Osteoarthritis of the coxofemoral joint in 24 horses: Evaluation of radiography, ultrasonography, intra-articular anaesthesia, treatment and outcome.

BACKGROUND: Few case reports describe equine coxofemoral joint osteoarthritis (CFJOA). OBJECTIVES: To evaluate diagnostic findings and outcome of horses with CFJOA and to provide a score facilitating radiographic assessment. STUDY DESIGN: Retrospective case series. METHODS: History, clinical signs, ultrasonographic, radiographic and intra-articular anaesthesia findings, treatments, outcome, and necropsy results of horses with CFJOA presented between 2002 and 2023 were collated. Radiographic findings were categorised to develop a radiographic score which was applied by two masked examiners. Intra- and inter-observer reliability was determined using weighted Cohen's kappa (Cκ) and the correlation between radiographic and ultrasound findings via Spearman correlation coefficient. RESULTS: The study included 24 horses (median age 14 years). Most of them (20/24) were chronically lame. Frequent clinical signs included unilateral gluteal muscle atrophy (18/21), lengthening of the stride of the affected limb (13/19) and locomotion on three tracks (13/20). Both imaging modalities enabled evaluation of periarticular osteophytes (correlation coefficient r = 0.64; p = 0.003). Additionally, radiography allowed detection of irregular joint spaces, subchondral bone opacity changes and femoral head flattening/tapering. Inter-observer (Cκ = 0.846) and intra-observer (Cκ = 0.853 and Cκ = 0.842) agreement was excellent. If treated, mostly intra-articular corticosteroids were administered (16/18). Nine horses were euthanised immediately or during follow-up examination. Post-mortem, the Ligamentum capitis ossis femoris was commonly found ruptured. All surviving horses remained lame. MAIN LIMITATIONS: Retrospective analysis of clinical records and subjective outcome assessment based on owner follow-up with potential recall bias. Due to overall disease severity, associations between different grades of clinical findings, radiographic abnormalities and outcome could not be evaluated. CONCLUSIONS: Typical clinical signs may indicate CFJOA. Standardised evaluation of ventrodorsal radiographs allows a comprehensive diagnosis. Postmortem findings suggest joint instability as a possible causative factor that may contribute to the poor prognosis and resistance to medical therapy of the disorder.

Ultrasound-guided lateral pericapsular hip desensitization of the articular branches of the cranial gluteal nerve: A canine cadaveric study and feasibility study in dogs.

OBJECTIVE: To develop and assess the feasibility, as a diagnostic block, of an ultrasound-guided lateral pericapsular hip desensitization (L-PHD) technique in dogs. STUDY DESIGN: Prospective, randomized, anatomical and feasibility study. ANIMALS: A total of 11 canine cadavers and eight adult dogs scheduled for acetabular surgical denervation. METHODS: After studying the ultrasound anatomy of the lateral aspect of the gluteal region and determining an acoustic window to perform an ultrasound-guided L-PHD in three canine cadavers, the right and left hemipelves of eight canine cadavers were injected in the interfascial plane located lateral (LL-PHD group) or medial (LM-PHD group) to the deep gluteal muscle, with 0.05 mL kg-1 of dye per hip on each cadaver. The staining of the pericapsular nerves was assessed by anatomical dissection. Then, the LM-PHD was performed using 2% lidocaine as a diagnostic block in dogs scheduled for acetabular surgical denervation. Positive predictive value (PPV) was calculated for those animals who had favorable outcomes after acetabular surgical denervation. RESULTS: The ultrasound-guided LL-PHD and LM-PHD could be performed by inserting the needle lateral and medial to the deep gluteal muscle. Ultrasound-guided LL-PHD stained the cranial gluteal nerve and its muscular branches in all injections and partially stained the lumbosacral trunk in two out of eight cadavers. The LM-PHD selectively stained the articular branches of the cranial gluteal nerve in all but one cadaver. The PPV for LM-PHD successful test prediction was 85.7% (95% confidence interval: 48.6% to 98.6%). CONCLUSIONS: and clinical significance Ultrasound-guided LM-PHD using 0.05 mL kg-1 of dye selectively stained the articular branches of the cranial gluteal nerve in canine cadavers. The LM-PHD technique is feasible and could be used as a diagnostic block before acetabular surgical denervation in dogs.

Radiographic Diagnosis of Hip Laxity in Rottweilers: Interobserver Agreement at Eight- and Twelve-Months of Age.

Hip laxity is one of the predisposing factors of canine hip dysplasia. The early diagnosis of hip laxity allows veterinarians to prevent the participation of dysplastic dogs in breeding programs, which could lower the disease's prevalence due to its genetic background. Furthermore, it allows them to plan preventive/therapeutic procedures for mild/near-normal hips to reduce the symptoms of the disease at older ages. A reliable screening program must be repeatable and reproducible, and intra- and inter-observer studies can help us to determine the best methods. In this study, we aimed to evaluate the radiographic parameters used for the early diagnosis of hip dysplasia in Rottweilers at 8 and 12 months of age with five observers to assess the interobserver agreements. According to our findings, there were high interobserver agreements at both ages for the quantitative values, such as the center edge angle (CEA), dorsal acetabular rim slope (DARS), distraction index (DI), and Norberg angle (NA), whereas we recorded from poor to moderate agreements for the qualitative values, such as the grading of the dorsal acetabular rim (GDAR), grading of the degenerative joint disease (GDJD), location of the center of the femoral head (LCFH), and sclerosis of the cranial acetabular rim (SCAR).

Pericapsular hip desensitization in dogs: a cadaveric study and case series.

OBJECTIVE: To develop and assess the efficacy of an ultrasound (US)-guided pericapsular hip desensitization (PHD) technique in dogs. STUDY DESIGN: Prospective, randomized, anatomical study and a case series. ANIMALS: A total of 30 healthy dogs, eight canine cadavers and seven dogs with hip osteoarthritis. METHODS: After studying the US anatomy of the medial aspect of the coxofemoral joint and determining an acoustic window to perform an US-guided PHD in healthy dogs, the US-guided PHD was performed bilaterally in canine cadavers. A low [(LV) 0.1 mL kg-1] and high [(HV) 0.2 mL kg-1] volume of dye was injected per hip on each cadaver. The staining of the pericapsular nerves was assessed by anatomical dissection, and comparison between LV and HV was assessed using Fisher's exact test. Then, the US-guided PHD was performed using a triamcinolone-bupivacaine solution in dogs with hip osteoarthritis. Dynamic pain response was assessed before and after injection. The canine brief pain inventory (CBPI) questionnaire was used to assess treatment efficacy and duration. RESULTS: The US-guided PHD could be performed by inserting the needle between the iliopsoas muscle and the periosteum of the ilium. The articular branches of the femoral and obturator nerves were stained in all cadavers using both volumes. The main femoral nerve was never stained, but the main obturator nerve was stained in 37.5% and 100% of injections using LV and HV, respectively (p = 0.026). Treated animals showed decreased dynamic pain response after the injection. Compared with baseline, CBPI scores were reduced by ≥ 50% for ≥ 12 weeks in all but one dog. CONCLUSIONS AND CLINICAL SIGNIFICANCE: The US-guided PHD with both 0.1 and 0.2 mL kg-1 volumes stained the articular branches of the femoral and obturator nerves in canine cadavers and was associated with clinical improvement in dogs with hip osteoarthritis.

Ultrasound is an accurate method compared to radiography for diagnosing the presence of acute hip luxation in cadaver dogs and can identify the direction of luxation with variable reliability.

Acute hip luxation is a common musculoskeletal injury in dogs, with radiographs being the preferred imaging modality for confirming the diagnosis. In large animal and human medicine, ultrasound is often utilized for this purpose. The objectives of this three-part study were to utilize a canine cadaver model to establish ultrasonographic features of hip luxation and evaluate the accuracy and reliability for diagnosing hip luxation with ultrasound. For the first prospective, exploratory study, a cadaver model was developed that allowed manual luxation and subsequent ultrasonography of the hip joint while in four directions of luxation. For the second prospective, anatomic study, a description of the ultrasonographic features for each direction of luxation was created. For the third prospective diagnostic accuracy, observer agreement study, 16 residency-trained and intern veterinarians without prior experience in this technique performed randomized, repeated ultrasound exams on cadaver hips assigned as normal or luxated (equally distributed between the 4 directions). A total of 1140 hip ultrasounds were performed with good accuracy (median, 90.8%; range, 61.4-100%), sensitivity (89.5%), and specificity (80.0%) for diagnosing the presence of hip luxation. Accuracy for identifying the correct quadrant of luxation was significantly lower (mean, 58.6%; range, 24.6-90.8%; P < 0.001). Intraobserver accuracy agreement varied widely from none to almost perfect agreement, and interobserver agreement ranged from slight to moderate agreement. The results of this study supported the use of ultrasound for diagnosing the presence of hip luxation but did not support replacing radiographs for diagnosing the direction of luxation.

