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Loh JR, Cleland N, Beierer L, Drew J, Wilson L, Delisser P. Caudoventral hip luxation in 160 dogs (2003-2023): A multicenter retrospective case series. Vet Surg 2024; 53:586-595. [PMID: 38558417 DOI: 10.1111/vsu.14093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 02/13/2024] [Accepted: 03/16/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVE To describe patient characteristics, etiology, treatment outcomes and complications of caudoventral hip luxation (CvHL) in a large cohort of dogs and investigate factors associated with nonsurgical treatment outcomes. STUDY DESIGN Multicenter retrospective case series. ANIMAL POPULATION A total of 160 client-owned dogs (170 limbs). METHODS Medical records from 2003 to 2023 were reviewed for signalment, history, treatment outcomes and complications. Logistic regression was performed to investigate factors associated with nonsurgical treatment outcome. RESULTS Low-trauma accidents accounted for 82.9% of cases. Over-represented breeds included poodles (38.1%) and poodle crosses (11.3%). On a per-treatment basis, success rates of closed reduction alone, closed reduction/Ehmer sling, closed reduction/hobbles were 9.1%, 15.2% and 48.8%, respectively. When accounting for repeated attempts using closed reduction alone, Ehmer sling, or hobbles, eventual success rate increased to 10.3%, 18.5% and 61.8%, respectively. Success rate for toggle rod stabilization was 88.2%. Complication rate of hobbles was 31.9% versus 60.6% for Ehmer slings. Use of hobbles (OR:7.62, p = .001, CI:2.23-26.05), treatment by specialist surgeons (OR:2.68, p = .047, CI: 1.01-7.08) and increasing age (OR:1.15, p < .005, CI: 1.08-1.23) were associated with successful nonsurgical treatments. CONCLUSION Low-trauma etiology, and poodles and their crosses were over-represented in cases of CvHL. Success rate of nonsurgical treatments was lower than previously reported. Hobbles were 7.6 times more likely to be successful when compared to dogs treated without hobbles and remains a viable noninvasive first-line treatment. CLINICAL SIGNIFICANCE/IMPACT Hobbles are recommended as a low-morbidity first-line treatment for CvHL. An Ehmer sling is not recommended. Toggle rod stabilization is an effective surgical treatment for CvHL.
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Affiliation(s)
- Jun Ren Loh
- Veterinary Specialist Services, Brisbane, Australia
| | | | - Lucas Beierer
- Queensland Veterinary Specialists, Brisbane, Australia
| | - Jarrod Drew
- Animal Referral Hospital, Brisbane, Australia
| | | | - Peter Delisser
- University of California, School of Veterinary Medicine, Davis, California
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Espinel Rupérez J, Serrano Crehuet T, Hoey S, Arthurs GI, Mullins RA. Arthroscopic-assisted hip toggle stabilization in cats: An ex vivo feasibility study. Vet Surg 2023; 52:853-863. [PMID: 36811178 DOI: 10.1111/vsu.13942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 12/01/2022] [Accepted: 01/19/2023] [Indexed: 02/24/2023]
Abstract
OBJECTIVE To describe arthroscopic-assisted hip toggle stabilization (AA-HTS) in cats, evaluate its feasibility and associated rate of iatrogenic injury, and assess deviations from planned surgical technique. STUDY DESIGN Ex vivo study. ANIMALS Skeletally mature cat cadavers (n = 7). METHODS Preoperative pelvic computed tomography (CT) was performed for surgical planning and to identify the ideal femoral bone tunnel projection. Ultrasound-guided transection of ligament of head of femur was performed. Following exploratory arthroscopy, AA-HTS was performed using a commercially available aiming device. Surgical time, intraoperative complications, and feasibility of technique were recorded. Iatrogenic injury and technique deviations were assessed by postoperative CT and gross dissection. RESULTS Diagnostic arthroscopy and AA-HTS were successfully performed in all 14 joints. Median (range) surgical time was 46.5 (29-144) min, including 7 (3-12) min for diagnostic arthroscopy and 40 (26-134) min for AA-HTS. Intraoperative complications occurred in 5 hips, related to bone tunnel creation (4) and toggle dislodgment (1). Toggle passage through the femoral tunnel was the most challenging component of technique, recorded as mildly difficult in 6 joints. No damage to periarticular/intrapelvic structures was identified. Minor articular cartilage damage (<10% total cartilage area) was identified in 10 joints. Thirteen deviations (8 major, 5 minor) in surgical technique from preoperative planning were identified in 7 joints. CONCLUSION In feline cadavers AA-HTS was feasible but was associated with a high rate of minor cartilage injury, intraoperative complications, and technique deviations. CLINICAL SIGNIFICANCE Hip toggle stabilization using an arthroscopic-assisted approach may be an effective technique for management of coxofemoral luxation in cats.
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Affiliation(s)
- Jorge Espinel Rupérez
- Department of Small Animal Surgery, Section of Small Animal Clinical Studies, University College Dublin, Dublin, Ireland
| | - Tomas Serrano Crehuet
- Department of Small Animal Surgery, Section of Small Animal Clinical Studies, University College Dublin, Dublin, Ireland
| | - Seamus Hoey
- Equine Clinical Studies, Diagnostic Imaging and Anaesthesia, School of Veterinary Medicine, University College Dublin, Dublin, Ireland
| | - Gareth I Arthurs
- Arthurs Veterinary Specialists, Towcester Veterinary Centre, Towcester, UK
| | - Ronan A Mullins
- Department of Small Animal Surgery, Section of Small Animal Clinical Studies, University College Dublin, Dublin, Ireland
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Knell SC, Longo F, Wolfer N, Schmierer PA, Hermann A, Pozzi A. Outcome and Complications following Stabilization of Coxofemoral Luxations in Cats Using a Modified Hip Toggle Stabilization-A Retrospective Multicentre Study. Vet Comp Orthop Traumatol 2023. [PMID: 37116537 DOI: 10.1055/s-0043-1768230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
OBJECTIVES The main aim of this study was to report the surgical technique, the complications and the clinical outcomes of the mini-Tight Rope system (mini-TR) for a modified hip toggle stabilization of coxofemoral luxation in cats. STUDY DESIGN A multicentre retrospective study. ANIMALS Thirty-two client-owned cats. METHODS Medical records (2009-2017) of cats, which underwent stabilization of a coxofemoral luxation with the mini-TR and had at least a 3-month follow-up, were reviewed. The femoral tunnel diameter, the use of one or two FiberWire loops, perioperative complications and clinical outcomes were recorded. Follow-up information was obtained through clinical and radiographic examinations and an owner questionnaire. RESULTS Thirty-two cats met the inclusion criteria. Concurrent injuries were present in 16 cats. A single or double loop mini-TR was used in 21 and 12 cats respectively. One double loop (1/12 cats) and four single loop (4/16 cats) sutures failed. Moderate-to-severe coxofemoral osteoarthritis developed in 14/27 cats. Owner questionnaires revealed excellent clinical outcomes. CLINICAL SIGNIFICANCE Mini-TR with a double-stranded implant is recommended to decrease the risk of suture failure. Osteoarthritis is common after open reduction of hip luxations.
