Caudoventral hip luxation in 160 dogs (2003-2023): A multicenter retrospective case series.

OBJECTIVE: To describe patient characteristics, etiology, treatment outcomes and complications of caudoventral hip luxation (CvHL) in a large cohort of dogs and investigate factors associated with nonsurgical treatment outcomes. STUDY DESIGN: Multicenter retrospective case series. ANIMAL POPULATION: A total of 160 client-owned dogs (170 limbs). METHODS: Medical records from 2003 to 2023 were reviewed for signalment, history, treatment outcomes and complications. Logistic regression was performed to investigate factors associated with nonsurgical treatment outcome. RESULTS: Low-trauma accidents accounted for 82.9% of cases. Over-represented breeds included poodles (38.1%) and poodle crosses (11.3%). On a per-treatment basis, success rates of closed reduction alone, closed reduction/Ehmer sling, closed reduction/hobbles were 9.1%, 15.2% and 48.8%, respectively. When accounting for repeated attempts using closed reduction alone, Ehmer sling, or hobbles, eventual success rate increased to 10.3%, 18.5% and 61.8%, respectively. Success rate for toggle rod stabilization was 88.2%. Complication rate of hobbles was 31.9% versus 60.6% for Ehmer slings. Use of hobbles (OR:7.62, p = .001, CI:2.23-26.05), treatment by specialist surgeons (OR:2.68, p = .047, CI: 1.01-7.08) and increasing age (OR:1.15, p < .005, CI: 1.08-1.23) were associated with successful nonsurgical treatments. CONCLUSION: Low-trauma etiology, and poodles and their crosses were over-represented in cases of CvHL. Success rate of nonsurgical treatments was lower than previously reported. Hobbles were 7.6 times more likely to be successful when compared to dogs treated without hobbles and remains a viable noninvasive first-line treatment. CLINICAL SIGNIFICANCE/IMPACT: Hobbles are recommended as a low-morbidity first-line treatment for CvHL. An Ehmer sling is not recommended. Toggle rod stabilization is an effective surgical treatment for CvHL.

Comparison of the distraction index and Norberg angle with radiographic grading of canine hip dysplasia.

The Orthopedic Foundation for Animals (OFA) radiographic grading system stands as a well-established benchmark for categorizing hip dysplasia in canines. Although more objective techniques to quantify early hip laxity in young dogs, such as the Norberg angle (NA) and distraction index (DI), have been documented, there is a scarcity of published studies that directly compare these radiographic measures. The primary objectives of this prospective, analytical study were to assess and compare the NA and DI measures with OFA grades within a cohort of dogs. Thirty dogs (57 hip joints) were evaluated, with a mean age of 5.4 ± 2.9 years and a mean body weight of 34.3 ± 7.1 kg. The discriminative power of hip dysplasia for DI and NA used OFA as a reference were compared by multivariate discriminant analysis test. Using the DI (≤0.3) 12 joints were classified as normal, using NA (≥105°) 24 joints and using OFA (≤3) 29. When comparing the discriminant power of NA with OFA resulting similar (P = .8324) with correct classifications of 81% using cross validation, however, the discriminant power of dysplasia of the DI resulted significantly greater (P = .0034) than OFA with correct classifications of only 59% using cross-validation, consequently it was possible determined that of 29 patients with OFA ≤ 3, 20 had DI > 0.3. These findings demonstrated that phenotypic healthy dogs according to OFA grading can present passive hip joint laxity, as demonstrated by radiographic evaluation with distraction. Furthermore, DI can contribute to the screening of CHD when evaluated in conjunction with OFA grading.

Mechanical osteoarthritis of the hip in a one medicine concept: a narrative review.

