction of the pelvic limb in 60 (74%), symptoms of lameness in 45 ( 60%), symptoms or pain with passive movement of the limb in 26 (32%) and crepitus in 8 (10%) animals (Table 1). The proportion of dogs weighing more than 15 kg was small, but this group tended to have worse outcomes than smaller patients. Subjective assessment showed that the fewest postoperative problems were observed in cats. Although clinical lameness was not detected in any cat, owners of 5 of 15 cats reported shortening their stride after physical activity, with changes in weather, fast or slow gaits, or after long periods of rest. According to the owners’ observations, when the operated limb was loaded with a slow gait, 69 (85%) animals looked normal, and normal function with fast gait, it was preserved in 52 animals (64%). Lameness after strenuous physical activity was observed in 19 patients (23%), and in cold weather - in 20 (24%) (Table 2).

However, 78 of 81 (96%) owners considered the outcome of the operation to be successful.

The average recovery period was 4 to 6 weeks in cats and small dogs and 7 to 9 weeks in dogs weighing more than 15 kg, although the period of postoperative lameness in the latter group was on average shorter than in smaller patients. Based on information obtained from owner questionnaires and the results of repeated clinical examination, functional results were assessed as good in 38% of cases, satisfactory in 20% and unsatisfactory in 42%. There was no correlation between body weight and functional outcome (Table 3). Symptoms present before surgery persisted for an average of 5 weeks in animals with good results and an average of 7 weeks in animals with worse surgical results (Table 4).

Postoperative radiographs showed complete osteotomy of the femoral head and neck in 40 animals (60%), half of which also underwent resection of the lesser trochanter (Table 5).

Table 1. Clinical signs in 66 dogs and 15 cats 7 months to 10 years (mean 4 years) after femoral head and neck osteotomy.

Clinical parameters
Clinical parameters
Caudodorsal displacement of the femur
Muscle atrophy
Decreased range of motion

Pain with passive movements
Crepitus

Table 2. Subjective information obtained from owners of 66 dogs and 15 cats after osteotomy of the femoral head and neck.

Clinical parameters	Total n=81	Dogs			Cats n=15
Clinical parameters	Total n=81		15-25 kg n=51	> 25 kg n=11	Cats n=15
Average duration of postoperative symptoms (P=dogs with Perthes disease; O=other dogs)
Average postoperative recovery time
Normal (100%) support on the operated limb - with a slow gait - with a fast gait
Lameness after strenuous physical activity
Lameness in wet or cold weather
Satisfactory result

Table 3. Functional outcome depending on body weight.

		Functional result
		Good	Satisfactory	Unsatisfactory
Dogs		16	7	28
	15-25 kg	3	1	-
	> 25kg	2	3	6
Cats	4.4 kg (average)	10	5	-

Table 4. Functional outcome depending on the duration of postoperative symptoms.

The proportion of animals with satisfactory functional outcome was slightly greater after incomplete resection than after complete resection. X-rays, made during the follow-up period, showed proliferation of bone tissue in the area of the lesser trochanter in 34 animals (51%); 13 of these animals underwent resection of the lesser trochanter, while 21 did not (Fig. 5). Ossification in this area was noted in all cats (Fig. 6), while in dogs the incidence of osteophyte formation after complete and incomplete resection of the femoral head and neck was similar. There was no correlation between osteophyte formation and functional outcome.

On average, analysis of the movements of all dogs studied using kinetic data showed a shortening of the stance phase on the operated limb compared to the opposite limb (Table 6). In dogs weighing less than 15 kg, the peak vertical support load was slightly increased at the walk, but increased to 13% of body weight at the trot, while in dogs weighing more than 25 kg the load on the operated limb was lower by an average of 6% from body weight at both gaits. However, only one large dog has been tested on a treadmill while trotting. The slope of the ground load curve was used as a measure of force transfer, which was steeper in small dogs than in large dogs. The integral (total area under the curve), which is a measure of load impulse, was increased only in trot and decreased in other gaits due to a reduction in the duration of the stance phase (Fig. 7). The kinematic amplitudes of the hip, knee and tarsal joints varied significantly, but the graphs showed a characteristic pattern for each joint. The hip joint angle was slightly reduced in small dogs and markedly reduced in large dogs, indicating resistance to joint extension (Fig. 8).

