Coxofemoral Joint Research Articles

Protocol of Femur Extraction from Bats in Fluid-Preserved Collections

AbstractThe anatomy of appendicular bones has been demonstrated to be informative for taxonomic, paleontological, and functional studies of bats. Its use in such studies, however, is limited by the small number of skeletons available for this taxonomic group in scientific collections. Here we describe a protocol for the extraction of the femur from fluid-preserved bats. This protocol was successfully tested on a large sample, including 58 species in 43 genera and 9 families (a total of 183 specimens), and is minimally invasive, requiring only two incisions in the leg at disarticulation points (knee and coxofemoral joints). This method provides material for appendicular anatomical research with minimal damage to external morphology.

Total Hip Replacement for Treatment of Chronic Coxofemoral Joint Dislocation in 7 Dogs

Total Hip Replacement for Treatment of Chronic Coxofemoral Joint Dislocation in 7 Dogs

Change in Shear Elastic Modulus of Thigh Muscle by Changing Muscle Length Using Ultrasound Shear Wave Elastography in Beagle Dogs.

This study investigated the relationship between the change in the shear elastic modulus and the change in muscle length using ultrasound shear wave elastography. Four thigh muscles, cranial part of the sartorius, vastus lateralis, biceps femoris and semitendinosus muscles, of 21 pelvic limbs in 12 clinically healthy Beagle dogs were used. The muscle length was estimated using a radiograph and the flexed and extended positions of the coxofemoral and stifle joints, respectively. The shear elastic modulus (kPa) was measured in two joint positions using ultrasound shear wave elastography. Shear elastic modulus was expressed as median of 10 consecutive measurements. The percentage change of elastic modulus was calculated from the shear elastic modulus in elongated condition and pre-elongated condition of muscle. The elastic modulus of all muscles increased when the muscle was elongated. The shear elastic modulus for both joint positions and the percentage change of the shear elastic modulus (%) in cranial part of the sartorius were highest in all muscles. Intra-observer correlation coefficient (1.2) was 0.75 to 0.96 and intra-observer correlation coefficients (2.2) was 0.46 to 0.96. This study revealed that the shear elastic modulus of muscle was changed by the change in muscle length and increased when the muscle was elongated. Ultrasound shear wave elastography can be used to assess the elastic properties of canine muscle.

Séméiologie clinique de la hanche stricto-sensu (coxo-fémorale)

Nowadays, most young physicians over-trust the accuracy of imaging while underrating the interest of clinical examination to diagnose a pain arising from the coxo-femoral joint. In fact, even MRI can lack sensitivity to diagnose chondral defects and/or labrum tears. Moreover, the performances of clinical tests have been much under-evaluated in the past, when any single test was assessed separately and compared to a gold standard. In fact, a thorough clinical history and the combination of a large number of clinical tests dramatically improve the reliability of rheumatologist's opinion about the exact origin of pain in patients suffering from hip conditions (stricto-sensu, i.e. coxo-femoral joint, labrum, minor teres, and overlying capsule). This state of the art article (including 24 pictures and 20 videos) list the most useful or salient signs to seek for, and the best tests to perform, including some only recently described, to diagnose a pain arising from the hip, “stricto-sensu”.

Correlation of distraction index with arthroscopic findings in juvenile dogs with hip dysplasia.

To compare distraction index (DI) with hip arthroscopy findings in juvenile dogs with hip dysplasia undergoing unilateral or bilateral double pelvic osteotomy (DPO). Retrospective case series. Twenty dogs (36 hip joints). Medical records from dogs undergoing unilateral or bilateral DPO (2011-2016) were reviewed. Distraction index was measured by using distraction view radiographs. Arthroscopic images were analyzed. Cartilage was graded by using the modified Outerbridge scale (0 = arthroscopically normal, 1 = chondromalacia, 2 = surface fibrillation, 3 = deep fissuring, 4 = full-thickness cartilage loss, and 5 = eburnation of exposed subchondral bone). Dorsal acetabular rim, acetabular labrum, the ligament of head of the femur, and synovitis were graded by using a four-point scale (normal, mild, moderate, severe). Spearman and Pearson correlations were used to compare DI between grade groups and age. Distraction index ranged from 0.4 to 1.0 (mean 0.69 ± 0.16). Most of the hips had an arthroscopically normal femoral head and acetabulum in most regions, except for the region at the insertion of the ligament of the head of the femur. There was a low positive correlation between synovitis and DI (Spearman ρ = 0.35, P = .0346). No other differences in DI were identified between grade or age groups. There was a low positive correlation between synovitis and DI. No other differences in DI were identified. Arthroscopic evaluation of the coxofemoral joint prior to DPO can allow detection of joint pathology that might not be appreciated by using traditional radiographic screening criteria.

Disarticulation-Associated Femoral Head Separation in Clinically Normal Broilers: Histologic Documentation of Underlying and Predisposing Cartilage Abnormalities.

Routine and quantitative histologic studies on femoral head separation (FHS) associated with coxofemoral joint disarticulation at necropsy were conducted on 125 femoral heads collected from 21- to 50-day-old clinically normal broilers. The study compared groups demonstrating grossly detached femoral heads (DFHs) with those having attached femoral heads (AFHs). Marked microscopic lesions compatible with osteochondrosis (OCD) consistently occurred along the separation surface in the DFH population. The histologic changes consisted of cartilage degeneration and necrosis sometimes forming small clefts or microfractures. Hemorrhage and less frequent inflammatory cells were often present along the separation surfaces. Small foci of OCD in the femur occurred in the AFH group with lesser frequency and severity. The histologic changes were mainly found within the proximal proliferative zone of the physis near the epiphyseal junction. Histomorphometry disclosed significant quantitative reductions in chondrocyte density with increased pyknosis occurring adjacent to the separation site and to a lesser extent in deeper regions of the growth plate for the DFH compared with AFH. Measurements made along the separation surface of the percentage length occupied by osteochondrotic defects and actual separated cartilage disclosed significant differences between evaluation groups. However, determinations of vascular canal areas present within two or more regions of the growth plate revealed a slight and significant increased area for DFH compared with AFH. Severity scores for the occurrence of microthrombi within the growth plate showed no difference between the groups. The pathogenesis of FHS in broilers is related to defective cartilage production or degeneration resulting in increased fragility. This contrasts with the proposed pathogenesis of OCD in mammals, which involves ischemic necrosis due to underlying vascular defects. The results for the FHS-disarticulation model also differ from those reported for glucorticoid-induced femoral head necrosis in broilers. The FHS-associated lesions occurred without histologic evidence of bacterial chondritis or osteomyelitis.

Musculoskeletal ultrasound: a useful tool for diagnosis of hip developmental dysplasia: One single-center experience.

Developmental dysplasia of the hip (DDH) is one of the most common congenital abnormalities of the musculoskeletal apparatus in newborns. The aim of this study was to analyze the contribution of ultrasonography in the detection of DDH in newborns and infants, identifying the regional incidence of this pathology in the central area of Romania, emphasizing the risk factors that underlie DDH etiopathogenicity.This article represents a retrospective study of 847 newborns and infants examined in the Imagistic Department of a medical center from the central area of Romania, between January 1 and December 31, 2016. The ultrasound examinations were performed for the bilateral coxofemoral joints, using the method and technique described by Graf. For subjects born in the same medical center, data regarding mother's age, birth weights, and type of delivery (natural vs. caesarian section) were statistically analyzed.In our study group, the frequency of ultrasound diagnosis obtained from the examinations of right and left hips showed that the most frequent stage was type IA, and the rarest stage was III. The IA stage of right coxofemoral joints (87.3%) was higher than in the left coxofemoral joints (87.2%). The incidence of hip dysplasia (type III) diagnosed with ultrasound examinations in subjects from the central area of Romania was 0.2% (0.1% in both hips and 0.1% for the left coxofemoral joint).The musculoskeletal ultrasound examination is effective in early detection of hip dysplasia. The implementation of national and regional programs that promote indications, risk factors, and the screening age for DDH in both rural and urban areas could be a step forward in the early diagnosis of hip dysplasia for newborns and infants. The low incidence of DDH from our study group is not able to identify the role of advanced age of the mother, high birth weight of the newborn, or caesarean section as risk factors involved in the etiology of hip dysplasia. The implementation of national and regional programs that promote the musculoskeletal ultrasound as a screening imagistic investigation for DDH, in both rural and urban areas, could be a step forward in the early diagnosis of hip dysplasia for newborns and infants.

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.

Surgical Correction of Congenital Bilateral Patellar Luxation in a Pup - A Case Report

Luxation of patella may be congenital or traumatic origin, and can affect any breed. The congenital form is related to developmental abnormalities of the limb that create malalignment of quadriceps group of muscles. With underlying abnormalities of hip and stifle joint congenital lateral patellar luxation have skeletal abnormalities like retroversion of femoral head and neck, coxa vara (altered angle of inclination), genu valgum and shallow trochlear groove with poorly developed trochlear ridges (Denny and Butterworth, 2006). Luxation of patella is a common cause of lameness in dog which can be in medial or lateral displacement. The incidence of medial patellar luxation is 5 times more than lateral luxation and is seen more in large breeds of dogs. Lateral patellar luxation may predispose the dogs to knock knee (genu valgum) and cow hock (hock valgus) condition (Robins, 1990). The cause of lateral patellar luxation is unknown but is thought to be related to anteversion or coxa valga of the coxofemoral joint, which shifts the line of force produced by the pull of quadriceps lateral to the longitudinal axis of the trochlear groove. This abnormally directed lateral force pulls the patella from the trochlear sulcus causing skeletal abnormalities (Fossum, 2002).

Pseudo-abcès musculaire d’origine microcristalline : une localisation exceptionnelle de chondrocalcinose

IntroductionChondrocalcinosis results from calcium pyrophosphate crystals deposition in the joints. We report an exceptional case of aseptic psoas abscess with a deposition of calcium pyrophosphate crystals. Case reportA 92-year-old man presented to our department for an acute onset of inflammatory pain in the left hip. Computed tomography detected a coxofemoral arthritis and multiple intramuscular collections located in the iliopsoas muscle and the gluteus minimus. A sample of the fluid was obtained with a guided aspiration, and its analysis revealed an inflammatory liquid with no bacteria but numerous calcium pyrophosphate crystals. The final diagnosis was thus a muscular calcium pyrophosphate deposition pseudo-abscess, associated with a hip arthritis. ConclusionHip chondrocalcinosis is unusual, and the association with intramuscular deposition of calcium pyrophosphate crystals seems extremely rare as we found only four other published cases. A microcrystalline arthritis could have spread from the coxofemoral joint through the iliopsoas bursa and into the muscle. However, the imaging aspect with an abscess and a predominant muscular injury might suggest a mechanism of crystal formation originating directly within the muscle. The outcome was always favourable even if some patients required surgery.

Provisional heritability estimates of four distraction index traits in a breeding population of German Shepherd dogs

AIMTo obtain provisional estimates of the heritability (h2) of passive laxity of the coxofemoral joints of a breeding colony of German Shepherd dogs, measured using the PennHIP distraction index (DI).METHODSRecords were obtained of the PennHIP DI of right and left hips of 195 German Shepherd dogs (377 DI records) from the dog breeding colony of the New Zealand Police Dog Breeding Centre between 2003 and 2016, as well as pedigree records of 884 animals over four generations. Estimates of h2 and variance components for the log transformed DI data were obtained using restricted maximum likelihood procedures with a single trait sire model. Four DI traits for each dog were analysed: left hip, right hip, mean and worse-hip DI. The model included the fixed effects of sex and year of birth, with the age at scoring as a covariable, the random sire effect and residual error for each observation.RESULTSThe h2 of the DI of the left hip (0.81, SE 0.40) was higher than the h2 of the DI of the right hip (0.35, SE 0.36). The h2 for the worse-hip DI (0.15, SE 0.28) in each dog was lower than the h2 of the individual hip DI, or the h2 for the mean of the two hips (0.53, SE 0.36) in each dog. The low number of generations prevented a meaningful analysis of the genetic trend.CONCLUSIONS AND CLINICAL RELEVANCEThe h2 estimates for the left, right and mean DI traits were moderate to high, whereas the h2 estimates for the worse-hip DI (as used by the PennHIP programme for ranking of dogs) was low, but all estimates had large SE due to the small sample size. This provisional estimate of the h2 of four distraction index traits suggests that the mean DI could be useful as a selection tool against canine hip dysplasia in German Shepherd dogs, whereas the worse-hip DI may be less effective. Heritability estimates from a population with a greater number of DI measures is needed to validate this finding given the large SE in our study.

Salmonella Contamination in Broiler Synovial Fluid: Are We Missing a Potential Reservoir?

The objective of this study was to assess the presence and characteristics of Salmonella enterica found in the synovial fluid of broiler carcasses. The synovial fluid of three individual joints from 500 broiler carcasses was individually sampled from five broiler processing facilities located in the Southeast and West regions of the United States (1,500 total samples). The external surface of broiler carcass was decontaminated before sampling of the shoulder, coxofemoral, and tibiofemoral joints. Individual samples were enriched, composited, and subjected to rapid PCR-based detection of Salmonella. Individual samples from any positive composites were also enriched before determination of Salmonella presence in the same manner. Positive individual samples were subjected to secondary enrichment before plating onto selective agar for isolation of Salmonella. Salmonella isolates were serotyped before determination of antimicrobial susceptibility. Overall, 1.00% (5 of 500 broiler carcasses) of composite samples and 0.47% (7 of 1,500 samples) of individual samples were positive for Salmonella. Five of the seven isolates were susceptible to all drugs tested and determined to be Salmonella Enteritidis. The remaining two isolates, identified as Salmonella Typhimurium, were resistant to streptomycin. To our knowledge, no previous assessments of Salmonella in the synovial fluid of broilers has been reported; however, results of the present study suggested that the synovial fluid may be a reservoir for Salmonella in broilers. Although the prevalence of Salmonella is low, this information provides valuable insight into potential poultry contamination pathways and warrants further exploration.

Method for auxiliary use of thermography in diagnosing inflammation in the coxofemoral joint in dogs

Joint diseases are relatively common in domestic animals, such as dogs. The involved inflammation produces thermal emission, which can be imaged using specific sensors that allow capturing of infrared images. Given that there have been few reports on the use of thermography in the diagnosis of inflammation associated with diseases of the hip joint in dogs, we here propose a method for identification of inflammatory foci in dogs by using infrared thermometry. The present study aimed to find non-invasive and low-cost resources that couldfacilitate a clinical diagnosis in cases withinflammation in the coxofemoral joint of dogs.To this end, we developed a system in whichthe Flir Systems TG165 thermograph is coupled to a black PVC cannula with a 30-cm focus-to-animal distance.External effects of the environment on the temperature of the animalswere compared with the body temperature as measured by a conventional thermometer.Thirty-one dogs with and without inflammation in the coxofemoral joint underwent clinical evaluation.We verified that the temperature registered by the thermograph inthe animals with joint inflammation was significantlydifferentfrom that incontrol animals without inflammation, in the lateral projection.The method showed a sensitivity of 80%, specificity of 87.5%, and accuracy of 83.87%. This standardized method of diagnosis of inflammatory foci in the coxofemoral articulation of dogs by way of thermography showed sensitivity, specificity, and satisfactory accuracy.

Recurrent Multi-Organ Cystic Echinococcosis

Abstract Cystic echinococcosis is the disease that occupies, together with trichinosis, the first place in the zoonoses in Romania. We present the case of a 75-year-old urban patient known for echinococcosis, firstly operated for bone cysts in the right coxofemoral joint at the age of 24, then in 2000 she was operated for a lung hydatid cyst and in 2011 she underwent a surgery for recurrent bone echinococcosis. After a 7-year lull, she returns due to the appearance of tumorous masses in the abdominal right flank, the right thigh, accompanied by pain in the right coxofemoral joint, functional impotence of the right lower limb, asthenia, anorexia. Based on clinical, immunological, imagistic examinations, the diagnosis of cystic echinococcosis localised in the liver, bone and muscle was established. Since the patient in association had ischaemic heart disease in NYHA III (New York Heart Association) congestive heart failure, surgical treatment was delayed and preoperative treatment with Albendazole 10-15mg/kg/day was started. Initially we will apply a conservative treatment, laparoscopic drainage and aspiration of the contents, saline instillation and aspiration.

The importance of the elemental functional mobility coefficient in assessing the functional status of the coxofemoral joint

The importance of the elemental functional mobility coefficient in assessing the functional status of the coxofemoral joint

Sidewinder syndrome associated with partial rupture of the ligamentum capitis ossis femoris

A 25-year-old Welsh Cob stallion was presented with a sudden onset of abnormal hind limb gait. Being led at walk on a straight line, the hindquarters were shifted to the...

Post - Traumatic Hip with Obtu rator Dislocation: Case Report a nd Review of t he Literature

Introduction: Traumatic dislocation of the coxofemoral joint is defined as the permanent posterior or anterior displacement of the femoral head out of the acetabular cavity. It is generally the consequence of a violent trauma, most often an accident on the public road. o ur case it is a post - traumatic hip obtu rator dislocation, managed in our department. Clinical case and results: 16 years old patient, with no particular history, victim of a road accident, causing a closed trauma to his left hip, right ankle and left wrist. It presents with a vicious attitude: left lower limb in flexion, abductio n, external rotation. An X - ray reques ted objective obturator dislocation with a small bone fragment of the head. A bone reconstruction CT was completed in favour of obturator dislocation with head fracture type 1 according to Pipkin's classification. Patient sent directly to the block, he ben efits from a reduction under sedation according to Boehler's maneuver, control by scopy, then immoblisation by zimmer splint after testing the stability of dislocation. Patient is hospitalized in our ward for monitoring then follow - up in consultation. Resu lts were satisfactory, removal of the zimmer splint at the 6th week. Total support was possible at week 12, with complete mobility, patient reviewed afterworld without clinico - radiological signs of aseptic necrosis of the femoral - head. Conclusion: The frac ture - luxation of the femoral head is a serious lesion. It is necessary to think about it in front of each dislocation not to ignore the associated fracture which still darkens the prognosis.

OSTEOPETROSIS AND ENDOPROSTHETICS - CLINICAL OBSERVATIONS

Aim - to evaluate the efficacy of treatment of secondary arthrosis of the coxofemoral joints associated with osteopetrosis using arthroplasty. Materials and methods - clinical observation of two cases of treatment of patients with autosomal dominant form of osteopetrosis who underwent total hip arthroplasty at the Federal State Budgetary Institution Federal Center of Traumatology, Orthopaedics and Endoprosthesis replacement (Cheboksary). Results. We obtained positive results and patient’s satisfaction with the function of prosthetic joints with a follow-up period of 3.5 years. This method of treatment showed its efficacy during the specified follow-up period. Arthroplasty provides relief from pain, improved quality of life and increased mobility of the joint for patients with coxarthrosis associated with osteopetrosis.

Tophaceous hip gouty arthritis revealing asymptomatic axial gout

BackgroundHip and axial involvement is uncommon during gout and may raise diagnostic challenges. We describe a rare case of tophaceous hip gout which lead to the diagnosis of asymptomatic axial tophaceous gout at a single rheumatology center. Case presentationA 35-year-old man, diagnosed with tophaceous polyarticular gout 14 years before presentation, consulted for a gout attack with reduced hip range‐of‐motion on physical examination and an increased serum uric acid level (655 µmol/L). He had been regularly taking colchicine, allopurinol (300 mg/j), and occasionally non-steroidal antiinflammatory drugs. Plain Radiography of the hips revealed bilateral circumferential joint space narrowing, subchondral erosions of the right acetabular, a calcified soft tissue tophus of the left hip and bilateral sacroiliitis grade IV. Computed tomography (CT) showed total ankylosis of the upper segments of both sacroiliac joints and bilateral hip joint space narrowing, subchondral geode eroding the right acetabulum. Moreover, CT revealed soft-tissue tophi involving the major trochanter of the left acetabulum, the right coxofemoral joint and lowest two levels of lumbar facet joints (L4-L5; L5-S1). A spinal and plevis magnetic resonance imaging (MRI) concluded on a gouty tophi, locolized bilaterally intraarticularly in the coxofemoral joints, gluteus medius bursae, lumbar facet joints (L4-L5; L5-S1), and cofirmed bilateral sacroiliitis. ConclusionThe axial and hip gouty arthritis are exceptionnel localisation. Radiographic imaging tools, mainly CT and MRI, may show the monosodium urate crystals and tophi that can contribute to bone and joint lesions of gout. They also allow the exclusion of other possible etiologies such as spondylodiscitis, infection, and neoplasia.

Minimally invasive technique for coxofemoral luxation stabilisation using transarticular toggle system: a cadaveric study.

To present a novel, semi-closed, surgical technique for coxofemoral luxation stabilisation using a transarticular toggle rod. Cadaveric study. Craniodorsal luxation was generated by transecting the ligamentum teres in 12 coxofemoral joints and was then reduced using a closed technique. Anteversion and inclination angles were measured using fluoroscopic projections. An arthroscope was inserted through a bone tunnel drilled from the third trochanter through the femoral neck. Following retraction of the arthroscope, a hole was drilled through the acetabular fossa via the femoral bone tunnel. A standard Arthrex® TightRope toggle button was pushed through the femoral bone tunnel into the acetabular fossa hole and tied over the oval metallic button above the third trochanter site. The exit point of the drill hole over the femoral head and that in the acetabular fossa were evaluated by surgical exposure of the coxofemoral articular surfaces. The TightRope entrance point into the acetabular fossa was accurate in all joints, with a mean distance from the acetabular fossa centre of 0·06 ±0·1 mm. The measured distance of the TightRope exit point from the femoral head to the fovea capitis was 2·04 ±1·7 mm. Femoral head cartilage damage was detected in nine of 12 joints. Closed reduction and stabilisation of coxofemoral luxations can be achieved using this minimally invasive technique. Refinements to the technique may be needed for its application in clinical cases due to relative high incidence of femoral head cartilage damage.