Human and veterinary medicine have historically presented many medical areas of potential synergy and convergence. Mechanical osteoarthritis (MOA) is characterized by a gradual complex imbalance between cartilage production, loss, and derangement. Any joint instability that results in an abnormal overload of the joint surface can trigger MOA. As MOA has a prevailing mechanical aetiology, treatment effectiveness can only be accomplished if altered joint mechanics and mechanosensitive pathways are normalized and restored. Otherwise, the inflammatory cascade of osteoarthritis will be initiated, and the changes may become irreversible. The management of the disease using non-steroidal anti-inflammatory drugs, analgesics, physical therapy, diet changes, or nutraceuticals is conservative and less effective. MOA is a determinant factor for the development of hip dysplasia in both humans and dogs. Hip dysplasia is a hereditary disease with a high incidence and, therefore, of great clinical importance due to the associated discomfort and significant functional limitations. Furthermore, on account of analogous human and canine hip dysplasia disease and under the One Medicine concept, unifying veterinary and human research could improve the well-being and health of both species, increasing the acknowledgement of shared diseases. Great success has been accomplished in humans regarding preventive conservative management of hip dysplasia and following One Medicine concept, similar measures would benefit dogs. Moreover, animal models have long been used to better understand the different diseases' mechanisms. Current research in animal models was addressed and the role of rabbit models in pathophysiologic studies and of the dog as a spontaneous animal model were highlighted, denoting the inexistence of rabbit functional models to investigate therapeutic approaches in hip MOA.

B-mode ultrasonography and ARFI elastography of articular and peri-articular structures of the hip joint in non-dysplastic and dysplastic dogs as confirmed by radiographic examination.

BACKGROUND: Canine hip dysplasia is a common orthopedic disease in veterinary practice. The diagnosis is made by radiographic examinations that evaluate bone alterations associated with hip dysplasia. Although radiographic examination is the gold standard for diagnosis, it does not allow a detailed evaluation of soft tissues such as the joint capsule and periarticular muscles. This study aimed to evaluate the accuracy of B-mode ultrasonography and acoustic radiation force impulse (ARFI) elastography in assessing the joint capsule and periarticular muscles of dogs using the Orthopedic Foundation of Animals (OFA) classification and the distraction index (DI) in the early and late diagnosis of hip dysplasia. This study sought to propose a protocol for the ultrasonographic evaluation of the structures involved in canine hip dysplasia. METHODS: Radiographic and ultrasonographic evaluations were performed on 108 hip joints of 54 dogs. Thirty dogs were older than 2 years and 24 were aged between 4 and 10 months. RESULTS: It was verified that an increase in pectineus muscle stiffness (cutoff value > 2.77 m/s) by elastography in some dysplastic dogs and an increase in the thickness of the joint capsule (cutoff value > 0.9 mm) in B-mode ultrasonography, were associated with a distraction index > 0.5, with both having a positive correlation. In B-mode ultrasonographic evaluation, the presence of signs of degenerative joint disease, such as irregularities of the cranial edge of the acetabulum and femoral head, were associated with a distraction index > 0.5 in canines, with a specificity of 94%. In adult dogs, the findings of degenerative joint disease on ultrasound were associated with a diseased OFA classification (P < 0.05). Measurement of the joint capsule > 1.10 mm was diagnostic for dysplasia in unhealthy dogs by OFA. CONCLUSIONS: ARFI elastography has shown that the pectineus muscle may experience changes in stiffness in dysplastic animals. Additionally, changes in joint capsule thickness can be identified in B-mode in young and adult dogs with dysplastic joints, which contributes to the diagnosis of hip dysplasia.

Arthroscopic-assisted hip toggle stabilization in cats: An ex vivo feasibility study.

OBJECTIVE: To describe arthroscopic-assisted hip toggle stabilization (AA-HTS) in cats, evaluate its feasibility and associated rate of iatrogenic injury, and assess deviations from planned surgical technique. STUDY DESIGN: Ex vivo study. ANIMALS: Skeletally mature cat cadavers (n = 7). METHODS: Preoperative pelvic computed tomography (CT) was performed for surgical planning and to identify the ideal femoral bone tunnel projection. Ultrasound-guided transection of ligament of head of femur was performed. Following exploratory arthroscopy, AA-HTS was performed using a commercially available aiming device. Surgical time, intraoperative complications, and feasibility of technique were recorded. Iatrogenic injury and technique deviations were assessed by postoperative CT and gross dissection. RESULTS: Diagnostic arthroscopy and AA-HTS were successfully performed in all 14 joints. Median (range) surgical time was 46.5 (29-144) min, including 7 (3-12) min for diagnostic arthroscopy and 40 (26-134) min for AA-HTS. Intraoperative complications occurred in 5 hips, related to bone tunnel creation (4) and toggle dislodgment (1). Toggle passage through the femoral tunnel was the most challenging component of technique, recorded as mildly difficult in 6 joints. No damage to periarticular/intrapelvic structures was identified. Minor articular cartilage damage (<10% total cartilage area) was identified in 10 joints. Thirteen deviations (8 major, 5 minor) in surgical technique from preoperative planning were identified in 7 joints. CONCLUSION: In feline cadavers AA-HTS was feasible but was associated with a high rate of minor cartilage injury, intraoperative complications, and technique deviations. CLINICAL SIGNIFICANCE: Hip toggle stabilization using an arthroscopic-assisted approach may be an effective technique for management of coxofemoral luxation in cats.

Modified toggle pin technique combined with prosthetic capsular reconstruction for surgical stabilization of coxofemoral luxation in a Shetland pony.

OBJECTIVE: To describe open reduction and surgical stabilization of a coxofemoral luxation in a pony using a modified toggle pin technique and prosthetic joint capsule reconstruction without osteotomy of the greater trochanter. ANIMAL: A 2-year-old Shetland pony with a bodyweight of 167 kg. STUDY DESIGN: Case report. METHODS: Radiographic examination confirmed craniodorsal luxation of the left coxofemoral joint. An open reduction with the aid of a pulley system was performed. A toggle pin was inserted through a bone tunnel extending from the level of the femoral shaft through the femoral head and the center of the acetabulum for the pin to be positioned on the medial wall of the acetabulum. FiberWire was subsequently passed through the cranial and caudal aspects of the acetabulum as well as a transverse tunnel in the femoral neck in a figure of 8 to facilitate capsular reconstruction. The pony was placed in a sling for 8 weeks and gradually returned to normal activity over 2 months. RESULTS: Postoperative radiographic examination confirmed the position of the femoral head in the acetabulum with the implants in place. On 2-year follow-up the pony was sound at walk and trot. CONCLUSION: A combined intra- and extra-articular stabilization technique for coxofemoral luxation in a pony resulted in successful long-term reduction and excellent outcome.

Successful total hip arthroplasty in a miniature horse.

OBJECTIVE: To describe the surgical treatment, postoperative management, and outcome of a miniature horse undergoing total hip arthroplasty (THA). STUDY DESIGN: Case report. ANIMALS: A 4-year-old miniature horse stallion weighing 85 kg. METHODS: The horse presented with left coxofemoral luxation of ~6 weeks duration. Computed tomography confirmed craniodorsal luxation with marked degenerative changes to the femoral head. The horse underwent THA using cementless press fit implants, including an interlocking lateral bolt for the femoral stem. RESULTS: The horse recovered well from anesthesia but suffered a coma-like episode after returning to a stable. Following treatment of presumed hypovolemia, the horse regained normal mentation and was discharged 24 days after surgery. At reassessment 12 weeks postoperatively, the horse was 2/10 left hind limb lameness at trot with good healing of the surgery site. Five months postoperatively mild (1/10) lameness remained at trot but the horse was able to canter normally on both reins. The horse has since been managed normally with no veterinary treatment required for 32 months postoperatively. CONCLUSION: Total hip arthroplasty is possible in miniature horses weighing up to 85 kg and can result in a good long-term outcome.

Clinical outcomes of double pelvic osteotomies in eight dogs with hip dysplasia aged 10-28 months.

OBJECTIVE: To report the short-term outcome of double pelvic osteotomy (DPO) in dogs with canine hip dysplasia ≥10 months of age. STUDY DESIGN: Case series. ANIMALS OR SAMPLE POPULATION: Eleven hips in eight dogs aged between 10 to 28 months. METHODS: Dogs clinically affected by hip dysplasia with a hip reduction angle <40°, subluxation angle <25°, dorsal acetabular rim angle between 7.5-25°, and minimal osteoarthritic changes were considered as candidates for DPO. The clinical outcome was subjectively assessed using a lameness score and pain scale upon hip extension. Norberg angle, percentage of the area of the femoral head coverage, percentage of linear femoral head coverage, pelvic width dimensions were measured on pre and postoperative radiographs. RESULTS: At the 8-week follow-up examination, all the dogs had no lameness with no pain upon hip extension. Median Norberg angle increased by 21.8% (p < .01), median percentage of the area of the femoral head coverage increased by 66.7% (p < .01) and percentage of linear femoral head coverage increased by 162.5% (p < .01) 1 year after DPO. No changes to pelvic canal width after DPO were detected. CONCLUSION: Double pelvic osteotomy improved joint congruity and clinical signs in dogs affected by hip dysplasia without osteoarthritis that were ≥10 months of age. CLINICAL SIGNIFICANCE (OR IMPACT): Double pelvic osteotomy may be a treatment option for dogs with hip dysplasia ≥10 months of age. A large study assessing long-term outcomes is indicated.

Open hip reduction using a novel transarticular suture stabilisation technique in 24 dogs: a retrospective study of technique, outcome and complications.

CASE HISTORY: Medical records of a single private practice (Illinois, USA) were retrospectively reviewed to identify dogs (n = 24) that had an open hip reduction with a transarticular suture stabilisation technique after presenting with a traumatic coxofemoral luxation between April 2003 and December 2018. CLINICAL FINDINGS: Dogs that met the inclusion criteria were of various breeds with a median body weight of 18.1 (min 4.2, max 54.5) kg and mean age at presentation of 6.5 (min 1, max 11) years. The surgical technique, short-term outcome and complications were extracted from the medical records. Long-term (>2 years) follow-up data was obtained by a telephone interview with each owner. TREATMENT AND OUTCOME: All dogs underwent open hip reduction using a novel transarticular suture stabilisation technique. The outcome was reported by owners to be excellent in 18/24 (75%) dogs with full return of limb function. Sixty-six percent (16/24) of owners reported that no lameness was observed 2 months after surgery. No minor complications were noted in this study. The hips of 6/24 (25%) dogs reluxated after surgery (defined as a major complication), which required femoral head and neck excision surgery. CLINICAL RELEVANCE: Open coxofemoral joint reduction using a novel transarticular suture technique is a viable surgical option to consider in dogs that present with a traumatic coxofemoral luxation.

Risk factors for reluxation after toggle rod stabilization for treatment of coxofemoral luxation in 128 dogs.

OBJECTIVE: Evaluate the risk factors for reluxation and outcomes for dogs with a toggle rod construct. STUDY DESIGN: Retrospective case series. ANIMALS: One hundred twenty-eight client-owned dogs. METHODS: Medical records from 2007 to 2018 were reviewed for signalment, history, surgery, and outcome for dogs with a coxofemoral luxation repaired with a commercial toggle rod and nylon monofilament suture construct. Univariate and multiple logistics regression analysis were performed to assess risk factors associated with postoperative luxation. Primary veterinarians and owners were contacted for follow-up via telephone or electronic communication. RESULTS: The overall complication rate was 24.2%, and the reluxation rate was 14.8%. There was a decreased risk of reluxation when the cause was traumatic in origin (odds ratio [OR] 0.10) or when the lameness was severe at presentation (OR 0.42). Fifteen of 58 (25.9%) owners contacted completed a follow-up survey. CONCLUSION: Dogs with nontraumatic, low impact luxations were at a higher risk for reluxation. CLINICAL SIGNIFICANCE: Dogs of any body condition with a traumatic coxofemoral luxation are at lowest risk for reluxation.

Complications and outcomes of cats with coxofemoral luxation treated with hip toggle stabilization using ultrahigh-molecular-weight-polyethylene or nylon (2009-2018): 48 cats.

OBJECTIVE: To report overall rate and type of complications and outcomes of cats with coxofemoral luxation managed with hip toggle stabilization (HTS), to compare rate of postoperative complications and outcomes of cats treated with ultrahigh-molecular-weight-polyethylene (UHMWPE) or nylon, and to identify risk factors for reluxation and non-excellent outcomes. STUDY DESIGN: Multi-institutional retrospective cohort study. SAMPLE POPULATION: Forty-eight client-owned cats. METHODS: Medical records of cats that underwent HTS from 2008-2018 using UHMWPE or nylon were reviewed. Univariable and multivariable logistic regression was performed to assess for factors associated with reluxation and non-excellent outcome. Final outcome was obtained from owner questionnaire. RESULTS: Intraoperative and postoperative complications were recorded in two (4.2%) and 11 (24.4%) cats, respectively. The most common postoperative complication was reluxation (n = 5 [11.1%]). Outcome was classified as excellent in 81.1% and good in 16.2% of cats after a median of 445.5 days (range, 53-3720). No difference in rate of complications or outcomes was identified between UHMWPE and nylon. Performance of additional orthopedic procedures, occurrence of intraoperative complications, and non-performance of capsulorrhaphy were associated with reluxation. Performance of additional non-hip procedures (orthopedic/nonorthopedic) was associated with non-excellent outcome. CONCLUSION: Hip toggle stabilization was associated with a low rate of intraoperative complications and reluxation and excellent long-term outcomes in most cats. No difference in rate of postoperative complications or outcomes of cats treated using UHMWPE or nylon was identified. Cats that underwent additional orthopedic procedures had greater risk of reluxation. CLINICAL SIGNIFICANCE: Hip toggle stabilization is an effective technique for management of coxofemoral luxation in cats. Comparable results are expected using UHMWPE or nylon.

Deep transfer learning can be used for the detection of hip joints in pelvis radiographs and the classification of their hip dysplasia status.

Reports of machine learning implementations in veterinary imaging are infrequent but changes in machine learning architecture and access to increased computing power will likely prompt increased interest. This diagnostic accuracy study describes a particular form of machine learning, a deep learning convolution neural network (ConvNet) for hip joint detection and classification of hip dysplasia from ventro-dorsal (VD) pelvis radiographs submitted for hip dysplasia screening. 11,759 pelvis images were available together with their Fédération Cynologique Internationale (FCI) scores. The dataset was dicotomized into images showing no signs of hip dysplasia (FCI grades "A" and "B", the "A-B" group) and hips showing signs of dysplasia (FCI grades "C", "D," and "E", the "C-E" group). In a transfer learning approach, an existing pretrained ConvNet was fine-tuned to provide models to recognize hip joints in VD pelvis images and to classify them according to their FCI score grouping. The results yielded two models. The first was successful in detecting hip joints in the VD pelvis images (intersection over union of 85%). The second yielded a sensitivity of 0.53, a specificity of 0.92, a positive predictive value of 0.91, and a negative predictive value of 0.81 for the classification of detected hip joints as being in the "C-E" group. ConvNets and transfer learning are applicable to veterinary imaging. The models obtained have potential to be a tool to aid in hip screening protocols if hip dysplasia classification performance was improved through access to more data and possibly by model optimization.

Successful Treatment of Acute Craniodorsal Coxofemoral Luxation in a Scarlet Ibis (Eudocimus ruber) Using Closed Reduction and a Modified Ehmer Sling.

Whereas craniodorsal displacement of the coxofemoral joint is the most common luxation reported in small and large mammals, it occurs less often in avian species. Closed reduction and external coaptation with a modified Ehmer sling is the initial treatment, in most cases, for small animals (eg, dogs, cats) that present with a coxofemoral luxation. However, the Ehmer sling is reported to have a low success rate in treating coxofemoral luxations in these animals. Intractable coxofemoral luxations require an open surgical reduction. A few successful closed reductions of coxofemoral luxations have been reported in avian patients, as well as open reduction surgical techniques to repair avian coxofemoral luxations. The successful treatment of an acute craniodorsal coxofemoral luxation in a scarlet ibis (Eudocimus ruber) with a closed reduction and a modified Ehmer sling is described in this clinical report. The specific characteristics of both the patient and the injury are thought to have contributed to the success in this case.

Assessment of the medium- to long-term radiographically confirmed outcome for juvenile dogs with hip dysplasia treated with double pelvic osteotomy.

OBJECTIVE: To assess the medium- to long-term radiographically confirmed outcomes in juvenile dogs with hip dysplasia (HD) that did and did not undergo double pelvic osteotomy (DPO). STUDY DESIGN: Retrospective case-controlled. ANIMALS: Twenty-six dogs with HD that were candidates for DPO; 22 dogs underwent DPO (16 bilateral, six unilateral); four dogs did not. METHODS: Initial and follow-up radiographs of DPO candidates (2011-2017) that did and did not undergo surgery were reviewed, and the British Veterinary Association and Kennel Club Hip Dysplasia Scheme score (BVA-HD), osteoarthritis score (OAS) and laxity index score (LI) were determined. Baseline and follow-up BVA-HD, OAS, and change in radiographically confirmed scores were compared by using analysis of variance for correlated samples. RESULTS: There was no significant difference in BVA-HD or OAS between surgically treated and nonsurgically treated cohorts at baseline. Follow-up radiographs (median, 49 months) revealed that most (34/38) hips had a BVA-HD ≤10 after DPO, while four of eight hips from the nonsurgical cohort had BVA-HD >10. Follow-up BVA-HD and OAS were lower in hips after surgery (BVA-HD median 2.15, interquartile range [Q1-Q3] 1.3-4.1; OAS median 1.9, Q1-Q3 1.1-4.1) compared with the nonsurgically treated cohort (BVA-HD median 11.4, Q1-Q3 8.1-17.5, P < .01; OAS median 7.0, Q1-Q3 5.1-13.4, P < .01). Seven hips with an LI >1 had no radiographically confirmed progression of osteoarthritis after DPO. CONCLUSION: Double pelvic osteotomy prevented radiographically confirmed progression of osteoarthritis in the medium- to long-term. Laxity index score > 1 was not a contraindication for DPO in this study. CLINICAL SIGNIFICANCE: Double pelvic osteotomy prevents progression of radiographically confirmed features of osteoarthritis in juvenile dogs with HD.