Effect of Femoral Head and Neck Osteotomy on Canines' Functional Pelvic Position and Locomotion.

The long-term effect of femoral head and neck osteotomy (FHO) on the locomotory system of dogs was evaluated. The study comprised an owner questionnaire and an orthopaedic examination, anatomical measurements, and pressure-sensitive walkway analysis for dogs. Linear mixed effect models were used for statistical analysis. Ten dogs with a median of 2.5 years since their unilateral FHO were included. According to the questionnaire results, nine dogs had returned to a normal physical activity level. Muscle atrophy (p = 0.005), less extension in the coxofemoral joint (p = 0.003), and less static weight bearing on the FHO limb (p = 0.003) were observed. No consistent pattern regarding tilt or position of the pelvis was noted when measuring height of the tuber ischii (p = 0.39). Five of the dogs tilted away from, and five towards the FHO side when measured from the tuber sacrale with a Myrin goniometer. No differences regarding stance time, swing time, or peak pressure between the FHO and non-FHO limb were seen in trot (p = 0.70, p = 0.26, and p = 0.91, respectively). Over the long term, the FHO limb has muscle atrophy, decreased coxofemoral extension, and decreased static weight bearing. However, this does not seem to affect the trot of the dogs. Dog owners considered the outcome of surgery to be good or excellent.

Developmental features of the canid proximocaudal femur.

We continued direct morphological studies of the canid coxofemoral joint, considering early-life spatial relationships around the locus of the proximocaudal joint capsule insertion. Our primary goal was to elucidate the postnatal developmental gross anatomy of the proximocaudal femur, among juveniles across Canidae. From an original database of 267 independent (museum) specimens from 11 canid taxa and 1 hybrid taxon, we identified 29 ancient or modern candidate juvenile specimens (nine taxa and one hybrid taxon). Based on optimal ability to recognize landmarks, the best photographic data were categorized into five groups of four each (n = 20). The data groups approximated early juvenile, early-mid juvenile, mid-juvenile, mid-late juvenile; and young adult stages. In this descriptive photographic essay, we demonstrate the developmental spatial proximity among (a) the dorsal meeting of the respective lateral and medial extensions from the growth centers of the femoral head and greater trochanter; (b) the caudodorsal aspect of the coxofemoral joint capsule attachment; (c) a segment of the proximocaudal femoral shaft physis; and (d) an eventual associated mineralized prominence. The latter occurs frequently but not universally, suggesting natural population variability across taxa. Across taxa and juvenile age categories, the morphology thus supports developmental conservation among ancient and modern Canidae. The biomechanical and biological cause-effect implications are not yet clear. For zoological purposes, we apply the term postdevelopmental mineralized prominence to the residual caudolateral surface feature. We extend the original anatomical work of Morgan in zoological and phylogenic arenas, using direct observation of cleared skeletal specimens.

The nature of coxofemoral joint pathology across family Canidae.

We evaluated coxofemoral joints from museum specimens of: Vulpes lagopus; Vulpes vulpes; Vulpes velox; Nyctereutes procyonoides; Urocyon cinereoargenteus; Aenocyon [Canis] dirus; Canis latrans; Canis lupus lupus; Canis lupus familiaris; C. l. familiaris × latrans; and Canis dingo. Acetabular components included: fossa; articular surface; medial and lateral articular margins; and periarticular surfaces. Acetabular components variably revealed: osteophyte-like features; varying appearance of articular margin rims (especially contour changes); rough bone surfaces (especially fossa and articular surface); and surface wear. Proximal femoral components included: articular surface; articular margin; periarticular surfaces; and joint capsule attachment. Femoral components variably revealed: rough bone surface; bone loss; articular margin osteophyte-like features; caudal post-developmental mineralized prominence; and enthesophytes along the joint capsule attachment. Non-metric multidimensional scaling was used to analyze right-left asymmetric relationships between observed traits, across taxa. Significantly different acetabular trait asymmetry involved only C. latrans-C. l. familiaris; V. vulpes-N. procyonoides, and U. cinereoargenteus-N. procyonoides. There were no significant lateralized differences in proximal femoral traits involving modern canids, ancient and modern C. l. familiaris, or modern vulpines. Thus, the observations were strongly bilateral. We hypothesized high similarity of traits across taxa. The data confirm the hypothesis and strongly suggest broad and deep morphological and mechanistic conservation that almost certainly pre-existed (at least) all modern canids. Further zoological studies are needed to evaluate phylogenic implications in greater detail.

Case Report: Trans-Articular External Skeletal Fixation of the Hip for a Highly Comminuted Juxta-Articular Fracture of the Proximal Femur Caused by Gunshot Injury in a Cat.

This report describes a novel surgical technique for trans-articular external skeletal fixation (TA-ESF) of the hip to stabilize a rare, highly comminuted juxta-articular fracture of the proximal femoral segment involving the metaphysis and diaphysis in a cat. A 2-year-old, castrated male, Korean shorthair cat was admitted for a left femoral fracture caused by gunshot injury. Radiographs and computed tomography (CT) scans revealed a highly comminuted proximal femoral diaphyseal fracture that involved the femoral neck and the greater trochanter. The left femoral head was intact on CT. Under fluoroscopic guidance, an intramedullary Steinmann pin was placed to align the femur, and five positive-profile, end-threaded pins were placed in the left hemipelvis and distal femur. A triangulated frame of connecting bars was constructed using Steinmann pins and epoxy resin for TA-ESF. This secured the pins placed in the pelvis and femur as well as the intramedullary pin, providing proximal femoral stabilization by trans-articular fixation of the hip. The cat began placing weight on the left pelvic limb 4 days postoperatively, and progressively obtained near-normal limb function by day 112. The TA-ESF was partially dismantled to a linear tie-in construct on day 64 and was completely removed on day 161. Final radiographs on day 161 revealed lack of bone healing in the proximal segment, especially femoral head and neck, despite functional recovery of the injured leg. At one year postoperatively, the cat had normal limb function without any noticeable complications. On follow-up 29 months after surgery, the owner reported that the cat had normal limb function without any noticeable complications. Despite insufficient bone healing in the cat, TA-ESF of the hip allowed for satisfactory functional recovery of this challenging juxta-articular fracture of the proximal femur, which was not amenable to stabilization with a traditional non-load-sharing fixation system.

Prenatal Screening for Developmental Displacement of the Hip: The BUDDHA (Pre-Birth Ultrasound for Developmental Displacement of the Hip Assessment) Study.

BACKGROUND: developmental dysplasia of the hip has an incidence of 3-5 out of 1000 children. Currently, only postnatal screening is available. OBJECTIVE: to test the feasibility of a method based on Graf technique application at antenatal ultrasound in assessing the normal development of the hip in unselected term fetuses. METHODS: a prospective cohort study in a single university tertiary hospital from January 2017 to January 2020. Single uncomplicated term pregnancies (37-40 weeks) attending our center for routine ultrasound were consecutively recruited for the purpose of the study. A 3D volume acquisition was launched on the coxofemoral joint of the fetus by a single expert operator, and offline analysis was then performed in the multiplanar mode by two operators (blinded to each other analysis) in order to measure the alpha and beta angles according to our modified Graf technique. Intra- and inter-observer variations were calculated. Reference charts for normal values of both angles were produced. Postnatal ultrasound was then performed to measure the Graf angles in newborns, confirming a normal development of the hip. RESULTS: in the study period, 433 uncomplicated term pregnancies underwent 3D ultrasound for the assessment of the fetal hip. One case was subsequently excluded because of confirmed postnatal diagnosis of developmental dysplasia of the hip. The measurement of our modified Graf angles was feasible at prenatal ultrasound with a good reproducibility. The inter-rater and intra-rater reliability of both angles was substantial. Reference charts for normal values of both angles were produced. CONCLUSIONS: the evaluation of the coxofemoral joint in fetuses at term of gestation has never been attempted before. The Graf technique application, currently employed at postnatal ultrasound, may also be adapted to prenatal ultrasound with a substantial reproducibility. However, there was no evidence of a linear relationship between prenatal and postnatal alpha angles and beta angles. Further research is needed to establish if developmental dysplasia of the hip could be diagnosed antenatally.

Iliofemoral technique modification using an anchor screw as treatment of canine traumatic hip luxation - case report / [Modificação da técnica de sutura iliofemoral com uso de parafuso âncora no tratamento da luxação coxofemoral traumática em cães - relato de caso]

Twelve dogs with traumatic hip luxation were selected for surgical intervention with a modified iliofemoral suture technique using an anchor screw to substitute the passage of suture material through a perforated tunnel in the ilium. Six procedures were performed with non-absorbable suture and other six with absorbable suture materials. These cases were evaluated at 15, 30, 60, and 90 days after surgery by performing an ambulation analysis and palpation of the joint. In all cases, there was a return of partial and total limb support in an average of 3 and 19 postoperative, respectively. The fixation strategy of the suture material in the ilium using an anchor screw proved to be efficient with a smaller surgical approach and lesser surgical difficulty, maintaining joint congruence in acute as chronic luxation cases. The use of absorbable and non-absorbable sutures had excellent clinical results, but there was a subjective superiority of the first ones, once 4 dogs of the non-absorbable group presented some discomfort during the postoperative palpation of the joint, 90 days after surgery.(AU)

Doze cães com luxação coxofemoral traumática foram submetidos à intervenção cirúrgica de sutura iliofemoral modificada com uso de parafuso âncora substituindo a passagem de fio através de túnel perfurado no ílio. Seis procedimentos foram realizados com fio não absorvível, e outros seis com fio absorvível. Os casos foram avaliados aos 15, 30, 60 e 90 dias após a cirurgia, por meio de análise de deambulação e palpação articular. Em todos os casos, houve retorno de suporte parcial e total do peso no membro operado, em média, aos três e 19 dias de pós-operatório, respectivamente. A estratégia de fixação do fio de sutura no ílio com parafuso âncora se mostrou eficaz, permitindo uma abordagem cirúrgica menos invasiva, com menor dificuldade na execução, garantindo manutenção da congruência articular tanto em quadros de luxação aguda como crônica. O uso de fio absorvível e não absorvível teve bons resultados clínicos, porém houve uma superioridade subjetiva do primeiro, uma vez que quatro pacientes do grupo fio inabsorvível mostraram desconforto à palpação da articulação aos 90 dias após a cirurgia.(AU)

Features of the Femoral Proximocaudal Joint Capsule Insertion Among Canids.

This observational study was conducted to evaluate the anatomic relationship between the proximocaudal femoral joint capsule insertion and the femoral caudolateral curvilinear osteophyte (CCO), across ancient and modern domestic and non-domestic canids. Museum specimens of proximal femora were screened for presence of remnant enthesophytes of the caudal joint capsule insertion (first inclusion criterion) and then for the CCO (second inclusion criterion). The initially screened population included 267 dry bone specimens: Six Canis species, hybrid coyote × domestic dog, and five vulpines (three Vulpes species, one Urocyon, and one Nyctereutes). Proximocaudal joint capsule insertion remnant enthesophytes were limiting at n = 19 specimens: Seven ancient domestic dogs, four modern coyotes, two ancient coyotes, two modern hybrid coyote × dog, two modern red foxes, and two modern raccoon dogs. The joint capsule enthesophytes are associated with inflammation, but are observed far less frequently than the CCO. The CCO is seen radiographically but is visible more frequently by direct inspection. The primary inclusion criterion necessarily was a visible caudal joint capsule insertion; spatial relationships of the CCO can be assigned with confidence only when a capsule insertion line can be recognized clearly. We demonstrate that the anatomic CCO associates with the joint capsule insertion being nonspecific and species-independent. A joint capsule insertion-CCO spatial relationship across species is an important new observation, strongly indicating that both are pathological features. Our data indicate need for new research to characterize the canid coxofemoral joint and its overt and incipient pathology in a phylogenetic context. Anat Rec, 302:2164-2170, 2019. © 2019 American Association for Anatomy.

Feline hip joint anatomy in magnetic resonance images.

The aim of this study was to develop an anatomical model of the feline hip joint for low-field magnetic resonance imaging (LF-MRI) based on high-field magnetic resonance imaging (HF-MRI). The study was performed on six adult clinically healthy European shorthair cats, aged 1-3 years, with body weight of 2.8-4.4 kg. The animals were examined with the use of the Vet-MRI Grande Esaote LF (0.25 T) scanner and high-field Siemens Magnetom TRIO (3 T) MRI scanner. In the LF-MRI, most satisfactory results in T1-weighted images were obtained when TE was 26 ms in all three planes and when TR was 350-950 ms in the transverse plane, 950-1150 ms in the sagittal plane and 520-750 ms in the dorsal plane. In T2-weighted images, TE was 90 ms in the transverse and dorsal plane and 120 ms in the sagittal plane. The results were presented as images acquired with LF-MRI scanners in three planes. The slice thickness was 3 mm for each plane. In LF-MRI, muscles in the hip joint region and round ligament were well visualized. Unlike in LF-MRI, the cross section of the femoral nerve was identified in HF-MRI scans. In examinations of the feline hip joint, the main limitations of LF-MRI were a lack of reliable contrast between articular cartilage and synovial fluid as well as longer scan time. Despite the above, LF-MRI images were characterized by good contrast between bones and the surrounding soft tissues.

Agmatine for Pain Management in Dogs With Coxofemoral Joint Osteoarthritis: A Pilot Study.

Background: Pain from coxofemoral joint (CFJ) osteoarthritis (OA) characteristic of canine hip dysplasia (CHD) afflicts many dogs. Intervertebral disc (IVD) degeneration is a common CFJ OA comorbidity. Non-steroidal anti-inflammatory drug (NSAID) administration is standard for treatment of pain from degenerative joint disease. Potential side effects and tolerance from prolonged administration drive efforts to identify compounds that may be alternatives to or combined with NSAIDs. Agmatine, decarboxylated arginine, reportedly alleviates neuropathic pain, a likely component of OA pain. The objective of this study was to compare treatment response to agmatine and carprofen in dogs with varying degrees of CFJ OA with or without IVD degeneration and to test the hypothesis that agmatine improves hindlimb use comparably to carprofen and more than placebo. Methods: Nine hound-type dogs received oral carprofen (4.4 mg/kg, sid) for 7 days. Six months later, oral agmatine sulfate (25 mg/kg, bid) or placebo (hydroxypropyl methylcellulose, bid) was administered to the same dogs for 28 days with a 2 week washout period between treatments. Validated pain assessment scores were measured before treatment and every seven days throughout the treatment periods. Serum chemistry levels and ground reaction forces (GRF) were quantified before and after each treatment period. A board-certified radiologist quantified radiographic CFJ OA based on Orthopedic Foundation for Animals criteria and IVD degeneration on magnetic resonance images. GRFs were compared among treatments at each time point and among time points for each treatment. Results: There were no detectable adverse effects with any treatment. Significant results included improved GRFs in dogs with mild CFJ OA (N = 3) following agmatine administration compared to carprofen or placebo and a trend for improved GRFs in dogs with moderate CFJ OA (N = 2) following carprofen vs. agmatine or placebo. Neither agmatine nor carprofen improved GRFs in dogs with severe CFJ OA (N = 4). The GRFs improved in dogs with IVD degeneration (N = 3) following carprofen treatment compared to agmatine or placebo regardless of CFJ OA score, but no effect was observed in dogs with normal lumbar spines (N = 6). Conclusions: Results support agmatine over carprofen treatment to improve limb use in dogs with early or mild CFJ OA, while carprofen may be the better choice for dogs with moderate CFJ OA or IVD degeneration regardless of CFJ OA severity.

FEMORAL HEAD RESECTION IN TWO LIVINGSTONE'S FRUIT BATS (PTEROPUS LIVINGSTONII).

Two Livingstone's fruit bats (Pteropus livingstonii) presented with a unilateral partial paresis of the hind limbs. Radiographs revealed luxation of the coxofemoral joint and degenerative joint disease in the right coxofemoral joint in one case. The second case presented with recurrent luxation of the coxofemoral joint with osteoarthrosis of the femoral head. Clinical findings in both cases led to a decision to perform a femoral head resection. The performed surgery led to the recovery of normal function of the limb without any complications in both cases.

Use of computed tomography to compare two femoral head and neck excision ostectomy techniques as performed by two novice veterinarians.

OBJECTIVES: To compare the results of femoral head and neck excision (FHNE) ostectomy performed by two novice veterinarians using an osteotome and mallet or microsagittal saw. METHODS: In this ex vivo cadaveric study, hindlimbs of eight canine cadavers were randomized to FHNE with osteotome or micro sagittal saw as performed by two recently graduated veterinarians. The hindimbs were imaged by computed tomography (CT) before and after the osteotomy. Post FHNE CT images were evaluated by a board certified radiologist blinded to the ostectomy technique for assessment of the number of bone fragments, fissures, smoothness of osteotomy margination, and volume of residual femoral neck. RESULTS: Femoral head and neck excision performed with the osteotome produced more peri-ostectomy bone fragments, cortical fissures, irregular margins, and residual femoral neck volume, compared with osteotomy using a saw. CLINICAL RELEVANCE: Compared to FHNE performed with a sagittal saw, osteotome FHNE resulted in a greater bone trauma and residual neck bone volume, which would require post-ostectomy modification in a clinical setting.

Traumatic conditions of the coxofemoral joint: luxation, femoral head-neck fracture, acetabular fracture.

Diagnosis and treatment of traumatic conditions of the hip joint in cattle remain a challenge for the veterinarian. This article is intended to give an overview of the most common orthopedic problems of the bovine coxofemoral joint, diagnostic procedures, and treatment options.

Hallazgos ecográficos de la articulación coxofemoral y su correlación con la actividad de la enfermedad y hallazgos clínicos en artritis reumatoide / Sonographic findings of the joint coxofemoral and correlation with disease activity and clinical findings in rheumatoid arthritis

To describe the sonographic findings of the hip joint in patients with rheumatoid arthritis and to assess their correlation with signs and symptoms of disease activity (pain, range of motion, overall disease activity). Methods: We performed an observational, cross-sectional and analytical study. Patients aged 18 60 years of age diagnosed with rheumatoid arthritis were included. We did not include patients with hip prostheses or hip infiltration in the previous 3 months. We performed an ultrasound examination (7-12 MHz linear transducer) of both hips and recorded demographic, clinical, ultrasonographic and goniometric findings (flexion, extension, abduction, adduction, internal and external rotation). Results: We evaluated 102 hips of 51 patients (37 women) aged 43.5 +/- 9.4 years, body mass index (BMI): 26.4 +/- 5.18, disease duration: 117 +/- 107 months, DAS28: 4.08 +/- 1.58, hip pain history: 20 (39.2 percent), concurrent hip pain 3 (5.8 percent), use of DMARDs: 47 (92.1 percent), biological therapy 8 (15.68 percent), comorbidity: 25 (50.1 percent), positive rheumatoid factor: 43 (84.3 percent) and evocation of pain: 28 (54.9 percent). Ultrasound findings: Osteophytes: 52 (50.9 percent), cartilage injury: 47 (46.0 percent), trochanteric enthesopathy: 33 (32.3 percent), effusion: 14 (13.7 percent), erosions: 6 (5.8 percent), synovial hypertrophy: 5 (4.9 percent) and iliopsoas bursitis 2 (1.9 percent). There was no correlation of ultrasound with DAS28 or laboratory parameters. Evoking pain correlated with the presence of effusion (p = 0.038). Conclusions: The major ultrasound abnormalities were osteophytes, articular cartilage injury and trochanteric enthesopathy. According to our findings is advisable to include hip in the clinical assessment and initial and subsequent ultrasound evaluation of patients with rheumatoid arthritis...

Describir los hallazgos ecográficos de la articulación coxofemoral en pacientes con artritis reumatoide y evaluar su correlación con los signos y síntomas de actividad de la enfermedad (dolor, rango de movimiento, actividad global de la enfermedad). Material y métodos: Es un estudio observacional, transversal y analítico. Se incluyeron pacientes de 18 a 60 años de edad con diagnóstico de artritis reumatoide. No se incluyeron pacientes con prótesis de cadera o infiltración de la cadera en los tres meses previos. Se realizó ecografía (transductor lineal 7-12 MHz) de ambas caderas y se registraron datos demográficos, clínicos, ecográficos y goniométricos (flexión, extensión, abducción, aducción, rotación interna y externa). Resultados: Se evaluaron 102 caderas de 51 pacientes (37 mujeres) con edad de 43,5 +/- 9,4 años, índice de masa corporal (IMC): 26,4 +/- 5,18, evolución de la enfermedad: 117 +/- 107 meses, DAS28: 4,08 +/- 1,58, historia de dolor: 20 (39,2 por ciento), dolor concurrente: 3 (5,8 por ciento), uso de FARME: 47 (92,1 por ciento), terapia biológica: 8 (15,68 por ciento), comorbilidad: 25 (50,1 por ciento), factor reumatoide positivo: 43 (84,3 por ciento) y evocación de dolor: 28 (54,9 por ciento). Hallazgos ecográficos: Osteofitos: 52 (50,9 por ciento), lesión de cartílago: 47 (46,0 por ciento), entesopatía trocantérica: 33(32,3 por ciento), derrame: 14 (13,7 por ciento), erosiones: 6 (5,8 por ciento), hipertrofia sinovial: 5 (4,9 por ciento) y bursitis iliopsoas: 2 (1,9 por ciento). No se encontró correlación de la ecografía con el DAS28 ni con los parámetros de laboratorio. La evocación de dolor se correlacionó con la presencia de derrame (p = 0,038).Conclusiones: Las principales alteraciones ecográficas fueron osteofitos, lesión del cartílago articular y entesopatía trocantérica. De acuerdo a nuestros hallazgos, es recomendable incluir a la cadera en la valoración clínica y ecográfica inicial y subsecuente de los...

Antecedentes, historia y pronóstico de la displasia del desarrollo de la cadera / Backgrounds, history and prognosis of hip dysplasia development

La displasia de cadera es una enfermedad que se presenta en niños menores de dos años, pero puede tener consecuencias importantes en edad adulta, incluso, puede llevar a osteoartrosis de cadera, y por tanto, desembocar en invalidez en adultos jóvenes. La displasia de cadera es una afección ósea que puede tener su raíz en defectos congénitos, hereditarios, o degenerativos que llevan a una formación inadecuada de la articulación de la cadera (coxofemoral) que puede provocar, a mediano plazo, una deficiente formación de la articulación y cojera y a largo plazo, desgaste excesivo de la articulación e invalidez. Por tanto, se requieren estudios actualizados que relaten los avances más importantes en la comprensión, desarrollo, pronóstico y tratamiento de esta importante enfermedad que afecta de 15 a 20 por cada 1 000 niños y tiene como principal víctima a las niñas recién nacidas. Desde este punto de vista el objetivo de este artículo es presentar el estado del arte, los antecedentes, historia y pronóstico de la displasia del desarrollo de la cadera. Por tanto, este trabajo puede ser de especial importancia para los médicos, ortopedistas y fisioterapeutas que requieran de una actualización en el tema de la displasia de la cadera

Hip dysplasia is a disease present in children under two years, but may to have significant consequences in adulthood; even it may leads to a hip osteoarthrosis and thus, to provoke disability in young adults. The his dysplasia is a bone affection that may to have its origin in congenital, hereditary or degenerative disorders that a medium term may to cause of an inappropriate formation in hip joint (coxofemoral) and claudication, and at long term, an excessive corrosion and disability. Thus, updated studies are necessary relating the more significant advances in understanding, development, prognosis and treatment of this important entity affecting 15-20 by each 1 000 children and its major victims are the newborn girls. From this point of view, the aim of present paper is to present the backgrounds, history and prognosis of hip dysplasia development. Therefore, present paper may to be very important for physicians, orthopedists, and physiotherapists updating on hip dysplasia

Antecedentes, historia y pronóstico de la displasia del desarrollo de la cadera / Backgrounds, history and prognosis of hip dysplasia development

La displasia de cadera es una enfermedad que se presenta en niños menores de dos años, pero puede tener consecuencias importantes en edad adulta, incluso, puede llevar a osteoartrosis de cadera, y por tanto, desembocar en invalidez en adultos jóvenes. La displasia de cadera es una afección ósea que puede tener su raíz en defectos congénitos, hereditarios, o degenerativos que llevan a una formación inadecuada de la articulación de la cadera (coxofemoral) que puede provocar, a mediano plazo, una deficiente formación de la articulación y cojera y a largo plazo, desgaste excesivo de la articulación e invalidez. Por tanto, se requieren estudios actualizados que relaten los avances más importantes en la comprensión, desarrollo, pronóstico y tratamiento de esta importante enfermedad que afecta de 15 a 20 por cada 1 000 niños y tiene como principal víctima a las niñas recién nacidas. Desde este punto de vista el objetivo de este artículo es presentar el estado del arte, los antecedentes, historia y pronóstico de la displasia del desarrollo de la cadera. Por tanto, este trabajo puede ser de especial importancia para los médicos, ortopedistas y fisioterapeutas que requieran de una actualización en el tema de la displasia de la cadera(AU)

Hip dysplasia is a disease present in children under two years, but may to have significant consequences in adulthood; even it may leads to a hip osteoarthrosis and thus, to provoke disability in young adults. The his dysplasia is a bone affection that may to have its origin in congenital, hereditary or degenerative disorders that a medium term may to cause of an inappropriate formation in hip joint (coxofemoral) and claudication, and at long term, an excessive corrosion and disability. Thus, updated studies are necessary relating the more significant advances in understanding, development, prognosis and treatment of this important entity affecting 15-20 by each 1 000 children and its major victims are the newborn girls. From this point of view, the aim of present paper is to present the backgrounds, history and prognosis of hip dysplasia development. Therefore, present paper may to be very important for physicians, orthopedists, and physiotherapists updating on hip dysplasia(AU)