Comparison of arthroscopic and radiographic abnormalities in the hip joints of juvenile dogs with hip dysplasia

Ian G. Holsworth Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA 95616.
Present address is the Veterinary Medical and Surgical Group, 2199 Sperry Ave, Ventura, CA 93003.

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Kurt S. Schulz Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA 95616.

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Philip H. Kass Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616.

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William E. Scherrer Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA 95616.

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Brian S. Beale Gulf Coast Veterinary Hospital, 1111 W Loop S, Ste 160, Houston, TX 77027.

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James L. Cook Comparative Orthopaedic Laboratory, College of Veterinary Medicine, University of Missouri, Columbia, MO 65211.

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William J. Hornof Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA 95616.
Present address is Eklin Medical Systems Inc, 532 Weddell Dr, Sunnyvale, CA 94089.

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Abstract

Objective—To compare radiographic and arthroscopic abnormalities in juvenile dogs with clinically apparent hip dysplasia.

Design—Case series.

Animals—52 dogs (70 hip joints) with clinical signs of hip dysplasia scheduled to undergo triple pelvic osteotomy.

Procedure—A ventrodorsal radiographic projection of the pelvis was evaluated by a radiologist unaware of clinical and arthroscopic findings, and radiographic osteoarthritic abnormalities were judged and scored as absent (0), mild (1), moderate (2), or severe (3). Arthroscopy was performed by a surgeon unaware of clinical and radiographic findings, and arthroscopic abnormalities were graded from 0 (normal) to 5 (exposed, eburnated subchondral bone).

Results—In 30 of the 70 (43%) hip joints, no radiographic osteoarthritic abnormalities were seen. Severe, full-thickness articular cartilage lesions (grade 4) of the femoral head or acetabulum were seen arthroscopically in 14 (20%) joints. Lesions ≥ grade 2 were seen in 60 (86%) joints. Partial tearing of the ligament of the femoral head was present in 57 (81%) joints, and complete rupture was seen in 5 (7%). Radiographic abnormalities were seen in 13 of the 14 (93%; 95% confidence interval, 66% to 99.8%) joints with grade 4 arthroscopic abnormalities but in only 23 of the 46 (50%; 95% confidence interval, 35% to 65%) joints with grade 2 or 3 arthroscopic abnormalities.

Conclusions and Clinical Relevance—Results suggest that radiography is not a sensitive method for identifying moderate cartilage lesions in juvenile dogs with hip dysplasia. If moderate cartilage lesions are an important prognostic indicator for the success of triple pelvic osteotomy, then methods other than radiography should be used to detect these lesions. (J Am Vet Med Assoc 2005;227:1091–1094)

Abstract

Objective—To compare radiographic and arthroscopic abnormalities in juvenile dogs with clinically apparent hip dysplasia.

Design—Case series.

Animals—52 dogs (70 hip joints) with clinical signs of hip dysplasia scheduled to undergo triple pelvic osteotomy.

Procedure—A ventrodorsal radiographic projection of the pelvis was evaluated by a radiologist unaware of clinical and arthroscopic findings, and radiographic osteoarthritic abnormalities were judged and scored as absent (0), mild (1), moderate (2), or severe (3). Arthroscopy was performed by a surgeon unaware of clinical and radiographic findings, and arthroscopic abnormalities were graded from 0 (normal) to 5 (exposed, eburnated subchondral bone).

Results—In 30 of the 70 (43%) hip joints, no radiographic osteoarthritic abnormalities were seen. Severe, full-thickness articular cartilage lesions (grade 4) of the femoral head or acetabulum were seen arthroscopically in 14 (20%) joints. Lesions ≥ grade 2 were seen in 60 (86%) joints. Partial tearing of the ligament of the femoral head was present in 57 (81%) joints, and complete rupture was seen in 5 (7%). Radiographic abnormalities were seen in 13 of the 14 (93%; 95% confidence interval, 66% to 99.8%) joints with grade 4 arthroscopic abnormalities but in only 23 of the 46 (50%; 95% confidence interval, 35% to 65%) joints with grade 2 or 3 arthroscopic abnormalities.

Conclusions and Clinical Relevance—Results suggest that radiography is not a sensitive method for identifying moderate cartilage lesions in juvenile dogs with hip dysplasia. If moderate cartilage lesions are an important prognostic indicator for the success of triple pelvic osteotomy, then methods other than radiography should be used to detect these lesions. (J Am Vet Med Assoc 2005;227:1091–1094)

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