Coxofemoral Joint Luxation in Dogs Treated with Toggle Rod Stabilization: A Multi-Institutional Retrospective Review with Client Survey.

Coxofemoral luxation is the most common type of joint luxation observed clinically in dogs. This retrospective study determines the complications and outcomes of open reduction and internal fixation of coxofemoral luxations using a toggle rod stabilization in 58 dogs. The purpose of the study was to compare the results with previous studies to ascertain commonalities and differences. A majority of the canine luxations were stabilized using a 4.0 or 3.2 mm commercial toggle rod and either one or two strands of OrthoFiber, FiberWire, or monofilament nylon suture. Postoperative complications developed in 25 of the 58 (43%) dogs, with major complications in 9 cases (15.5%). The most common major complication was reluxation, which occurred in 6 dogs (10%). Five of the 6 cases of reluxation received monofilament suture, although there was not a statistically significant relationship between suture type and reluxation. Owner responses to a questionnaire reported good to excellent results for satisfaction with the procedure in 90% of cases. Results of the present study suggest that toggle rod stabilization remains an effective method for the treatment of coxofemoral joint luxation in dogs.

The CT dorsolateral subluxation index is a feasible method for quantifying laxity in the feline hip joint.

The dorsolateral subluxation index of the femoral head is a good proxy of hip dysplasia in dogs. An exploratory, prospective, descriptive study was carried out in order to assess whether the dorsolateral subluxation index may also be useful to improve diagnosis of hip dysplasia in cats. The dorsolateral subluxation index was determined by CT scans simulating the loading position, and compared with measurements of the Norberg-Olsson angle. A total of 82 cats were subjected to radiographic examination of the pelvis, in the standard ventro-dorsal projection, and to CT scans of the pelvis and hips. The Norberg-Olsson angle of each hip was calculated radiographically, while the dorsolateral subluxation index of the femur was calculated on CT images according to a technique recently developed for evaluation of hip dysplasia in dogs. Using the Norberg-Olsson angle a total of 52 hips (31,7%) were diagnosed as dysplastic, 74 (45,1%) as non-dysplastic, and 38 (23,1%) as borderline. Using the dorsolateral subluxation index, values ranged from a minimum of 34.6% to a maximum of 66.6% and four distribution classes were proposed. Findings indicated that the dorsolateral subluxation index previously described as method for quantifying hip dysplasia in dogs is also a feasible method for quantifying hip dysplasia in cats. Future studies are needed to more definitively determine the diagnostic sensitivity of this method.

Mechanical analysis of suture attachment methods in toggle suture constructs.

OBJECTIVE: To determine the effect of the method used to attach OrthoFiber #5 to a 1/8-in Securos toggle rod on the mechanical properties of the resulting construct. STUDY DESIGN: Prospective bench top mechanical analysis. SAMPLE POPULATION: One hundred twenty-eight OrthoFiber #5-toggle rod suture constructs. METHODS: Toggle-suture constructs (groups A-H) were prepared by using 8 methods to attach OrthoFiber #5 to a 1/8-in toggle rod (n = 16 constructs/group). A servohydraulic materials-testing machine was used to test each toggle-suture construct in tension. Mean load to failure, cycles to failure, construct stiffness, and suture elongation under static and cyclic loading were compared among types of constructs. RESULTS: Mean load to failure was greatest (>500 N) for constructs D (P ≤ .048) and G (P ≤ .048). Mean construct stiffness of D (53.52 N/mm) and E (53.6 N/mm) was greater than that of the 6 other constructs (P ≤ .040). Construct A sustained the most elongation in acute (23.47 mm; P < .001) and cyclic (18.53 mm; P < .003) loading. Cycles to failure was greater for construct C (622 cycles) compared with constructs A, B, and H (P = .008, P = .009, and P = .010, respectively). CONCLUSION: The method used to attach OrthoFiber #5 to a 1/8-in toggle rod influenced the mechanical properties of the construct. No one construct outperformed other groups in all areas of testing, but construct D was superior when mean load to failure and construct stiffness were considered. CLINICAL IMPACT: Construct D, with OrthoFiber #5, passed straight through the toggle rod eyelet, may provide superior stability and resistance to fatigue failure to toggle-in repairs of coxofemoral luxations.

Arthroscopic placement of a toggle rod to correct coxofemoral luxation in a dog.

OBJECTIVE: To describe a minimally invasive toggle repair technique under arthroscopic guidance to correct a coxofemoral luxation in a canine. STUDY DESIGN: Case report ANIMALS: A 9-year-old, male (neutered) Alaskan husky. METHODS: Prior to surgery, the coxofemoral luxation was reduced in a closed fashion. With standard arthroscopic portals, the completely torn round ligament was removed with a motorized shaver. A bone tunnel was created between the femoral head and the acetabulum by using an intra-articular drill guide, guide wires, and a cannulated drill bit. A toggle rod was inserted into the bone tunnel and tied to a 4-hole button located over the third trochanter. The implant position was confirmed via fluoroscopy. RESULTS: Within 24 hours of surgery, the dog was weight bearing with mild lameness. Six weeks postoperatively, radiographic assessment revealed that the implant location was unchanged, with no lameness documented. At 6 months postoperatively, the dog had returned to normal function with no reported complications. CONCLUSION: The toggle rod repair of a coxofemoral luxation under arthroscopic guidance was successful in the dog described in this case report. CLINICAL SIGNIFICANCE: Minimally invasive, arthroscopic guided toggle rod stabilization may be an alternative to the currently accepted open approach when addressing coxofemoral luxations.

Femoral head ostectomy for the treatment of acetabular fracture and coxofemoral joint luxation in a Potbelly pig.

OBJECTIVE: To report the successful surgical treatment of a comminuted left acetabular fracture, a dorsally luxated left femoral head, and avulsion of the ligament of the femoral head by femoral head ostectomy (FHO) and physical therapy in a companion Potbelly pig. STUDY DESIGN: Case report. ANIMALS: A 1-year-old, 13 kg, castrated male, companion Potbelly pig. METHODS: The pig presented with a nonweight bearing left pelvic limb lameness of 3 weeks' duration that was noticed shortly after the pig got caught under a fence. Under general anesthesia a lateral approach was made to the fractured limb. A FHO was performed as described for dogs. Following surgery, a period of physical therapy was initiated based on protocols described for dogs. RESULTS: The canine surgical procedure with the approach modified for pigs was successfully performed in our pig. Following surgery, the pig was comfortable and weight bearing. A physical therapy regimen of supervised activity, stairs, and water therapy was used to rehabilitate the leg, as well as a weight management protocol to maintain ideal body condition. The owner was highly satisfied with the outcome. Telephone follow-up with the owner at 12 months after surgery revealed no impairment to movement, and the pig was maintaining normal ambulation without lameness. No complications were observed with this case. CONCLUSION: FHO, as described for dogs, provided a favorable outcome for hip luxation caused by acetabular fracture, luxation, and avulsion of the femoral head ligament in this small size Potbelly pig.

Femoral head ostectomy and medial patellar ligament desmotomy to treat a pregnant miniature horse with coxofemoral joint luxation and upward fixation of the patella.

A 2-year-old, 8-weeks pregnant, non-weight bearing miniature horse mare was treated for a 6-day-old left coxofemoral joint luxation with a femoral head ostectomy. The procedure had no negative effects on pregnancy or parturition and 23 months following surgery the horse had minimal lameness.

Ostectomie de la tête fémorale et desmotomie du ligament patellaire médial pour traiter une jument miniature gravide atteinte d'une luxation de l'articulation coxofémorale et d'une fixation supérieure de la rotule. Une jument miniature non portante gravide de 8 semaines et âgée de 2 ans a été traitée pour une luxation de l'articulation coxofémorale gauche datant de 6 jours à l'aide d'une ostectomie de la tête fémorale. L'intervention n'a pas eu d'effets négatifs sur la gestation ou la parturition et 23 mois après la chirurgie, la jument présentait une boiterie minime.(Traduit par Isabelle Vallières).