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

Abstract

ObjectiveTo evaluate efficacy of denervation of the of the hip joint capsule (HJC), as a treatment of hip joint pain. Specifically, we tested the hypothesis that HJC denervation will significantly reduce the number of sensory neurons innervating the capsule.Study designDenervation of the HJC from a medial or lateral approach was followed by retrograde tracing of sensory neurons innervating the capsule.AnimalsTwenty adult male sheep (30–40 kg of body weight; Polish merino breed) were used in the study.MethodsThe hip joint was denervated from medial (n = 5) or lateral (n = 5) surgical approaches. Immediately after denervation, the retrograde neural tract tracer Fast Blue (FB) was injected into the HJC. An additional ten animals (n = 5 for medial and n = 5 for lateral approach) received the same treatment without HJC denervation to provide the appropriate controls.ResultsResults of the study revealed that the vast majority of retrogradely labelled sensory neurons innervating the HJC originate from fifth lumbar to second sacral dorsal root ganglia. Both the medial and the lateral denervations significantly reduced the number of sensory neurons innervating the HJC (39.2% and 69.0% reduction respectively).ConclusionsThese results show that denervation of the HJC is an effective surgical procedure for reduction of the sensory neuronal input to the HJC. Moreover, the lateral approach was found to be significantly more effective for reducing sensory innervation as compared to the medial one.

Mechanical osteoarthritis of the hip in a one medicine concept: a narrative review

“…These surgical alternatives include juvenile pubic symphysiodesis [ 85 , 126 ] and pelvic osteotomies [ 85 ]. For dogs displaying symptomatic disability and pain with severe degenerative joint disease, joint capsular denervation [ 127 , 128 ], femoral head and neck ostectomy, and total hip replacement are the existing salvage surgical procedures [ 85 ]. Nevertheless, preventive surgical options, in the most severe cases, may not be as effective long-term [ 129 ], since total hip replacement is the only procedure capable of restoring the lost hindlimb function in certain stages of HD [ 130 ].…”