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Affiliation(s)
- Sebastian Christoph Knell
- Department for Small Animals, Clinic for Small Animal Surgery, Vetsuisse Faculty University of Zurich, Zurich, Switzerland
| | - Federico Longo
- Department for Small Animals, Clinic for Small Animal Surgery, Vetsuisse Faculty University of Zurich, Zurich, Switzerland
| | - Nadja Wolfer
- Department for Clinical Diagnostics and Services, Clinic for Diagnostic Imaging, Vetsuisse Faculty University of Zurich, Zurich, Switzerland
| | - Philipp A Schmierer
- Department for Small Animals, Clinic for Small Animal Surgery, Vetsuisse Faculty University of Zurich, Zurich, Switzerland
- Tierärztliche Klinik Posthausen, Posthausen, Germany
| | - Andreas Hermann
- Department of Clinical Veterinary Medicine, Vetsuisse Faculty University of Berne, Berne, Switzerland
| | - Antonio Pozzi
- Department for Small Animals, Clinic for Small Animal Surgery, Vetsuisse Faculty University of Zurich, Zurich, Switzerland
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Abibe RB, Rahal SC, dos Reis Mesquita L, Doiche D, da Silva JP, Mamprim MJ, Pinho RH, Battazza A, Alves CEF, Saunders WB. Ligamentum teres reconstruction using autogenous semitendinosus tendon with toggle technique in rabbits. PeerJ 2023; 11:e14777. [PMID: 36987457 PMCID: PMC10040178 DOI: 10.7717/peerj.14777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 01/03/2023] [Indexed: 03/30/2023] Open
Abstract
Background Ligamentum teres (LT) has traditionally been considered a vestigial or redundant structure in humans; however, based on new studies and the evolution of hip arthroscopy, the LT injury has been viewed as a source of hip pain. Therefore, LT reconstruction can be beneficial in some cases. Rabbits have been frequently used as a model for cranial cruciate ligament reconstruction but few studies are available for ligamentum teres reconstruction. Objective To evaluate the semitendinosus tendon to replace ligamentum teres with the toggle technique, using rabbits as an experimental model. Methods Twenty-six female Norfolk rabbits with approximately 3 months of age were divided into two equal groups after excision of ligamentum teres (LT) from the right hip joint: G1-no reconstruction of LT and capsulorrhaphy; G2-double-bundle reconstruction of the LT using semitendinosus tendon autograft. In both groups, the LT was removed from the right hip joint. In G2 the autograft was harvested from the left hind limb of the same rabbit. The rabbits were evaluated clinically at different time intervals; before surgery (M1), 48 h (M2), 15 days (M3), 30 days (M4) and 90 days (M5) after surgery. Results The rabbits supported their limbs on the ground in both the groups. As complications of the procedure, four hip joints showed subluxations in the radiographic evaluation of G1; three at M4 and one at M5. In G2; two luxations of hip joints at M3 and one subluxation at M4 were seen. On ultrasound, irregular articular surface was seen in 30.8% of the rabbits that had subluxation of hip joints. Gross evaluation identified tendon graft integrity in 76.92% of the rabbits. Histological analysis revealed graft adhesion to the bone in the early phase comprised of sharpey-like collagen fibers. Conclusion The double-bundle reconstruction of the LT using autologous semitendinosus tendon associated with the toggle rod shows an early phase of tendon graft ligamentization at 90 days post-operatively in young rabbits, but biomechanical bias suffered by the tendon during gait must be considered.
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Affiliation(s)
- Rebeca Bastos Abibe
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Sheila Canevese Rahal
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Luciane dos Reis Mesquita
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Danuta Doiche
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Jeana Pereira da Silva
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Maria Jaqueline Mamprim
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Renata Haddad Pinho
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Alexandre Battazza
- Department of Veterinary Clinic, School of Veterinary Medicine and Animal Science, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Carlos Eduardo Fonseca Alves
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil
| | - W. Brian Saunders
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, Texas, United States
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Letesson J, Goin B, Viguier E, Cachon T. Validation of a biomechanical testing protocol of craniodorsal hip luxation in feline cadavers and comparison of two ultra-high molecular weight polyethylene materials used for extra-articular hip stabilisation. J Feline Med Surg 2022; 24:e360-e369. [PMID: 36074899 PMCID: PMC10812304 DOI: 10.1177/1098612x221114851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The aim of our study was to describe a biomechanical testing protocol to reproduce ex vivo craniodorsal hip luxation specific to the feline model, and evaluate the biomechanical properties of an intact hip joint compared with the fixation strength of two different techniques of extra-articular hip stabilisation. METHODS Eighteen hip joints (femur and hemipelvis) were harvested from nine mature feline cadavers. CT was performed for each hip joint so that a biomechanical base specific to each joint morphotype could be created using computer-aided design. The biomechanical bases were then produced using a three-dimensional printer to secure the hip joints during testing. A total of 34 biomechanical compression tests were performed. Eighteen compression tests were performed in the control group, of which two fractured. The remaining 16 hip joints were then randomly assigned either to group A (hip joints stabilised with an extra-articular ultra-high molecular weight polyethylene (UHMWPE) implant secured by an interference screw [n = 8]) or to group B (hip joints stabilised with a UHMWPE iliofemoral suture [n = 8]). RESULTS Mean ± SD yield, failure load and linear stiffness in the control group were 616 ± 168 N, 666 ± 158 N and 231 ± 50 N/mm, respectively. The relative fixation strength (% of intact joint) before hip luxation in groups A and B was 43.8% and 34.7%, respectively. No statistical difference was found between groups A and B for yield and failure load. However, the reoccurrence of craniodorsal hip luxation was higher in group B than in group A, in 5/8 and 0/8 tests, respectively. Moreover, in group A, the extra-articular UHMWPE implant induced caudodorsal hip luxation, reported as failure mode in 7/8 cases. CONCLUSIONS AND RELEVANCE This modified biomechanical protocol for testing craniodorsal hip luxation in a feline model was validated as repeatable and with acceptable variance. The extra-articular UHMWPE implant stabilisation technique proved to be more efficient in avoiding reoccurrence of craniodorsal hip luxation than UHMWPE iliofemoral suture.
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Affiliation(s)
| | - Bastien Goin
- University of Lyon, VetAgro Sup, Interactions Cellules Environnement (ICE), Marcy l’Etoile, France
- Novetech Surgery, Monaco
| | - Eric Viguier
- University of Lyon, VetAgro Sup, Interactions Cellules Environnement (ICE), Marcy l’Etoile, France
| | - Thibaut Cachon
- University of Lyon, VetAgro Sup, Interactions Cellules Environnement (ICE), Marcy l’Etoile, France
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Traumatic Coxofemoral Luxation in Cats Treated with Hip-Toggle Stabilization Using the Mini Tightrope® Fixation System. ACTA VET-BEOGRAD 2022. [DOI: 10.2478/acve-2022-0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Abstract
The aim of this retrospective study was to evaluate the clinical and radiographic outcomes of 21 cats that underwent coxofemoral toggle stabilization using the Mini TightRope® Fixation System (mTR®). Data were compiled from client-owned cats with traumatic hip luxation. Each cat underwent the same protocol including orthopedic assessment, preoperative radiographic evaluation, surgical procedure, postoperative management and clinical re-examination at 14 days, 8 weeks and 12 months following surgery. Age, body weight, implants and osteoarthritis progression were recorded. A lameness score 0-4 was assigned to each cat. Pain upon hip extension was not quantified but as pain reaction or no pain reaction. Major complications and osteoarthritic (OA) changes were recorded. Osteoarthritic changes were classified on a 0-4 scale. Twenty-one cats were included in the study. Coxofemoral luxations were stabilized using a mTR®. At 8 weeks, weight bearing was considered normal (grade 0) in all cats and no pain reaction was elicited during hip extension. One year after surgery, orthopedic examination was within the normal limits and according to the owners, all animals exhibited a normal physical activity. No complications were recorded. Evidence of slight OA changes were observed in 5 out of 21 cats. The final outcome was considered excellent in 16/21 patients and good in 5/21 cats. The application of the mTR® system can be considered a suitable surgical treatment in cats affected by traumatic hip luxation.
