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DARthroplasty
Treatment modalities for hip dysplasia in the young dog
include triple pelvic osteotomy (TPO), femoral head osteotomy
(FHO), and total hip replacement (THR). There is a group
of dogs that fall into a gray zone. They are not candidates
for a TPO; they do not have advanced degenerative joint
disease (DJD) and are not candidates for a FHO; and they
may be too young for a THR. Yet they can have hip pain
or lameness that may not respond well to medical management.
These dogs may be good candidates for DARthroplasty.
Radiographs from these dogs usually reveal shallow hip
joints with little or no dorsal acetabular rim. Subluxation
may be moderate to severe.
DARthroplasty creates a shelf of bone from corticocancellous
strips harvested from the wing of the ilium which are
then sutured together to create a cup. This cup is slid
under the gluteal muscles and tucked under the rotators,
thereby protecting it from the sciatic nerve, then sutured
to the joint capsule. The lateral cortex of the acetabular
rim is perforated with holes to promote bony fusion of
the graft to the rim.
Over a period of several months, a fused boney shelf forms
in place of the deficient acetabular rim giving the patient
a naturally formed dorsal acetabular rim providing near
normal to normal hip function. Most patients can run and
do all the usual things young dogs are supposed to do.
A FHO or THR can always be done at a later date, should
failure of the DARthroplasty procedure occur.
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for DARthroplasty should have a high Patient Assessment Score
(PAS), which in general means that the patient is of mild
temperament and in good physical and physiological condition
to withstand 4-5 hours of surgery. In addition, the owner
must be compliant with strict aftercare protocol. Only patients
with high PAS scores are good candidates for success. |
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