The decrease in the angle of the hip joint was compensated mainly by extension of the tarsal joint.

Discussion

The pioneers who pioneered the use of OGHA in veterinary medicine (21, 24) were pleased to find a promising, simple, and inexpensive method for the treatment of complex hip disorders. However, the use of OGBC as a panacea requires critical consideration. In our study, the effectiveness of OGBC was examined in a population limited to dogs and cats with predominantly chronic (weeks-long) symptoms (14, 16). Our results are consistent with those of Duff and Campbell, who found that progressive muscle atrophy and contractures associated with claudication were detrimental to surgical outcome (4). In contrast to total hip replacement, complete muscle recovery does not usually occur after OHHA (9, 15). The age of the animals did not correlate with the outcome, which is consistent with the data of Gendreau and Cawley (6).

Table 5. Radiographic and functional outcomes in 55 dogs and 12 cats immediately after femoral head and neck osteotomy surgery and at an average of 4 years after surgery.

X-ray results	Functional results: dogs (n=55)	Functional results: cats (n=12)
X-ray results
Immediately after surgery
Incomplete resection
Complete resection
With removal of the lesser trochanter
Without removing the lesser trochanter
Follow-up*
Bone proliferation
Incomplete resection
Complete resection
With removal of the lesser trochanter
Without removing the lesser trochanter
No bone proliferation
Incomplete resection
Complete resection
With removal of the lesser trochanter
Without removing the lesser trochanter

*Follow-up examination was performed an average of 4 years after femoral head and neck osteotomy.

It was not possible to determine the effect of changes in surgical technique, in particular, interposition of the joint capsule or fixation of the greater trochanter with sutures, on the outcome retrospectively, since the medical records were incomplete. Evaluation of radiographs showed that removal of the lesser trochanter to eliminate pain due to femoral and femoral contact pelvic bones does not affect the outcome; Bone proliferation in the area of the resected or retained lesser trochanter did not correlate with functional outcome. The rate of unsatisfactory results after incomplete resection of the femoral neck was slightly higher than after complete resection, which is consistent with the results of Lee and Fry (10). However, the correlation between clinical presentation and radiographic findings was negligible, which is consistent with the findings of Duff and Campbell (5).

Of the 81 dogs and cats, 38% had limb function assessed as good on average 4 years after surgery, 20% as satisfactory, and 42% as unsatisfactory. These results may seem poor compared to other studies, but it should be noted that most of these studies were based on owner opinion (1, 2, 4, 7, 8, 10–12, 20–22, 24). The vast majority (96%) of our patient owners also rated the outcome as favorable.

Despite the lameness and lack of weight bearing on the limb, some dogs did not show any pain or limitation in range of motion that may be responsible for the lameness.

Passive movement of the operated limb caused pain in only about 33% of animals, while lameness was observed in 56% of cases, and more animals had other signs of dysfunction, such as muscle atrophy (Table 1). Consequently, the cause of lameness is not always obvious. In the absence of pain, the lameness may be mechanical due to scarring. The results of the movement analysis showed functional impairment in all 17 dogs after OHA. These animals showed a reduction in support contact time regardless of body weight, even if lameness was not noticeable on clinical examination. In small dogs, the vertical support force during stride was almost equal on both pelvic limbs, while in (a relatively small number of) large dogs this force was reduced on the operated limb, presumably due to the animal's desire to spare it.

Rice. 5. X-rays of an 8-month-old, 5-kg Jack Russell Terrier with Legg-Calvé-Perthes disease. Ventrodorsal view of the pelvis:

a) before surgery;

b) immediately after surgery with complete resection, including the lesser trochanter;

c) 8 months after surgery, slight proliferation of bone tissue without deterioration of function.

Rice. 6. X-rays of a two-year-old cat weighing 3.5 kg with repeated dislocation of the hip joint. Ventrodorsal view of the pelvis:

a) before surgery;

b) immediately after surgery with incomplete resection of the lesser trochanter; pronounced proliferation of bone tissue in the area of the lesser trochanter without deterioration in function.

With the exception of one dog, kinetic studies at trotting have only been performed in small dogs; the results showed increased load on the operated limb. This phenomenon was noted by Dueland et al in a comparative study of total hip replacement and OGHA, which led the authors to question the superiority of hip replacement over OGHA in quadrupeds (3). However, gait analysis in people with shortened limbs suggests that the increased load is caused by a shift in the center of gravity toward the shortened side (13).

In our study, owners often noted that dogs avoided trotting. During trotting, pairs of limbs move diagonally towards each other, and at some point one of the pelvic limbs bears approximately 60–80% of the body weight. It is unknown whether avoidance of the trot is associated with the occurrence of this short-term severe loading or with a decrease in the ability to extend the hip joint. Based on our kinematic data, dogs with a reduced range of motion in the hip joint after OHA compensate for this mainly due to greater extension at the tarsal joint.

In conclusion, we note that the present study revealed discrepancies between the results of objective clinical assessment and subjective observations of owners of animals who have undergone ACH. This clearly shows that the effectiveness of surgical treatment should not be determined using questionnaires. The currently accepted view that small dogs compensate better than large dogs for the effects of OHCA should be reconsidered in light of our results from the movement analysis. Reduction of pain after OHHA comes at the expense of some impairment of limb function, even in small dogs, where lameness may be difficult to detect with the naked eye due to their rapid movements. Thus, OHA should be limited to exceptional circumstances when joint preservation is not possible or infection or other contraindications preclude joint replacement, even in small dogs (16).

Table 6. Results of motion analysis of 17 dogs after osteotomy of the femoral head and neck.

Average values			Dogs>15 kg (28.1 – 44.5 kg) Operated/opposite limb
Duration of the stance phase (ms)
Duration of the stance phase (ms)
Peak vertical support load (% of body weight)
Peak vertical support load (% of body weight)
Support load curve slope (% of body weight)
Support load curve slope (% of body weight)
Impulse (% of body weight x sec.)
Impulse (% of body weight x sec.)
Hip Angle Range (degrees)
Knee Angle Range (degrees)
Tarsal joint angle range (degrees)

Rice. 7. Ground force curve, 5.8 kg Yorkshire terrier 6 years after right femoral head and neck osteotomy during a) walking and b) trotting. Y axis: N = Newtons; X-axis: time in seconds; F1 = right thoracic limb; F4 = left thoracic limb; F2 = right pelvic limb; F3 = left pelvic limb.

Rice. 8. Schematic representation of the hip and stifle angle of a 44.5 kg Saint Bernard dog 6 years and 7 months after osteotomy of the right femoral head and neck; a) right pelvic limb, b) left pelvic limb.

Green: hip angle; red: knee joint angle; y-axis: angle (degrees); x-axis: time (sec).

Resection of the femoral head. Treatment of hip dysplasia in dogs

The structure of the dog's hip joint

What does dysplasia mean in dogs?

Clinical signs of hip dysplasia in dogs

Diagnosis of hip dysplasia in dogs

Bardens test

Methods for controlling hip dysplasia in dogs

Treatment of hip dysplasia in dogs

Pelvic osteotomies (double and triple)

Intertrochanteric osteotomy

Resection arthroplasty of the hip joint

Hip replacement

Clinical case of treatment of hip dysplasia in a dog

Summary

Introduction

Materials and methods

results

Discussion

Literature: