Luxation and Subluxation of the Coxofemoral Joint

Nixon, Alan J.; Ducharme, Norm G.

doi:10.1002/9781119108757.ch38

Cited by 4 publications

(12 citation statements)

References 23 publications

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“…Femoral head ostectomy (FHO) was considered but this is a salvage procedure, which typically results in ongoing lameness. 1,3,21 Comparison of outcomes following FHO and those following THA in horses is precluded by the low number of equine THA procedures that have been performed and the lack of information regarding long-term outcomes for both procedures. However, THA is considered superior to FHO to return dogs with hip dysplasia to normal function.…”

Section: Discussionmentioning

confidence: 99%

“…The authors believed attempted reduction, with or without stabilization, was unlikely to be successful due to the chronicity and marked degenerative changes to the femoral head and acetabulum. Femoral head ostectomy (FHO) was considered but this is a salvage procedure, which typically results in ongoing lameness 1,3,21 . Comparison of outcomes following FHO and those following THA in horses is precluded by the low number of equine THA procedures that have been performed and the lack of information regarding long‐term outcomes for both procedures.…”

Section: Discussionmentioning

confidence: 99%

“…joint capsule and the substantial overlying musculature. [1][2][3] In addition to the round ligament, the accessory ligament also supports the coxofemoral joint of the horse and is unique to equids. These two ligaments restrict the range of motion of the joint markedly, such that rotation and abduction are severely limited, in contrast to dogs and cats.…”

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confidence: 99%

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Successful total hip arthroplasty in a miniature horse

Cullen,

Pettitt,

Tomlinson

et al. 2023

Veterinary Surgery

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ObjectiveTo describe the surgical treatment, postoperative management, and outcome of a miniature horse undergoing total hip arthroplasty (THA).Study designCase report.AnimalsA 4‐year‐old miniature horse stallion weighing 85 kg.MethodsThe horse presented with left coxofemoral luxation of ~6 weeks duration. Computed tomography confirmed craniodorsal luxation with marked degenerative changes to the femoral head. The horse underwent THA using cementless press fit implants, including an interlocking lateral bolt for the femoral stem.ResultsThe horse recovered well from anesthesia but suffered a coma‐like episode after returning to a stable. Following treatment of presumed hypovolemia, the horse regained normal mentation and was discharged 24 days after surgery. At reassessment 12 weeks postoperatively, the horse was 2/10 left hind limb lameness at trot with good healing of the surgery site. Five months postoperatively mild (1/10) lameness remained at trot but the horse was able to canter normally on both reins. The horse has since been managed normally with no veterinary treatment required for 32 months postoperatively.ConclusionTotal hip arthroplasty is possible in miniature horses weighing up to 85 kg and can result in a good long‐term outcome.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Successful total hip arthroplasty in a miniature horse

Cullen,

Pettitt,

Tomlinson

et al. 2023

Veterinary Surgery

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“…Radiographs also determine the direction of luxation, evaluate for other abnormalities (e.g., fractures and degenerative joint disease), and guide treatment recommendations (e.g., closed vs. open reduction). In large animals, due to the physical and technical limitations of performing radiography, ultrasound is often the first‐line modality used for diagnosing hip luxation and fractures in bovine 6 and equine patients 7,8,9,10,11 . Ultrasound is also used extensively in human medicine to diagnose and monitor treatment of hip luxation in children 12,13,14,15,16,17 .…”

Section: Introductionmentioning

confidence: 99%

“…In large animals, due to the physical and technical limitations of performing radiography, ultrasound is often the first-line modality used for diagnosing hip luxation and fractures in bovine 6 and equine patients. 7,8,9,10,11 Ultrasound is also used extensively in human medicine to diagnose and monitor treatment of hip luxation in children. 12,13,14,15,16,17 Based on our review of the literature (PubMed, Google Scholar), the use of ultrasound in the diagnosis of canine hip luxation has not been previously studied.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound is an accurate method compared to radiography for diagnosing the presence of acute hip luxation in cadaver dogs and can identify the direction of luxation with variable reliability