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LeFloch MD, Coronado GS. Outcome of coxofemoral luxation treated with closed reduction in 51 cats. J Feline Med Surg 2022; 24:709-714. [PMID: 34533373 PMCID: PMC10812283 DOI: 10.1177/1098612x211041535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The aim of this study was to describe the outcomes and determine the reluxation rate of cats undergoing closed coxofemoral joint reduction, and to investigate potential risk factors for reluxation of the affected coxofemoral joint. METHODS Case information was obtained from electronic medical records from Ocean State Veterinary Specialists and Bay State Veterinary Emergency and Specialty Services between January 2008 and May 2020. Data obtained from 51 cats with coxofemoral joint luxations included patient signalment, direction of coxofemoral joint luxation, concurrent injuries, ease of reduction, time of injury to closed reduction, bandage application and outcome. Data were analyzed for association with outcomes. RESULTS Closed reduction of coxofemoral joint luxation in cats had a 51% success rate. The only risk factor demonstrating a statistically significant benefit to the success of closed coxofemoral joint reduction was the application of a bandage (P = 0.02). CONCLUSIONS AND RELEVANCE It may be worth attempting closed coxofemoral joint reduction in cats prior to recommending surgery. Placing a bandage (Ehmer or hobbles) after closed reduction may decrease the risk of the coxofemoral joint reluxating, but more studies are needed to evaluate this further. The outcome after closed reduction management for coxofemoral joint luxation in cats is similar to the previously reported success rate in dogs.
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Affiliation(s)
| | - George S Coronado
- Surgery, Ocean State Veterinary Specialists, East Greenwich, RI, USA
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Espinel Rupérez J, Arthurs GI, Hewit A, Langley-Hobbs S, Trostel CT, Phillips ASJ, Keeley B, Maritato KC, Jones SC, Franklin PH, Whitelock R, Fernández Pérez C, Mullins RA. Complications and outcomes of cats with coxofemoral luxation treated with hip toggle stabilization using ultrahigh-molecular-weight-polyethylene or nylon (2009-2018): 48 cats. Vet Surg 2021; 50:1042-1053. [PMID: 33713478 DOI: 10.1111/vsu.13595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 11/12/2020] [Accepted: 12/13/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To report overall rate and type of complications and outcomes of cats with coxofemoral luxation managed with hip toggle stabilization (HTS), to compare rate of postoperative complications and outcomes of cats treated with ultrahigh-molecular-weight-polyethylene (UHMWPE) or nylon, and to identify risk factors for reluxation and non-excellent outcomes. STUDY DESIGN Multi-institutional retrospective cohort study. SAMPLE POPULATION Forty-eight client-owned cats. METHODS Medical records of cats that underwent HTS from 2008-2018 using UHMWPE or nylon were reviewed. Univariable and multivariable logistic regression was performed to assess for factors associated with reluxation and non-excellent outcome. Final outcome was obtained from owner questionnaire. RESULTS Intraoperative and postoperative complications were recorded in two (4.2%) and 11 (24.4%) cats, respectively. The most common postoperative complication was reluxation (n = 5 [11.1%]). Outcome was classified as excellent in 81.1% and good in 16.2% of cats after a median of 445.5 days (range, 53-3720). No difference in rate of complications or outcomes was identified between UHMWPE and nylon. Performance of additional orthopedic procedures, occurrence of intraoperative complications, and non-performance of capsulorrhaphy were associated with reluxation. Performance of additional non-hip procedures (orthopedic/nonorthopedic) was associated with non-excellent outcome. CONCLUSION Hip toggle stabilization was associated with a low rate of intraoperative complications and reluxation and excellent long-term outcomes in most cats. No difference in rate of postoperative complications or outcomes of cats treated using UHMWPE or nylon was identified. Cats that underwent additional orthopedic procedures had greater risk of reluxation. CLINICAL SIGNIFICANCE Hip toggle stabilization is an effective technique for management of coxofemoral luxation in cats. Comparable results are expected using UHMWPE or nylon.
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Affiliation(s)
- Jorge Espinel Rupérez
- Section of Veterinary Clinical Sciences, University College Dublin, Dublin 4, Ireland
| | | | - Andrew Hewit
- Dick White Referrals, Cambridgeshire, United Kingdom
| | | | - C Todd Trostel
- Inland Valley Veterinary Specialists and Emergency Center, California
| | - Andrew S J Phillips
- Department of Clinical Science and Services, Royal Veterinary College, Hertfordshire, United Kingdom
| | - Ben Keeley
- Manchester Veterinary Specialists, Worsley, Manchester, United Kingdom
| | - Karl C Maritato
- MedVet Medical and Cancer Centers for Pets, Cincinnati, Ohio
| | - Stephen C Jones
- The Ohio State University College of Veterinary Medicine, Columbus, Ohio
| | - Phil H Franklin
- Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Richard Whitelock
- Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Cristina Fernández Pérez
- Servicio de Medicina Preventiva, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain
| | - Ronan A Mullins
- Section of Veterinary Clinical Sciences, University College Dublin, Dublin 4, Ireland
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Abstract
PRACTICAL RELEVANCE Traumatic joint luxations are usually associated with significant trauma and there may be concomitant systemic injury. Joints are unstable as a result of injury to one or more supporting structures and the clinician should aim to determine which structures are damaged with physical examination, diagnostic imaging and careful assessment under sedation/anaesthesia. The aim is to reduce the joint back to its anatomical position, and then to maintain this through repair of damaged structures. However, where this is not possible, replacement or removal (arthrodesis/excision arthroplasty) of the joint remain viable options. CLINICAL CHALLENGES Owing to the small size of feline joints and the severity of damage often seen, surgical management of these cases can be challenging. The first priority is to ensure the patient is systemically well before embarking on any specific surgical treatment of a luxated joint. Cats also present challenges in the postoperative period and a lack of patient and owner compliance can be detrimental to postoperative outcomes. AIMS This article aims to help the reader diagnose joint luxations and to assist decision-making with an overview of the management and treatment options available. EVIDENCE BASE There are a number of original articles and textbook chapters in the literature covering aspects of different joint luxations, particularly for the more common luxations. This article draws on information from key feline research and, where necessary, extrapolates from relevant canine research. The authors also offer practical guidance based on their own clinical experience.
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Affiliation(s)
- Richard L Meeson
- MA, VetMB, PhD, MVetMed, DipECVS, FHEA, FRCVS, RCVS & ECVS Specialist Small Animal Surgery
| | - Rhiannon Strickland
- Department of Clinical Science and Services, Queen Mother Hospital for Animals, Royal Veterinary College, University of London, London, UK
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Kraska KA, Jackson J. Mechanical analysis of suture attachment methods in toggle suture constructs. Vet Surg 2018; 47:1066-1073. [DOI: 10.1111/vsu.12952] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Revised: 07/09/2018] [Accepted: 07/15/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Kathleen A. Kraska
- Department of Small Animal SurgeryThe Animal Medical Center New York New York
| | - Joshua Jackson
- Department of Small Animal SurgeryVeterinary Specialty Hospital of San Diego San Diego California
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Segal U, Shani J, Joseph R. Minimally invasive technique for coxofemoral luxation stabilisation using transarticular toggle system: a cadaveric study. J Small Anim Pract 2017; 59:154-160. [PMID: 29105095 DOI: 10.1111/jsap.12765] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 09/02/2017] [Accepted: 09/05/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To present a novel, semi-closed, surgical technique for coxofemoral luxation stabilisation using a transarticular toggle rod. STUDY DESIGN Cadaveric study. MATERIALS AND METHODS 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. RESULTS 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. CONCLUSION AND CLINICAL RELEVANCE 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.
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Affiliation(s)
- U Segal
- Knowledge Farm Specialist Referral Center, Beit Berl 44905, Israel
| | - J Shani
- Knowledge Farm Specialist Referral Center, Beit Berl 44905, Israel
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