RESUMEN
The outcome of total hip arthroplasty (THA) in dogs is directly related to surgical planning. Templating of radiographs prior to THA should help the surgeon anticipate prosthesis size and femoral shape allowing canal fill of the proximal metaphysis by the implant ensuring primary stable fixation. The canal flare index (CFI) obtained from radiograph has been used as a measure of risk of complications for the technique in human beings and dogs. However, standard radiographs only provide limited data for the selection of cementless prostheses and the assessment of their fit within the femoral canal, due to factors like radiographic magnification and femoral rotation. Therefore, three-dimensional evaluation based on computed tomography (CT) may be a better tool for CFI measurement. The aim of this study was to compare anatomical measurement with CFI values obtained from craniocaudal radiography and CT. Craniocaudal radiographs using a horizontal radiographic beam (CR), CT, and anatomical macroscopic measurements (A) were obtained from 45 femurs from 23 canine cadavers. The differences between the values of CFI obtained from radiograph (CFI-R), computed tomography on transverse (CFI- TT) and longitudinal axis (CFI-TL) compared to the CFI obtained from macroscopic measurements - gold standard - (CFI-A), and 95% limits of agreement (LOA) between the values, were evaluated by the Bland-Altman method. Dimensions obtained from CT techniques had a greatest mean difference from anatomical and CFI values were also different (P=0.032). Under the experimental conditions, the craniocaudal radiograph, provided the most accurate measurement of the CFI (mean difference: 0.087 ± 0.42).(AU)
O resultado da artroplastia total do quadril (ATQ) em cães está diretamente relacionado ao planejamento cirúrgico. O templating radiográfico pré-operatório da ATQ deve ajudar o cirurgião a prever o tamanho da prótese e o formato do fêmur, o que permitirá um preenchimento ideal da metáfise proximal pelo implante, garantindo, assim, fixação primária estável. O índice de alargamento do canal (Canal Flare Index - CFI) obtido em radiografias tem sido utilizado como fator de risco de complicações para a técnica em humanos e cães. No entanto, as radiografias podem fornecer apenas dados limitados para a seleção de próteses não cimentadas e a avaliação do seu encaixe no canal femoral, devido a fatores como ampliação radiográfica e rotação femoral. Portanto, a avaliação tridimensional baseada na tomografia computadorizada (TC) pode ser uma ferramenta vantajosa para a mensuração do CFI. O objetivo deste estudo foi comparar a medida anatômica com os valores de CFI obtidos na radiografia craniocaudal e na TC. Radiografias craniocaudais utilizando feixe radiográfico horizontal (CR), tomografia computadorizada e medidas macroscópicas anatômicas (A) foram obtidas de 45 fêmures de 23 cadáveres caninos. As diferenças entre os valores de CFI obtidos na radiografia (CFI-R), na tomografia computadorizada no eixo transversal (CFI-TT) e no eixo longitudinal (CFI-TL), em comparação com os valores de CFI obtidos nas medições macroscópicas - padrão-ouro - (CFI-A) e os limites de concordância de 95% (LOA) entre os valores, foram avaliadas pelo método de Bland-Altman. As dimensões obtidas pelas técnicas de TC apresentaram maior diferença média dos valores anatômicos, e as do CFI também foram diferentes (P=0,032). Nas condições experimentais, a radiografia craniocaudal forneceu a medida mais precisa do CFI (diferença média: 0,087 ± 0,42) para representar o padrão-ouro deste estudo.(AU)
Asunto(s)
Animales , Perros , Artroplastia de Reemplazo de Cadera/métodos , Artroplastia de Reemplazo de Cadera/veterinaria , Fémur/cirugía , Fémur/diagnóstico por imagen , Tomografía Computarizada por Rayos X/veterinaria , Imagenología Tridimensional/veterinariaRESUMEN
Background: Osteosarcoma (OSA) is the most common primary bone tumor of the appendicular skeleton of dogs. Itmainly affects the metaphyseal region of long bones in large and giant breed dogs.The markedly aggressive and metastaticcharacter of the disease leads to an invariably poor to unfavorable prognosis.Although amputation is commonly performed,different surgical techniques may be used to preserve the limb. The most common methods of limb preserving surgeriesinvolve the use of endoprosthesis and allogeneic or autologous grafts. This report describes the successful use of total hipreplacement to treat a 3-year-old male dog, with OSA in the femoral head and neck.Case: This report describes the successful use of total hip replacement to treat a 3-year-old male dog, with OSA in thefemoral head and neck. The OSA stage IA located in the femoral head and neck was resected and treated through thelimb-sparing. The bone defect and joint function was reconstructed with total hip arthroplasty technique using a cementlesship prosthesis. The result of the histopathological analysis of the excised bone tissue showed a minimally productiveosteoblastic osteosarcoma. To date, the patient shows satisfactory movement rate and motion range, with no pain to palpationand without lameness in that limb. The radiographic follow-up after 24 months showed no local recurrence, metastasispulmonary or complications related to the implant. Total hip arthroplasty resulted in safe recovery of orthopedic signsassociated with osteosarcoma of the femoral head and neck [...]
Asunto(s)
Animales , Perros , Artroplastia de Reemplazo de Cadera/veterinaria , Ligamento Redondo del Fémur/cirugía , Osteosarcoma/veterinariaRESUMEN
Background: Osteosarcoma (OSA) is the most common primary bone tumor of the appendicular skeleton of dogs. Itmainly affects the metaphyseal region of long bones in large and giant breed dogs.The markedly aggressive and metastaticcharacter of the disease leads to an invariably poor to unfavorable prognosis.Although amputation is commonly performed,different surgical techniques may be used to preserve the limb. The most common methods of limb preserving surgeriesinvolve the use of endoprosthesis and allogeneic or autologous grafts. This report describes the successful use of total hipreplacement to treat a 3-year-old male dog, with OSA in the femoral head and neck.Case: This report describes the successful use of total hip replacement to treat a 3-year-old male dog, with OSA in thefemoral head and neck. The OSA stage IA located in the femoral head and neck was resected and treated through thelimb-sparing. The bone defect and joint function was reconstructed with total hip arthroplasty technique using a cementlesship prosthesis. The result of the histopathological analysis of the excised bone tissue showed a minimally productiveosteoblastic osteosarcoma. To date, the patient shows satisfactory movement rate and motion range, with no pain to palpationand without lameness in that limb. The radiographic follow-up after 24 months showed no local recurrence, metastasispulmonary or complications related to the implant. Total hip arthroplasty resulted in safe recovery of orthopedic signsassociated with osteosarcoma of the femoral head and neck [...](AU)
Asunto(s)
Animales , Perros , Artroplastia de Reemplazo de Cadera/veterinaria , Ligamento Redondo del Fémur/cirugía , Osteosarcoma/veterinariaRESUMEN
A artroplastia total da articulação coxofemoral é uma opção amplamente aceita no tratamento cirúrgico para displasia coxofemoral grave e outras causas de dor ou disfunção da articulação coxofemoral em cães. A artroplastia não cimentada foi desenvolvida com o objetivo de eliminar as limitações de durabilidade do sistema cimentado. A técnica baseia-se no conceito de fixação biológica e consiste na substituição da articulação coxofemoral com componentes acetabular e femoral, os quais são inicialmente encaixados por pressão em leitos preparados precisamente, de forma a promover estabilidade até a osteointegração completa do implante. O sucesso do procedimento envolve o paciente, a conformação e qualidade do implante e a precisão da elaborada técnica cirúrgica. Os índices de complicação são baixos, especialmente quando comparados aos do procedimento cimentado. Portanto, uma série de considerações e cuidados deve ser tomada para obterem-se resultados correspondentes com a alta taxa de sucesso da técnica. Objetiva-se com o presente trabalho apresentar uma revisão da literatura disponível sobre a utilização das próteses não cimentadas da articulação coxofemoral em cães. Esta técnica mostra-se efetiva no tratamento das disfunções graves da articulação coxofemoral com vantagens significativas quando comparada aos métodos anteriormente descritos.
The total hip replacement is widely accepted for the treatment of severe hip dysplasia and other causes of pain or hip dysfunction in dogs. Cementless arthroplasty was developed in order to remove the durability limitations of the cemented system. The concept of this technique is based on the biological fixation. Acetabular and femoral implants are precisely fitted by pressure in a way to promote stability until the osteointegration has been completed. The success of this procedure involves the patient, the conformation of the hip joint, the precision of the implants and the quality of surgical technique. The complication rate is low, specially when it is compared to cemented procedures. Therefore, a number of considerations and care must be taken to obtain results corresponding with the high success rate of the technique. The goal of this study is to present a review of the available literature about the use of uncemented hip prosthesis in dogs. This technique is shown to be effective in the treatment of serious disorders of the canine hip with significant advantages compared to previously described methods.
La artroplastia total coxofemoral es una opción ampliamente aceptada para el tratamiento quirúrgico de la displasia coxofemoral grave y otras causas de dolor o disfunción de la articulación de la cadera en perros. La artroplastia no cementada fue desarrollada para eliminar las limitaciones de la durabilidad del sistema cementado. La técnica se basa en el concepto de la fijación biológica y consiste en la sustitución de la articulación coxofemoral con los componentes acetabulares y femorales, que inicialmente están equipados por la presión en las camas preparadas precisamente con el fin de promover la estabilidad para completar la osteointegración del implante. El éxito del procedimiento implica en el paciente, la conformación, la calidad del implante y la precisión de la técnica desarrollada. Las tasas de complicaciones son bajas, especialmente en comparación con el procedimiento de cementado. Por lo tanto, se deben tomar una serie de consideraciones y cuidados para obtener los resultados correspondientes, con una alta tasa de éxito de la técnica. El objetivo de este trabajo fue presentar una revisión de literatura disponible sobre el uso de prótesis no cementadas de la articulación coxofemoral en perros. Esta técnica ha demostrado ser eficaz en el tratamiento de los trastornos graves de la articulación coxofemoral con ventajas significativas en comparación con los métodos descritos anteriormente.
Asunto(s)
Animales , Perros , Bioprótesis/veterinaria , Artroplastia de Reemplazo de Cadera/veterinaria , Fijación de Fractura/métodos , Displasia Pélvica Canina/cirugíaRESUMEN
BACKGROUND: This prospective experimental study evaluated the surgical procedure and results of modular hybrid total hip arthroplasty in dogs. METHODS: Ten skeletally mature healthy mongrel dogs with weights varying between 19 and 27 kg were used. Cemented modular femoral stems and uncemented porous-coated acetabular cups were employed. Clinical and radiographic evaluations were performed before surgery and at 30, 60, 90, 120, 180 and 360 days post-operation. RESULTS: Excellent weight bearing was noticed in the operated limb in seven dogs. Dislocation followed by loosening of the prosthesis was noticed in two dogs, which were therefore properly treated with a femoral head osteotomy. Femoral fracture occurred in one dog, which was promptly treated with full implant removal and femoral osteosynthesis. CONCLUSIONS: The canine modular hybrid total hip arthroplasty provided excellent functionality of the operated limb.