Postoperative Complications of Double Pelvic Osteotomy Using Specific Plates in 305 Dogs

Abstract

Objective The aim of this clinical retrospective study was to describe the postoperative complications and associated factors of double pelvic osteotomy (DPO) using DPO plates. Materials and Methods Medical records were searched for dogs that underwent unilateral or bilateral DPO using DPO plates from February 2009 to October 2018 and were re-evaluated for a minimum of 1 to 2 months postoperatively. A variety of commercially available, specific DPO plates were used. Complications were determined during the immediate postoperative period and at the time of the clinical and radiographic re-evaluations done 1 and/or 2 months postoperatively. Results A total of 458 DPO (226 right, 232 left) performed in 305 dogs satisfied the inclusion criteria. Double pelvic osteotomy plates from eight different manufacturers were used: Fixin (n = 160), Kyon (n = 154), New Generation Device (n = 63), Hofmann (n = 61), Veterinary Instrumentation (n = 12), DePuy Synthes (n = 4), Porte (n = 3) and Koenigsee (n = 1). Mean age of the dogs was 6.2 months (range: 5–8 months), and the body weight ranged from 10 to 47 kg. Overall, a total of 42 complications occurred in 38 DPO (8.2%). Complications included greenstick fracture of the ischium in 14 DPO (3%), isolated screw loosening in 13 DPO involving 16 of a total of 2,947 screws (0.5%), isolated screw breakage in 4 DPO involving 5 of 2,947 screws (0.1%), incomplete ilium fracture in 3 DPO (0.6%), partial caudal plate avulsion in 3 DPO (0.6%), iatrogenic sciatic neuropraxia in two DPO (0.4%), suspected surgical site infection (SSI) in 1 DPO (0.2%) and persistent pain and lameness caused by the implant in 2 DPO (0.4%). The case of suspected SSI and the two cases of persistent pain were classified as major complications (3 DPO, 0.6%), requiring medical and surgical intervention, respectively, whereas other 39 complications in 35 DPO were classified as minor, not requiring treatment (7.6%). Conclusion Double pelvic osteotomy using DPO plates appears to be a safe surgical option for the treatment of hip dysplasia in growing dogs; no catastrophic complications were reported and the incidence of complications (0.6% major complications and 7.6% minor complications) was low. This study showed that DPO using DPO plates and proper technique was safe in 92% of cases. The only two factors found to be significantly associated with the development of complications after DPO were the laterality (left-sided or right-sided) and body weight.

Evaluation of the Iatrogenic Sciatic Nerve Injury following Double Pelvic Osteotomy Performed with Piezoelectric Cutting Tool in Dogs

“…and in a bilateral single-session DPO. In both dogs neuropraxia was no longer apparent 1 month postoperatively [8].…”

“…Following these encouraging results, we evaluated the safety of the piezosurgery in dogs underwent DPO procedures in which iatrogenic sciatic nerve injury may occur [1,8].…”

“…Iatrogenic damage of the sciatic nerve may be associated to different surgical procedures such as hip fractures, total hip replacement and double pelvic osteotomy [1,8,10].…”

“…A paper focused on the DPO complications reported that injury of the sciatic nerve occurred in 0.4% in a study population of 305 dogs and 458 DPOs [8].…”

Epineural Neurorrhaphy of a Large Nerve Defect Due to IatroGenic Sciatic Nerve Injury in a Maltese Dog

“…Sciatic nerve injury usually develops secondary to a pelvic or femoral fracture, hip dysplasia [ 1 , 2 ] or iatrogenically during the repair of these fractures [ 3 ]. The proximal portion of the sciatic nerve is located deep near the bone and covered by deep and middle gluteal muscles, and the distal portion of the sciatic nerve is covered by biceps femoris, semitendinosus, and semimembranosus muscles.…”