Avaliação radiográfica da cobertura acetabular à cabeça femoral, após osteotomia tripla e aplicação de cunha sacroilíaca, em pelve de cadáveres de cães

Abstract

Pesq. Vet. Bras. 29(8):625-631, agosto 2009 RESUMO.-Na tentativa de evitar algumas das dificuldades associadas à osteotomia pélvica tripla (OPT), foi desenvolvido experimentalmente o método de aplicação de cunha na junção sacroilíaca para aumentar a ventroversão acetabular. O objetivo deste estudo foi aplicar as técnicas de cunha sacroilíaca e OPT em cadáveres e avaliar radiograficamente a eficácia da ventroversão acetabular. Para tal, foram utilizados 10 cadáveres de cães, adultos, com 15-25 kg. Em cada hemipelve direita foi realizada OPT com placas de 20° e 40°. Na hemipelve esquerda foram aplicadas cunhas nas articulações sacroilíacas de 20° e 40°. Avaliações radiográficas em projeções ventrodorsais foram realizadas para mensuração da cobertura acetabular à cabeça femoral nas duas técnicas. De acordo com os dados obtidos pode-se observar que não houve diferença entre a técnica de OPT e o uso de cunha sacroilíaca utilizando implantes de 20° e 40°, mas ocorreu diferença significativa (p<0,05) entre os cães antes e após a aplicação dos implantes de 20° e 40°, e também entre os que receberam implantes de 20° e os de 40°. A aplicação de cunha sacroilíaca produziu resultaAvaliação radiográfica da cobertura acetabular à cabeça femoral, após osteotomia tripla e aplicação de cunha sacroilíaca, em pelve de cadáveres de cães 1Everton Regonato 2 *, Júlio C. Attempting to avoid difficulties associated to triple pelvic osteotomy (TPO), the sacroiliac wedge method was experimentally developed to increase the acetabular ventroversion. The goal of this study was to apply the techniques of sacroiliac wedge and TPO to canine cadavers and radiographically evaluate the efficacy of acetabular ventroversion. Ten cadavers of adult dogs weighting 15-25 kg were used. To each right hemipelvis the technique of TPO with 20° and 40° plates was applied. In the left hemipelvis, 20° and 40º wedges in the sacroiliac joint were applied. Radiographic evaluations in standard projections were carried out for measurement of the acetabular covering of the head of the femur in the two techniques. There was no significant differences between TPO and the use of sacroiliac wedge using implants of 20° and 40°, however a significant difference (p<0,05) could be observed before and after application of the 20° and 40° implants, as well as between those that received 20° and of 40° implants. The application of sacroiliac wedge produced similar results of those observed in TPO, and it is more feasible.INDEX TERMS: Diseases of dogs, surgery, hip dysplasia.

Acetabular ventroversion using the sacroiliac wedge, with or without pelvic osteotomies in dogs: an ex vivo study

“…Once the sacroiliac joint was sectioned, a 2.5-mm bore was made on the lateral surface of the sacrum using a surgical drill, with the depth being 50% to 60% of that of the sacral body. Simultaneously, the wedge was positioned at the sacroiliac junction, with its base level with the dorsal plane of the sacrum, as described by Regonato et al (2009) (Fig.1A).…”

“…In a study with canine corpse pelves, Conzemius et al (1999) proposed the use of SW, producing an effect similar to that of TPO. Regonato et al (2009) demonstrated the surgical approach, and proved its efficiency for acetabular ventroversion, using castor bean (Ricinus communis) polyurethane wedges in canine corpses. This technique, besides promoting acetabular ventroversion, overcame the disadvantages of TPO, reducing surgical time, risks, and costs.…”

“…The diagnosis of CHD is based on the review, history, clinical signs, and orthopedic and radiographic examination (Piermattei et al 2015, Rocha et al 2013. The measurement of Norberg angle (NA) and acetabular coverage percentage (ACP) are effective methods for the detection of CHD in dogs, which can be calculated using specific software (Lopez et al 2008, Regonato et al 2009). Both assess the structural and functional conditions that influence the hip joint, such as joint laxity, hip joint subluxation, and acetabular configuration, but they are not evaluated by the same method since the craniolateral acetabular border influences the NA and the dorsal acetabular border the ACP measurement (Ohlerth et al 2001).…”

“…Surgical techniques for treating CHD aim to relieve the pain during ambulation and reduce the increased acetabular coverage, improving joint stability (Schachner & Lopez 2015). In this context, Slocum & Slocum (1992) reported triple pelvic osteotomy (TPO), and Conzemius et al (1999) and Regonato et al (2009) reported the sacroiliac wedge (SW), as techniques to increase the surface contact between the femoral head and acetabulum, by increasing the acetabular ventroversion, indicated in 5-12-month-old animals of large and giant breeds, restoring the joint function (David & Kasper 1992, Vezzoni 2007.…”

“…This technique, besides promoting acetabular ventroversion, overcame the disadvantages of TPO, reducing surgical time, risks, and costs. The SW technique involves the application of a wedge between the sacroiliac junction, promoting rotation of the acetabular segment, being associated with ischial and pubis osteotomies (Regonato et al 2009). The wedge stabilization at the sacroiliac junction is achieved using orthopedic screws applied to the lateral side of the ilium, passing through the wedge, and penetrating the sacral body (Conzemius et al 1999, Regonato et al 2009).…”