Effects of denervation of the hip joint on results of clinical observations and instrumented gait analysis in dogs with sodium urate crystal–induced synovitis

Abstract

OBJECTIVE To evaluate the effects of selective hip joint denervation on gait abnormalities and signs of hip joint pain in dogs. ANIMALS 6 healthy adult hound-type dogs. PROCEDURES Minimally invasive denervation was performed on the right hip joint of each dog. Two weeks later, sodium urate was injected into the right hip joint to induce synovitis. Dogs were evaluated clinically and by use of instrumented gait analysis before and 2 weeks after minimally invasive denervation and 4, 8, and 24 hours after induction of synovitis. Dogs were euthanized, and necropsy and histologic examination were performed. RESULTS No kinetic or kinematic gait modifications were detected 2 weeks after minimally invasive denervation. Denervation did not eliminate signs of pain and lameness associated with sodium urate-induced synovitis. Results of histologic examination confirmed that denervation was an effective method for transecting the innervation of the craniolateral and caudolateral aspects of the hip joint capsule. CONCLUSIONS AND CLINICAL RELEVANCE In this study, minimally invasive denervation did not result in gait modifications in dogs. Denervation did not abolish the signs of pain and lameness associated with generalized induced synovitis of the hip joint. Further studies are required before conclusions can be drawn regarding the clinical usefulness of hip joint denervation for dogs with hip dysplasia.

Efficacy of lateral- versus medial-approach hip joint capsule denervation as surgical treatments of the hip joint pain; a neuronal tract tracing study in the sheep

“…Studies using ground reaction force technique showed improvement in smaller percentages of patients [ 22 – 24 ]. One report showed the total ineffectiveness of minimally invasive denervation of the hip joint of in dogs [ 25 ] but unlike previous reports on hip dysplasia in this study pain and lameness were evoked by diffuse synovitis induced with injection of sodium urate into the right hip joint. Unfortunately, these collective studies were performed on small groups of animals (up to 10) making it difficult to draw final conclusions on significant effects.…”

“…Although the efficacy of the medial treatment is quite high a percentage of animals undergoing such denervation of the HJC fail to restore proper function of the joint. This has been suggested to result from insufficient abolition of pain sensation, or diverse hip joint pain cause (e.g., pain originating from the induced diffuse synovitis evoked by use of sodium urate crystal that influence on the efficacy of the denervation procedures [ 25 ]). The severity of degenerative joint diseases can also affect the efficacy of therapy [ 29 ].…”

“…It is very difficult to carry out the assessment of the effectiveness of the cranio-dorsal or ventral capsular neurectomy performed respectively from the lateral or medial approach which is based chiefly on subjective observations and information provided by the animal owners. Several published reports provide an objective assessment of the effectiveness of HJC denervation [ 22 – 25 ; 30 ]. Among these reports, a parametric assessments, showed that 50% of the operated dogs demonstrated no post-operative progress [ 22 – 24 ] in spite of nearly all owners reporting health progress in their animals.…”

Desnervação acetabular crânio lateral em cães com displasia coxofemoral: associar ou não com tenectomia pectínea, tenotomia do iliopsoas e desnervação ventral?

“…As diferenças nas intensidades de redução da dor destes dois testes, comparando MPE e MPD, não foram relevantes (Figura 2). Hassan et al (2016) sugerem que há possibilidade das alterações artríticas mais severas em cães mais velhos venham a progredir para a cápsula articular ventral não desnervada. No entanto, aqui foi observado que a desnervação ventral, mesmo nos 10 animais adultos apresentando DAD, não promoveu melhora adicional quando associada desnervação crânio lateral e ventral, confirmando a teoria que a região crânio lateral é a mais importante como origem de dor, por ser a região mais inervada e receber maior carga de distensão devido à instabilidade (Kinzel et al, 1998).…”

“…2011) realizaram a técnica de desnervação ventral associada a miectomia do músculo pectíneo. Estes autores tiveram bons resultados no alívio da dor, no entanto, os resultados do presente estudo, somados aos estudos anatômicos já realizados, mostrando que a região ventral da cápsula é minimamente inervada e recebe pouca distensão perante a instabilidade (Kinzel et al, 1998;Kinzel et al, 2002;Hassan et al, 2016), leva a crer que a desnervação ventral realizada pelos autores citados teve participação insignificante no alívio da dor e o alívio desta ocorreu apenas nos músculos adutores, que é consequência da dor capsular crânio lateral, não tendo influência de variações nas ramificações nervosas.…”