Download PDF
Vet Comp Orthop Traumatol 2022; 35(01): 047-056
DOI: 10.1055/s-0041-1735288
Clinical Communication

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

Francesca Tavola
1   AniCura Djursjukhuset Albano, Danderyd, Sweden
,
Dario Drudi
2   Clinica Veterinaria Vezzoni, Cremona, Italy
,
Luca Vezzoni 
2   Clinica Veterinaria Vezzoni, Cremona, Italy
,
Aldo Vezzoni
2   Clinica Veterinaria Vezzoni, Cremona, Italy
› Author Affiliations
› Further Information
    Permissions and Reprints

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.

Keywords

DPO implants - hip dysplasia - pelvic osteotomy - complication dog

Authors' Contributions

F.T. and A.V. contributed to the conception of study and acquisition of data. D.D., L.V. and A.V. designed the study. All the authors did data analysis and interpretation, and drafted, revised and approved the submitted manuscript. They are publically accountable for relevant content.


Supplementary Material



Publication History

Received: 13 April 2020

Accepted: 30 June 2021

Article published online:
29 September 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Riser WH. Canine hip dysplasia in disease mechanisms in small animal surgery. 2nd edition. Bojrab MJ. ed. Philadelphia: Lea & Febiger; 1993: 797-803
    Google Scholar
  • 2 Hohn RB, Janes JM. Pelvic osteotomy in the treatment of canine hip dysplasia. Clin Orthop Relat Res 1969; 62 (62) 70-78
    PubMedGoogle Scholar
  • 3 Hunt CA, Litsy AS. Stabilization of canine pelvic osteotomies with AO/ASIF plates and screws. Vet Comp Orthop Traumatol 1988; 01 (01) 52-57
    Article in Thieme ConnectPubMedGoogle Scholar
  • 4 Steel HH. Triple osteotomy of the innominate bone. J Bone Joint Surg Am 1973; 55 (02) 343-350
    CrossrefPubMedGoogle Scholar
  • 5 Salter RB. Innominate osteotomy in the treatment of congenital dislocation and subluxation of the hip. J Bone Joint Surg 1961; 43-B(3): 518-539
    CrossrefPubMedGoogle Scholar
  • 6 Slocum B, Devine T. Pelvic osteotomy in canine orthopedics. 2nd edition. Whittick WG. ed. Philadelphia: Lea & Febiger; 1990: 471-481
    Google Scholar
  • 7 Kotz R, Da Vid T, Helwig U, Uyka D, Wanivenhaus A, Windhager R. Polygonal triple osteotomy of the pelvis. A correction for dysplastic hip joints. Int Orthop 1992; 16 (04) 311-316
    CrossrefPubMedGoogle Scholar
  • 8 Slocum B, Devine T. Pelvic osteotomy technique for axial rotation of the acetabular segment in dogs. J Am Anim Hosp Assoc 1986; 22: 331-338
    PubMedGoogle Scholar
  • 9 Slocum B, Devine T. Pelvic osteotomy in the dog as treatment for hip dysplasia. Semin Vet Med Surg (Small Anim) 1987; 2 (02) 107-116 (Small Anim)
    PubMedGoogle Scholar
  • 10 Borostyankoi F, Rooks RL, Kobluk CN, Reed AL, Littledike ET. Results of single-session bilateral triple pelvic osteotomy with an eight-hole iliac bone plate in dogs: 95 cases (1996-1999). J Am Vet Med Assoc 2003; 222 (01) 54-59
    CrossrefPubMedGoogle Scholar
  • 11 Whelan MF, McCarthy RJ, Boudrieau RJ, Kraus KH. Increased sacral screw purchase minimizes screw loosening in canine triple pelvic osteotomy. Vet Surg 2004; 33 (06) 609-614
    CrossrefPubMedGoogle Scholar
  • 12 Graehler RA, Weigel JP, Pardo AD. The effects of plate type, angle of ilial osteotomy, and degree of axial rotation on the structural anatomy of the pelvis. Vet Surg 1994; 23 (01) 13-20
    CrossrefPubMedGoogle Scholar
  • 13 Doornink MT, Nieves MA, Evans R. