Use of Pelvic Symphysiectomy as a Treatment in Growing Dogs with Hip Dysplasia
Surgical Service. Teaching Hospital. Faculty of Veterinary Science, University of Buenos Aires, Argentina
Pelvic Symphysiectomy (PS) and posterior pelvic floor reconstruction determine an immediately lateral acetabular rotation, improving the femoral head coverage, and potentially a hip stability in dogs with hip dysplasia(CHD). This ventro lateral rotation goes on meanwhile dogs growth.
The purpose of this study was to determine the effects of PS in puppies with hip dysplasia.
The technique was applied in 25 dogs with bilateral CHD. The oldest dog was 10 months old and the youngest was 4 months old. Five of them were German Shepherds, 7 Rottweiler, 2 St. Bernard, 5 Labrador Retriever, 3 Golden Retriever, 2 mongrels and a case of Mareman Shepherd. All dogs had a positive Ortolani sign with an angle of reduction less than 45°. From radiographic point of view, hips were divided in three categories: mild, moderate and severe hip dysplasia with seven, thirteen and five animals felling into each categories respectively. General anesthesia with Halothane were used in all cases. All patients were put in dorsal recumbence with the hindlimbs free and perpendicular to the spine. A standard approach to the pelvic symphysis was performed.
A bone strip and all symphysis was eliminated together using an oscillant saw no further than the internal edge of obturator foramen. Bone synthesis was practiced by cerclages anchored in four screws, two of them fixed in the pubic bone and two in the ischium bone. Tarsal Hobbles sling was performed and left in place during 15 days to avoid exaggerate abduction movements. All dogs received antibiotics and analgesics for five days after surgery. X-rays were taking immediately after surgery and 2 months later in all animals, but could only be practiced in some patients at 6 months, two and four year after.
Patients were divided in four categories according the clinical evolution: poor, fair, good and very good; and in three categories according the radiographic evaluation: mild, moderate and severe hip dysplasia.
Period of time evaluation was between 6 and 48 months.
Twelve animals had very good evolution, eight had good and five had fair evolution. None dogs had poor evolution.
Radiographic evaluation showed good hip coaptation in 9 dogs, improve coaptation in 9 dogs and no improvement in 7 dogs.
PS has showed to be a good therapeutic technique in immature dogs with CHD. It is very important a correct patient selection. Best results were reached in animals less than 5 months old with mild to moderate hip dysplasia. In oldest puppies with few grows expectation, it could reduce hip CHD severity, but it would not stop the progression to degenerative joint disease. Although all patients had clinical improvement, in some cases it could be attributed to a spontaneous disease improvement showed around the year of age in some dogs.