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Canine Hip Dysplasia

Canine Hip Dysplasia. Uncemented Porous- Coated Anatomic Total Hip Arthroplasty as Treatment for Canine Hip Dysplasia. Presented by: Angela Tomars. Paige; Labrador Retriever/German Shepherd Mix. What is hip dysplasia?. Symptoms. Normal Canine Hip Anatomy. Normal Joint Features.

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Canine Hip Dysplasia

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  1. Canine Hip Dysplasia Uncemented Porous- Coated Anatomic Total Hip Arthroplasty as Treatment for Canine Hip Dysplasia Presented by: Angela Tomars

  2. Paige; Labrador Retriever/German Shepherd Mix

  3. What is hip dysplasia?

  4. Symptoms

  5. Normal Canine Hip Anatomy

  6. Normal Joint Features

  7. Healthy Joint Function Proper synthesis of chondrocytes Proper synthesis of synovial fluid Congruity between the femoral head and the acetabulum(3).

  8. Healthy Joint Components Canine chondrocytes (cell culture) Canine synovial fluid ( cell culture)

  9. Joint Components Healthy cartilage Inflamed cartilage Ample synovial fluid Decreased synovial fluid Bone spurs

  10. Weight gain exacerbates issue(3-5)

  11. Commonly Affected Breeds

  12. Criteria Necessary for Diagnosis

  13. Penn Hip Method 1.) Distraction View

  14. Penn Hip Method 2.) Compression View

  15. Penn Hip Method 3.) Extended Hip View

  16. OFA Method Fig. 1 OFA radiographs of a sheepdog-typical ventrodorsal position

  17. Comparison of Normal Hip vs. Hip Affected by Dysplasia

  18. Current Non-Surgical Treatments Traditional steroidal drugs such as Rimadyl(carprofen) Natural supplements, namely Glucosamine and Chondroitin, MSM ,Perna Mussels(1).

  19. Current Non-Surgical Treatments cont’d. Acupuncture Physical Therapy

  20. Current Non-Surgical Treatments Cont’d. NSAIDS such as Zubrin or Meloxicam

  21. Other non-surgical aids

  22. Other non- surgical aids cont’d.

  23. Surgery options 1.) Triple Pelvic Ostomy Cost: $800-$1200+ 2). Inter-Trochanteric Osteotomy Cost:$800-$1,000.00+ 3.) Total Hip Replacement Cost: $1,500.00+ (1).

  24. Canine Uncemented Porous-Coated Anatomic Total Hip Arthroplasty: Results of a Long- Term Prospective Evaluation of 50 Consecutive Cases Denis J. Marcellin-Little, DEDV,Diplomate ACVS, Diplomate ECVS, Bonnie A. DeYoung, David H. Doyens,B.S and David J. DeYoung, DVM, Diplomate ACVS , Diplomate ACVA

  25. Hypothesis “…clinically the prosthesis would allow satisfactory limb function in the long-term.”(2). Prosthesis for cement fixation Uncemented prosthesis

  26. Uncemented (BioMedrix BFX) Cemented( BioMedrix CFX)

  27. Experimental Design N=41 (50 prostheses; 9 bilateral) Surgeries performed between June 1988-March 1992 Follow-up 4-8 yrs. P.O.

  28. Experimental Design Confidence interval 95% Mean age: 2 yrs,8 months Range: 8 months-10.4 years

  29. Comparison of Prostheses Left; cemented prosthesis; Right: uncemented prosthesis

  30. Results 1.) 37 implants included in long- term radiographic evaluation 2.)13 dogs excluded (fewer than 5 years of follow-up) {n=7 deaths (did not appear to be related to THR} {n=5 early dislocation} {n=1 inability to contact owners} 3.) Number of follow-up radiographs=2-10 4.) At 5-8 years : abnormal 9 n=3 dislocation n=2 lumbosacral disease n=1 degenerative myelopathy n=1 autoimmune disease n=1 brain tumor n=1 osteosarcoma Of the femur

  31. Survivorship Rates Cumulative survival rate was 87% at 6 years n= 5 joints dislocated in first weeks n=1 osteosarcoma in femur n=1 late dislocation at 6 years after surgery Most common complication= early implant dislocation (5-50)

  32. Conclusions Comparison of Complications

  33. Recovery 1.) If bilateral surgery is needed: 3 weeks between procedures 2.) If no complications; resume normal activity within 2 months

  34. Conclusions Overall success rates of THR 92-95%! (6). Dogs return to normal activities

  35. Innovations in Cementless THR for humans

  36. References • “Canine Hip Dysplasia”; Working Dogs, Dec. 9, 2007. www.vetcentric.com/caninehipdysplasia. • “Canine Uncemented Porous-Coated Anatomic Total Hip Arthroplasty: Results of a Long-Term Prospective Evaluation of 50 Consecutive Cases”; D.J. Marcellin-Little, B.A. DeYoung, D.J. DeYoung, and D.H. Doyens; Journal of Veterinary Surgery Vol.28, Jan. 1999 ,pp. 10-20. • “Evaluation of a Circumferential Femoral Head Osteophtye as an Early Indicator of Osteoarthritis Characteristic of Canine Hip Dysplasia in Dogs”; S.D. Szabo, D.N. Biery, D.F. Lawler, F.S. Shofer, M.Y. Powers, R.D. Kealy, and G.K. Smith; Journal of the American Veterinary Medical Association Vol. 231, No.6 Sep. 15, 2007. • “Evaluation of the Effect of Limited Food Consumption on Radiographic Evidence of Osteoarthritis in Dogs”; R.D. Kealy, D.F. Lawler, J.M. Ballam, G. Lust, D.N. Biery, G. K. Smith and S. L. Mantz; Journal of the American Veterinary Medical Association Vol. 217, No.11, Dec. 1, 2000. • “Systematic Review of Clinical Trials of Treatments for Osteoarthritis in Dogs”; C.L. Aragon, E.H. Hofmeister, S.C. Budsberg; Journal of the American Veterinary Medical Association; Vol. 230, No.4, Feb. 15, 2007. • “Orthopedic Surgery”; Veterinary Sports Medicine Group, Dec. 2007, www.vetsportsmedicine.com/surgery.

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