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Surgical Management Of Coxofemoral Joint Diseases In Dogs

KrishiKosh

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Title Surgical Management Of Coxofemoral Joint Diseases In Dogs
 
Creator Prasad, A. Arun
 
Contributor Sureshkumar, R.
Jayaprakash, R.
Prathaban, S.
Balachandran, C.
 
Description Five hundred and seventy five dogs presented to Small Animal Orthopaedic
Unit of Madras Veterinary College Teaching Hospital, Chennai with coxofemoral
joint affections diagnosed clinically, orthopaedic and radiographic investigation were
chosen for the incidental studies. Hip dysplasia was found to be the most common
condition followed by osteoarthritis and fracture luxation. Higher incidence of hip
dysplasia was noticed in larger breeds at less than one year of age and during which
the clinical manifestation was noticed at the four to eight months of age. Osteoarthritis
was most commonly seen in the dogs older than four years in large breeds but also in
small breeds secondary to hip dysplasia and obesity. Fracture luxation was seen
subsequent to trauma during active period of life. Male dogs were found to be
commonly affected.
Fourteen cases that did not responded to conservative therapy, depending on
the severity of the condition, age, breed, weight and owners compliances were
subjected to surgical management. Eight dogs, five Labrador Retrievers and one each
of German Shepherd Dog, cross breed and Spitz that were less than 20 kg b.wt, small
and skeletally immature dogs with owner’s compliances were subjected to excision
arthroplasty. The average age of the dogs was 2.7 years with body weight of 17 kg
and the disease conditions were three cases of hip dysplasia with luxation, one case of
osteoarthritis and four femoral capital and neck fracture. Six dogs, three German
Shepherd Dog, two Labrador Retriever and one Great Dane that were more than 20 kg
b.wt. and with owners acceptance for total hip arthroplasty (THA) were subjected to
THA. The average age of dogs was four years with body weight of 30 kg. The disease
conditions were luxation in four cases and one each of osteoarthritis and degenerative
joint disease consequent to hip dysplasia.
Preoperatively, the common clinical signs included pain, varied degrees of
lameness, gait and postural abnormality with crepitation in case of osteoarthritis or
fracture, and increased laxity ‘Ortolani signs’ in hip dysplasia and limb shortening in
luxation. Radiographic studies, arthroscopy investigation and ultrasonography
examination were found to be an effective tool in diagnosing the severity of condition,
extent of joint involvement and for selection of treatment modalities. Haematological
and serum biochemical values were not altered due to the different coxofemoral joint
affections. Preoxygenation, tramadol-glycopyrrolate and propofol-isoflurane anaesthetic
regimen was found to be effective for both the surgeries and for total hip arthroplasty
intensive monitoring was carried out to prevent bone cement implantation syndrome
(BCIS).
The surgery was performed through craniolateral approach under lateral
recumbency. In excision arthroplasty, the femoral head and neck was removed by
osteotomy and allowed to form pseudoarthrosis. The clinical out come was graded
good in four cases, fair to moderate in three cases and poor in one case. Long term
outcome as per Western Ontario and McMaster University Osteoarthritis scoring
Index (WOMAC) scoring index were good in seven cases and poor in one.
In total hip arthroplasty after femoral head and neck excision, total hip
prosthesis made of medical grade stainless steel and acetabular cup made of ultra high
molecular weight polyethylene (UHMWPE) were used and polymethyl methacrylate
(PMMA) bone cement was used. Radiological and clinical assessment performed as
per WOMAC scoring index was excellent to good in four cases and moderate in two
cases. WOMAC scoring index was found to be effective in assessing functional
outcome. Postoperative care and rehabilitation were found to be important factors in
the functional outcome of the surgery and limb function.
From this study it could be concluded that excision arthroplasty was found to
be an effective method of treatment for coxofemoral joint diseases that were less than
20 kg b.wt., economical and easy procedure which provided pain free joint but led to
shortening of limb, decreased range of motion, asymmetry of hip and atrophy of thigh
muscle. Total hip arthroplasty was found to be effective in dogs that were more than
20 kg b.wt. where in the dogs gained pain free hip with increased range of motion of
the limb, symmetrical hip with improved gait and gaining of thigh muscle mass but
was costly and needed surgeon’s expertise. THA can also be performed in the dogs
less than 20 kg b.wt. with micro hip prosthesis. The postoperative morbidity of THA
could be minimized based on the expertise of the surgeon, weight of the dog, proper
postoperative care and standard procedure.
 
Date 2016-05-20T16:29:26Z
2016-05-20T16:29:26Z
2009
 
Type Thesis
 
Identifier http://krishikosh.egranth.ac.in/handle/1/66181
 
Language en
 
Format application/pdf
 
Publisher Tamil Nadu Veterinary and Animal Sciences University