Traumatic Coxofemoral Luxation Research Articles

Comparison of intraoperative outcomes in excision arthroplasty with or without partial tenotomy of deep gluteal muscle in dogs

Background: Excision arthroplasty is a commonly performed surgical technique for treating coxofemoral luxation in dogs. Favourable outcomes have been reported in dogs up to 15 kg. Aim: This study aimed to compare the intraoperative findings of two surgical approaches i.e., with or without partial deep gluteal muscle tenotomy in the excision arthroplasty in dogs. Methods: A total of 15 dogs having average body weight 15.6 kg (3.5-26) and 29.5 months (6-72) of age were brought to the Veterinary Surgery Clinics at University Veterinary Hospital, Samsun, Turkey with traumatic coxofemoral luxation or femur head/neck fracture. Craniolateral incision was used to approach the craniodorsal aspect of the hip joint in all cases. Myotomy of the superficial gluteal muscle and partial tenotomy of the deep gluteal was performed in one group. While blunt dissection approach was performed for elevation of gluteal muscles in another group. Results: Fifteen dogs (myotomy and tenotomy in 8 dogs and without tenotomy in 7 dogs) were diagnosed having lesions along with coxofemoral luxation in 9 cases, femoral neck fracture in 5 cases and caput femur fracture in 1 case. Partial tenotomy improved the exposure of joint capsule and femur neck. Discussion and Conclusion: The remnants of femoral neck after excision arthroplasty may contact the acetabulum and cause pain in the postoperative period. By applying the partial deep gluteal muscle tenotomy technique, surgeons can readily expose joint capsule, femoral head, femoral neck, and great and lesser trochanter.

A case report of a cementless total hip replacement performed in a pelvic limb amputee after a failed surgical reduction of a traumatic coxo-femoral luxation with a toggle rod.

Coxo-femoral luxation is the most common luxation seen in dogs after road traffic accidents. There are multiple surgical techniques to repair the luxation. These range from a capsular reconstruction to a total hip replacement. This case report describes a total hip replacement to repair a failed toggle rod repair of a coxo-femoral luxation in a Greyhound pelvic limb amputee. The dog returned to normal activity as a household pet three months post-surgery and at the last follow-up consultation at 12 months post-surgery the dog was able to maintain an acceptable activity level as an amputee with no radiographic signs of complications.

Evaluation of the treatment of traumatic coxofemoral luxations in dogs using toggle pin technique

This study was performed on 11 dogs diagnosed with traumatic coxofemoral luxation. The direction of the luxations, the operation details, postoperative complications, and radiographic evaluation were recorded during the study. The study utilized the toggle pin technique, which provided open-reduction techniques for the treatment of coxofemoral luxations. Polyester multifilament braided sutures with commercial toggle pins were employed in three cases, whereas toggle pins obtained from Kirschner wire and monofilament nylon suture material were performed in eight patients. Clinical and radiographic monitoring of postoperative lameness, complications, pain, and infection were assessed and recorded for comparison. Postoperative reluxation was observed in two cases in which multifilament braided polyester suture material was performed without other complications. In the cases without reluxation, it was noted that the animals used their limbs comfortably on the 1st postoperative day, and their lameness scores were 0 on the 7th postoperative day. As a result of the findings, the toggle pin technique using monofilament nylon suture could effectively treat coxofemoral luxations in dogs.

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.

Ílio-femoral suture with polyglecaprone thread to stabilize traumatic hip dislocation in a dog

Traumatic hip dislocations are orthopedic injuries commonly seen in the routine of the surgical clinic in pets such as dogs and cats. The aim of this study is to report a clinical case of the ilio-femoral suture technique with polyglecaprone thread to stabilize traumatic coxofemoral luxation in dogs. A mixed breed dog, three years old, with a body weight of 8.90 kg, was taken to the Veterinary Hospital of the Faculty of Veterinary Medicine and Zootechnics, presenting as a main complaint, a pedestrian hit over ten days ago and since then without support of the left pelvic limb. During the initial evaluation, it was found that the animal had functional impotence of the aforementioned limb. As a complementary examination, a ventro-dorsal and latero-lateral radiography of the pelvis region was requested. After diagnosing the hip dislocation with cranio-dorsal displacement of the femur, surgical treatment was instituted using the iliofemoral suture technique. The use of the ilio-femoral suture technique with absorbable suture was efficient in the treatment of craniodorsal hip dislocation in the patient in the present report, with return of limb functionality and regression of clinical signs.

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

Evaluate the risk factors for reluxation and outcomes for dogs with a toggle rod construct. Retrospective case series. One hundred twenty-eight client-owned dogs. 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. 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. Dogs with nontraumatic, low impact luxations were at a higher risk for reluxation. Dogs of any body condition with a traumatic coxofemoral luxation are at lowest risk for reluxation.

Luxação coxofemoral traumática em cães e gatos: estudo retrospectivo (1997-2006)

As luxações coxofemorais traumáticas são importantes afecções ortopédicas nos cães e gatos devido a grande frequência com que acometem esses animais. A principal causa são traumas ocasionados por atropelamentos, e a apresentação craniodorsal destaca-se dentre as demais. Podem ocorrer em qualquer raça, sexo e idade, porém os animais adultos são os mais frequentemente afetados. O tratamento primário de escolha é a redução fechada. No entanto, em algumas circunstâncias, faz-se necessário o uso do método aberto/cirúrgico. O objetivo deste trabalho foi avaliar os casos de luxações coxofemorais traumáticas no Hospital Veterinário Universitário da Universidade Federal de Santa Maria. Para isso, foi realizado um estudo retrospectivo dos atendimentos cirúrgicos realizados entre 1997 e 2006 nesse hospital. Observou-se alta incidência das luxações traumáticas (75,8%), sendo o traumatismo por automóveis a causa mais frequente (58,6%), seguido pelas quedas (17,3%), pelos agentes desconhecidos (17,2%) e pelas brigas (6,9%). A proporção canina/felina foi de 29:1, sendo os machos os mais acometidos em ambas as espécies: 65,5% dos cães e 100% dos gatos. Os animais mais predispostos eram da raça Poodle (44,8%) e aqueles sem raça definida (20,7%). Os tratamentos utilizados foram capsulorrafia (18,3%), pino transarticular (56,7%) e excisão artroplástica da cabeça e do colo femoral como método primário (25%). A taxa de sucesso foi de 71,1% nas duas primeiras técnicas, mostrando-se eficientes na redução da luxação coxofemoral traumática, recomendando-se a excisão da cabeça e do colo femoral em sua impossibilidade ou em complicações.

Treatment of traumatic coxo-femoral luxation by cemented total hip arthroplasty

SummarySurgical procedures such as total hip arthroplasty (THA) or femoral head and neck excision may be indicated as a treatment for traumatic coxo-femoral luxation that is complicated by pre-existing joint disease, concurrent fractures or recurrent luxation. The purpose of our study was to evaluate outcome after treatment of traumatic coxo-femoral luxation by THA. Medical records of dogs undergoing cemented THA from 1996 to 2002 were reviewed. Inclusion criteria were coxofemoral luxation resulting from severe external trauma and radiographic follow-up of at least 3 months. Ten dogs (12 THA) met the criteria for inclusion. Complications included THA luxation (n = 1) and a non-displaced peri-prosthetic femoral fracture (n = 1) that healed without further surgery. Median cumulative function scores from client questionnaires after THA were not significantly different in dogs with previously normal (8, range: 7-10), (n = 5) and dysplastic (9, range: 7–16), (n = 5) hips (P = 0.410). Six dogs were available for re-examination and force plate analysis at greater than 6 months post-THA, and none of these dogs had any visible lameness. Peak vertical force (% BWt) showed a trend towards being less in THA (60.8±5.1) than non-operated (68.1±6.1) hindlimbs (P = 0.057), whereas vertical impulse (% BWt x sec) was similar in THA (9.1±1.6) and non-operated (9.8±1.2) hindlimbs (P = 0.286). Our findings indicate that THA can be a successful treatment for traumatic coxo-femoral luxation, irrespective of the dysplastic status of the joint prior to injury.

Stabilization of traumatic coxofemoral luxation with an extra-capsular suture from the greater trochanter to the origin of the rectus femoris

SummaryA wide variety of surgical techniques to stabilize the coxo-femoral joint have been described in the veterinary literature. In this paper twenty small animals (19 dogs and 1 cat) were treated successfully with open reduction and an extra-capsular suture taken between the greater trochanter of the femur and the origin of the rectus femoris muscle. The technique is simple, quick and safe, and avoids many of the potential complications associated with other methods.

Treatment of traumatic coxofemoral luxation with triple pelvic osteotomy in 19 dogs (1987-1999)

SummaryThe objective of our study was to investigate, retrospectively, the role of triple pelvic osteotomy in the management of traumatic coxofemoral luxation. Nineteen patients were identified from medical record data and four dogs returned for long-term physical, goniometric and radiographic evaluation. Seventeen of nineteen dogs had maintenance of reduction of the hip. Due to poor outcome, two of these seventeen dogs required salvage procedures. Three of four dogs that returned for long-term follow-up, owner evaluation, radiographic scoring, and physical examination had satisfactory results. These four dogs had manual goniometric evaluations performed on the affected side, and the contralateral hip. A paired student t-test was used for statistical analysis, and internal rotation was the only value which was significantly (p d0.05) different between the two sides. Reduction alone is not a representation of success when evaluating open management of coxofemoral luxation, because two dogs with poor limb function necessitated femoral head and neck excision for limb salvage. The TPO does have a role in the treatment of traumatic coxofemoral luxation, but may not be sufficient in cases involving congenital dysplasia and/or intraarticular fractures.Triple pelvic osteotomy is a successful means of mitigating the sequela of congenital hip subluxation. This surgical technique can be used to manage dogs with traumatic coxofemoral luxation. There was an indication in this study that reduction alone is not a satisfactory means of evaluating management of traumatic coxofemoral luxation. Dogs with congenital dysplasia or intra-articular fractures associated with traumatic luxation may require alternate methods of reduction.

Kirschner-Ehmer創外固定器を用いて関節可動型整復術を行った犬の外傷性股関節脱臼2例

Movable extra-articular arthrodesis using a Kirschner-Ehmer external fixation system was applied as a new method for treating traumatic coxofemoral luxation in 2 dogs. After manipulative reduction of the hip under anesthesia, a Kirschner wire was orthodromically inserted into the femur from the fossa trochanterica. Then two half pins were inserted into the ilium and the ischiadic tuber and connected with two external parallel bars using two single and two double clamps so that the intramedullary pin lay between the two externalbars. Both animals were able to walk within a few days, and all external fixators were removed 13 and 23 days after surgery. Since the pin inserted into the femur is not fixed to the external bar, this method allows an extensive range of hip-joint motion during treatment.

Closed Toggle Pinning for Canine Traumatic Coxofemoral Luxation

SummaryA method of closed implantation of a toggle pin bone anchor and prosthetic ligament was developed for the treatment of traumatic canine coxofemoral luxation. Radiographic and anatomical evaluation of the canine femur and acetabulum were performed in order to develop an imaging and instrumentation technique that would allow closed placement of a toggle pin bone anchor under fluoroscopic guidance, while at the same time minimizing, or eliminating, damage to the articular cartilage. The surgical technique was then performed in 14 canine cadaver coxofemoral joints, followed by gross evaluation of implant placement, and potential cartilage or soft tissue damage. The cervical canal radiographic view of the proximal femur allowed placement of the drill hole through the fovea capitis of the femoral head without damaging the articular cartilage. The acetabular fossa was readily distinguishable from the acetabular articular cartilage on both of the lateral and ventrodorsal radiographic views of the pelvis. The toggle pin apparatus was inserted without damage to the articular cartilage in nine out of the fourteen hips and the bone tunnels were situated within the cancellous bone of the femoral neck in each of the nine specimens evaluated. Complications encountered during the procedure included bending and/or breakage of the guide wire in three hips and damage to the articular cartilage in two hips. The success of technique modifications designed to diminish the incidence of these complications awaits investigation in a clinical trial. Closed toggle pinning for canine traumatic coxofemoral luxation has the potential advantage of achieving rapid stabilization of the coxofemoral joint without damage to the articular cartilage and the need for an open approach to the joint. The clinical application of the technique is reported in one patient.The equipment and methodology for closed implantation of a toggle pin bone anchor and prosthetic ligament was developed for the treatment of traumatic coxofemoral luxation. A cadaver study was performed to assess the viability of the technique. Clinical application in one case is described.

Traumatic Coxofemoral Luxation in Dysplastic Dogs Managed with a Triple Pelvic Osteotomy: Results in four Dogs

SummaryTriple pelvic osteotomy (TPO) was used in the treatment for traumatic coxofemoral luxations in four adult, large breed dogs with hip dysplasia. Initial closed reductions failed in three and one dog had an initial closed reduction and subsequent open reduction of the coxofemoral luxation that failed. Hip dysplasia was thought to be a prominent factor contributing to the reluxation. TPO successfully maintained reduction of the coxofemoral luxation in all of the dogs. An increase in dorsal acetabular coverage of the femoral head following TPO was demonstrated by an increased Norberg angle. The improved congruency was thought to maintain reduction of the femoral head in the acetabulum and decrease stresses on the joint capsule, allowing healing to occur. Long-term (median: 343, mean ± SD: 406 ± 226 days follow-up) function of the affected limb was comparable to the contralateral limb. Three of the four dogs did not have radiographic progression of coxofemoral degenerative joint disease of the affected joint and differences in the progression of degenerative joint disease were not evident between the affected and the contralateral coxofemoral joint. A decrease in abduction and external rotation and an increase in internal rotation following TPO was noted in the affected coxofemoral joint. Our results establish the utility of this procedure in dysplastic dogs with traumatic coxofemoral luxations.Triple pelvic osteotomy used in the treatment for traumatic coxofemoral luxation in four adult, large breed dogs with hip dysplasia successfully maintained reduction and resulted in satisfactory limb function in all patients.