Todd‐Donato

Porter

VanDeventer

et al. 2022

Vet Radiology Ultrasound

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Acute hip luxation is a common musculoskeletal injury in dogs, with radiographs being the preferred imaging modality for confirming the diagnosis. In large animal and human medicine, ultrasound is often utilized for this purpose. The objectives of this three‐part study were to utilize a canine cadaver model to establish ultrasonographic features of hip luxation and evaluate the accuracy and reliability for diagnosing hip luxation with ultrasound. For the first prospective, exploratory study, a cadaver model was developed that allowed manual luxation and subsequent ultrasonography of the hip joint while in four directions of luxation. For the second prospective, anatomic study, a description of the ultrasonographic features for each direction of luxation was created. For the third prospective diagnostic accuracy, observer agreement study, 16 residency‐trained and intern veterinarians without prior experience in this technique performed randomized, repeated ultrasound exams on cadaver hips assigned as normal or luxated (equally distributed between the 4 directions). A total of 1140 hip ultrasounds were performed with good accuracy (median, 90.8%; range, 61.4–100%), sensitivity (89.5%), and specificity (80.0%) for diagnosing the presence of hip luxation. Accuracy for identifying the correct quadrant of luxation was significantly lower (mean, 58.6%; range, 24.6–90.8%; P < 0.001). Intraobserver accuracy agreement varied widely from none to almost perfect agreement, and interobserver agreement ranged from slight to moderate agreement. The results of this study supported the use of ultrasound for diagnosing the presence of hip luxation but did not support replacing radiographs for diagnosing the direction of luxation.

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Osteoarthritis of the coxofemoral joint in 24 horses: Evaluation of radiography, ultrasonography, intra‐articular anaesthesia, treatment and outcome

Sauer,

Hellige,

Beineke

et al. 2024

Equine Veterinary Journal

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BackgroundFew case reports describe equine coxofemoral joint osteoarthritis (CFJOA).ObjectivesTo evaluate diagnostic findings and outcome of horses with CFJOA and to provide a score facilitating radiographic assessment.Study designRetrospective case series.MethodsHistory, clinical signs, ultrasonographic, radiographic and intra‐articular anaesthesia findings, treatments, outcome, and necropsy results of horses with CFJOA presented between 2002 and 2023 were collated. Radiographic findings were categorised to develop a radiographic score which was applied by two masked examiners. Intra‐ and inter‐observer reliability was determined using weighted Cohen's kappa (Cκ) and the correlation between radiographic and ultrasound findings via Spearman correlation coefficient.ResultsThe study included 24 horses (median age 14 years). Most of them (20/24) were chronically lame. Frequent clinical signs included unilateral gluteal muscle atrophy (18/21), lengthening of the stride of the affected limb (13/19) and locomotion on three tracks (13/20). Both imaging modalities enabled evaluation of periarticular osteophytes (correlation coefficient r = 0.64; p = 0.003). Additionally, radiography allowed detection of irregular joint spaces, subchondral bone opacity changes and femoral head flattening/tapering. Inter‐observer (Cκ = 0.846) and intra‐observer (Cκ = 0.853 and Cκ = 0.842) agreement was excellent. If treated, mostly intra‐articular corticosteroids were administered (16/18). Nine horses were euthanised immediately or during follow‐up examination. Post‐mortem, the Ligamentum capitis ossis femoris was commonly found ruptured. All surviving horses remained lame.Main limitationsRetrospective analysis of clinical records and subjective outcome assessment based on owner follow‐up with potential recall bias. Due to overall disease severity, associations between different grades of clinical findings, radiographic abnormalities and outcome could not be evaluated.ConclusionsTypical clinical signs may indicate CFJOA. Standardised evaluation of ventrodorsal radiographs allows a comprehensive diagnosis. Postmortem findings suggest joint instability as a possible causative factor that may contribute to the poor prognosis and resistance to medical therapy of the disorder.

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Luxation and Subluxation of the Coxofemoral Joint

Cited by 4 publications

References 23 publications

Successful total hip arthroplasty in a miniature horse

Successful total hip arthroplasty in a miniature horse

Ultrasound is an accurate method compared to radiography for diagnosing the presence of acute hip luxation in cadaver dogs and can identify the direction of luxation with variable reliability

Osteoarthritis of the coxofemoral joint in 24 horses: Evaluation of radiography, ultrasonography, intra‐articular anaesthesia, treatment and outcome

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