Associação das osteotomias pélvica tripa e intertrocantérica como alternativa para o tratamento da displasia coxofemoral: estudo ex vivo

Abstract

Morais, Rafael da Cruz. Association of triple pelvic and intertrochnateric osteotomies as an alternative for the treatment of hip dysplasia: cadaveric study. Salvador, Bahia, 2022, 80p. Dissertação (Mestre em Ciência Animal nos Trópicos) – Escola de Medicina Veterinária e Zootecnia – Universidade Federal da Bahia, 2022. Several surgical procedures are described for the treatment of hip dysplasia (CHD), however, in young patients, intervention is recommended through the use of prophylactic techniques, in order to improve joint congruence. In medicine, the association of femoral and pelvic osteotomies is recommended for the treatment of disorders in the hip joint. The aim of this study was to evaluate the feasibility of varus intertrochanteric osteotomy (OITV) and triple pelvic osteotomy (OPT) in canine cadavers free of CHD and, in parallel, to radiographically verify the achieved acetabular coverage. For this purpose, nine adult canine cadavers weighing 15 to 23 kg were used. In the first moment (T1) OITV was performed in the right hemipelvis with a bone wedge at an angle of 20º and, in the left hemipelvis, the OPT with a plate angled at 30º, in the second moment (T2), the association of the techniques was recorded in the two antimeres .Ventrodorsal radiographic evaluations were obtained preoperatively (T0) and after performing the techniques at both times to measure Norberg angle (AN), percentage of acetabular coverage (PCA), femoral neck inclination angle (AICF) and width of the pelvic canal (LP). According to the results obtained, the OITV was not able to generate significant results in any of the times in the mean of the AN and in the PCA, although it generated increases in absolute numbers in the PCA in most cases. OPT was able to produce significant changes (p<0.05) in AN and PCA at both times, in relation to the preoperative moment and after association with OITV. The OPT applied unilaterally was able to significantly decrease the LP, in relation to the T0 period, however this result was not observed when applied bilaterally. The slight difference in PCA and AN measurements after OITV can be explained by the absence of dysplasia or subluxation in the hip joints included in the study. However, it was possible to note the preservation of good joint congruence. The association with OITV can allow the acetabular rotation resulting from the OPT to the minimum necessary degrees and reestablishment of good joint congruence, through the convergence of the center of the femoral head with the center of the acetabulum achieved with the application of the technique. Although they present complexity in their applications, the techniques proved to be feasible when performed on cadavers; therefore, further studies are needed to evaluate the clinical results in dogs with subluxation of the coxofemoral joint.