• 1. Rashmir-Raven AM, DeYoung DJ, Abrams CF Jr, et al. Subsidence of an uncemented canine femoral stem. Vet Surg 1992;21:327331.

  • 2. Liska WD. Micro total hip replacement for dogs and cats: surgical technique and outcomes. Vet Surg 2010;39:797810.

  • 3. Bradway JK, Morrey BF. The natural history of the silent hip in bilateral atraumatic osteonecrosis. J Arthroplasty 1993;8:383387.

  • 4. Boss JH, Misselevich I. Osteonecrosis of the femoral head of laboratory animals: the lessons learned from the comparative study of osteonecrosis in man and experimental animals. Vet Pathol 2003;40:345354.

    • Search Google Scholar
    • Export Citation
  • 5. Stulberg BN. Osteonecrosis: what to do, what to do! J Arthroplasty 2003;18:7479.

  • 6. Yoon BH, Jones LC, Chen CH, et al. Etiologic classification criteria of ARCO on femoral head osteonecrosis part 2: alcohol-associated osteonecrosis. J Arthroplasty 2019;34:169174.

    • Search Google Scholar
    • Export Citation
  • 7. Kang JS, Park S, Song JH, et al. Prevalence of osteonecrosis of the femoral head: a nationwide epidemiologic analysis in Korea. J Arthroplasty 2009;24:11781183.

    • Search Google Scholar
    • Export Citation
  • 8. Clohisy J, Robison J, Callaghan J, et al. Defining the etiologies of premature hip joint degeneration: do impingement disorders have a role? J Arthroplasty 2008;23:325.

    • Search Google Scholar
    • Export Citation
  • 9. Mont MA, Pivec R, Banerjee S, et al. High-dose corticosteroid use and risk of hip osteonecrosis: meta-analysis and systematic literature review. J Arthroplasty 2015;30:15061512.

    • Search Google Scholar
    • Export Citation
  • 10. Dy CJ, Thompson MT, Usrey MM, et al. The distribution of vascular foramina at the femoral head/neck junction: implications for resurfacing arthroplasty. J Arthroplasty 2012;27:16691675.

    • Search Google Scholar
    • Export Citation
  • 11. Lieberman JR, Varthi AG, Polkowski GG. Osteonecrosis of the knee—which joint preservation procedures work? J Arthroplasty 2014;29:5256.

    • Search Google Scholar
    • Export Citation
  • 12. Yoon BH, Mont MA, Koo KH, et al. The 2019 revised version of Association Research Circulation Osseous staging system of osteonecrosis of the femoral head. J Arthroplasty 2020;35:933940.

    • Search Google Scholar
    • Export Citation
  • 13. Mesko JW. Rapidly progressive femoral head osteolysis. J Arthroplasty 1993;8:541547.

  • 14. Lee JS, Suh KT. A pathological fracture of the femoral neck associated with osteonecrosis of the femoral head and a stress fracture of the contralateral femoral neck. J Arthroplasty 2005;20:807810.

    • Search Google Scholar
    • Export Citation
  • 15. Brinker MR, Rosenberg AG, Kull L, et al. Primary total hip arthroplasty using noncemented porous-coated femoral components in patients with osteonecrosis of the femoral head. J Arthroplasty 1994;9:457468.

    • Search Google Scholar
    • Export Citation
  • 16. Jankovits DA, Liska WD, Kalis RH. Treatment of avascular necrosis of the femoral head in small dogs with micro total hip replacement. Vet Surg 2012;41:143147.

    • Search Google Scholar
    • Export Citation
  • 17. Johnson AL, Pijanowski GJ, Stein LE. Osteochondritis dissecans of the femoral head of a Pekingese. J Am Vet Med Assoc 1985;187:623625.

    • Search Google Scholar
    • Export Citation
  • 18. McDonald M. Osteochondritis dissecans of the femoral head: a case report. J Small Anim Pract 1988;29:4953.

  • 19. Castro PF, Unruh SM, Ferrigno CRA, et al. What Is Your Diagnosis? Osteochondritis dissecans. J Am Vet Med Assoc 2009;235:151152.

  • 20. Budsberg SC, Chambers JN, Lue SL, et al. Prospective evaluation of ground reaction forces in dogs undergoing unilateral total hip replacement. Am J Vet Res 1996;57;17801785.

    • Search Google Scholar
    • Export Citation
  • 21. Off W, Matis U. Excision arthroplasty of the hip joint in dogs and cats. Clinical, radiographic, and gait analysis findings from the Department of Surgery, Veterinary Faculty of the Ludwig-Maximilians-University of Munich, Germany. 1997. Vet Comp Orthop Traumatol 2010;23:297305.

    • Search Google Scholar
    • Export Citation
  • 22. Accadbled F, Vial J, Sales de Gauzy J. Osteochondritis dissecans of the knee. Orthop Traumatol Surg Res 2018;104:S97S105.

  • 23. Catterall A. Pathology and classification. Hip 1985;12:6.

  • 24. Kollitz KM, Gee AO. Classifications in brief: the Herring lateral pillar classification for Legg-Calvé-Perthes disease. Clin Orthop Relat Res 2013;471:20682072.

    • Search Google Scholar
    • Export Citation
  • 25. Demko J, McLaughlin R. Developmental orthopedic disease. Vet Clin North Am Small Anim Pract 2005;35:11111135.

  • 26. Janke LJ, Liu C, Vogel P, et al. Primary epiphyseal arteriopathy in a mouse model of steroid-induced osteonecrosis. Am J Pathol 2013;183:1925.

    • Search Google Scholar
    • Export Citation
  • 27. Zizic TM. Osteonecrosis. Curr Opin Rheumatol 1991;3:481489.

  • 28. Mei XY, Alshaygy IS, Safir OA, et al. Fresh osteochondral allograft transplantation for treatment of large cartilage defects of the femoral head: a minimum two-year follow-up study of twenty-two patients. J Arthroplasty 2018;33:20502056.

    • Search Google Scholar
    • Export Citation
  • 29. Wang Q, Li D, Yang Z, et al. Femoral head and neck fenestration through a direct anterior approach combined with compacted autograft for the treatment of early stage nontraumatic osteonecrosis of the femoral head: a retrospective study. J Arthroplasty 2020;35:652660.

    • Search Google Scholar
    • Export Citation
  • 30. Issa K, Pivec R, Kapadia BH, et al. Osteonecrosis of the femoral head: the total hip replacement solution. Bone Joint J 2013;95:4650.

    • Search Google Scholar
    • Export Citation

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Idiopathic arteriopathy–induced focal osteonecrosis of the femoral head in a young dog

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  • 1 1Global Veterinary Specialists PLLC, Houston, TX 77496.
  • | 2 2BluePearl Specialty and Emergency Hospital Stone Oak, San Antonio, TX 78258.
  • | 3 3Department of Veterinary Pathobiology, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX 77843.

Abstract

CASE DESCRIPTION

A 15-month-old 6.5-kg (14.3-lb) castrated male mixed-breed dog was evaluated because of a 4-month history of progressive intermittent non–weight-bearing lameness of the left pelvic limb.

CLINICAL FINDINGS

Orthogonal radiography of the hip joints revealed a 4-mm atypical radiolucent lesion on the distal caudomedial aspect of the left femoral head and a disproportionately large-diameter femoral medullary canal with a low canal flare index. Prolonged unresponsiveness to medical management and progressive enlargement of the lesion prompted the recommendation for total hip replacement (THR).

TREATMENT AND OUTCOME

THR was performed to restore pain-free function of the left pelvic limb and normal activity. A circular osteochondral flap was grossly evident on the femoral head. Histopathologic findings for this portion of the bone indicated an arteriopathy-induced focal subchondral osteonecrosis that had resulted in articular surface collapse. The noted idiopathic arteriopathy had disrupted the normal blood supply to the affected area. On reexamination and radiographic evaluation 13 months after THR, the dog appeared to have pain-free function of the affected limb and had returned to normal activity with no reported complications or problems.

CLINICAL RELEVANCE

To the authors’ knowledge, this report represented the first description of arteriopathy-induced focal osteonecrosis of the caudomedial aspect of the femoral head and its successful treatment in a young dog. This type of lesion may more commonly be the cause of hip joint osteoarthritis in young dogs than previously recognized because establishing a definitive diagnosis requires early recognition and histologic evaluation before advanced degenerative changes develop that obscure the underlying etiology.

Abstract

CASE DESCRIPTION

A 15-month-old 6.5-kg (14.3-lb) castrated male mixed-breed dog was evaluated because of a 4-month history of progressive intermittent non–weight-bearing lameness of the left pelvic limb.

CLINICAL FINDINGS

Orthogonal radiography of the hip joints revealed a 4-mm atypical radiolucent lesion on the distal caudomedial aspect of the left femoral head and a disproportionately large-diameter femoral medullary canal with a low canal flare index. Prolonged unresponsiveness to medical management and progressive enlargement of the lesion prompted the recommendation for total hip replacement (THR).

TREATMENT AND OUTCOME

THR was performed to restore pain-free function of the left pelvic limb and normal activity. A circular osteochondral flap was grossly evident on the femoral head. Histopathologic findings for this portion of the bone indicated an arteriopathy-induced focal subchondral osteonecrosis that had resulted in articular surface collapse. The noted idiopathic arteriopathy had disrupted the normal blood supply to the affected area. On reexamination and radiographic evaluation 13 months after THR, the dog appeared to have pain-free function of the affected limb and had returned to normal activity with no reported complications or problems.

CLINICAL RELEVANCE

To the authors’ knowledge, this report represented the first description of arteriopathy-induced focal osteonecrosis of the caudomedial aspect of the femoral head and its successful treatment in a young dog. This type of lesion may more commonly be the cause of hip joint osteoarthritis in young dogs than previously recognized because establishing a definitive diagnosis requires early recognition and histologic evaluation before advanced degenerative changes develop that obscure the underlying etiology.

Contributor Notes

Address correspondence to Dr. Liska (DrLiska@GlobalVetSpecialists.org).