PubMed · 8116430
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M H Fessy, F Chauvin, J Bejui, L P Fischer. 1993. [Cementless acetabular implants. Primary fixation].. https://pubmed.ncbi.nlm.nih.gov/8116430/
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OBJECTIVE: To determine whether preoperative radiographic evidence of degenerative joint disease (DJD), hip joint laxity, or age at surgery is associated with long-standing DJD or hip function in dogs with hip dysplasia (HD) that had a triple pelvic osteotomy (TPO). DESIGN: Prospective study. ANIMALS: 34 dogs with HD. PROCEDURE: Dogs that had TPO performed during an 8-year period were chosen for long-term follow-up evaluation that included physical examinations, pelvic radiographs, and owner questionnaires. Data on radiographic evidence of DJD, Norberg angle, and percentage of femoral head coverage were retrieved from preoperative records and determined from follow-up radiographs. RESULTS: Approximately 40% of dogs had progression of DJD. Eighty-seven percent of dogs received excellent or good physical examination scores, and 76% received excellent or good at-home activity scores. Preoperative and long-standing DJD were not associated. The risk of DJD was increased with increased age at surgery, narrower preoperative Norberg angle, and lower percentage of femoral head coverage, but these variables were not associated with clinical hip function. CLINICAL IMPLICATIONS: TPO for treatment of HD in dogs may slow, rather than stop, radiographic progression of DJD; however, clinical outcome is acceptable for most dogs. Preoperative evidence of DJD may not be a limiting criterion in selecting dogs as suitable TPO candidates. Dogs with extensive hip joint laxity before surgery may be predisposed to developing DJD; thus, the risk-to-benefit ratio for TPO versus salvage procedures should be considered. Younger dogs may develop less severe DJD after TPO; surgery should be considered at the first sign of hip joint laxity and pain.
In 163 patients--125 (76.7%) female, 38 (23.3%) male--172 cementfree isoelastic acetabular cups were implanted. The average patient age was 72.6 years (range: 16 to 96 years). Sixty-seven (41.1%) patients with 72 (41.9%) cups could be followed-up for an average of 6.0 years (range: 2.0 to 12.2 years) after the procedure. Using the Harris-hip-score we found 49 (68.1%) "very good" to "fair" results. In 23 (31.9%) hips scoring had to be classified as "bad". The rate of cup-loosenings in the collective was low at 3.5% (6/172), probably due to the reduced physical activity of our comparatively older patients. Because after the 8th year symptomatic loosening must be routinely expected, the procedure is not indicated for younger patients. In older patients with femoral neck fractures the cementfree isoelastic acetabular cup has proven itself effective in our experience.
Open reduction with internal stabilization is considered to be the standard therapy for the treatment of displaced acetabular fractures. The internal fixation is routinely achieved by the use of plates and screws. The use of cerclage wires and cables as a reduction aid and definitive implant for stabilization has only occasionally been reported in the literature. The indication was mostly limited to use in elderly patients with insufficient bone stock. A newly instrument developed on the basis of a standard bone elevator is presented. It allows a safe, semiclosed application of a cerclage wire around the greater ischiatic notch through use of the second window of the ilioinguinal approach. A wide dissection at the "outside" of the pelvis is not necessary.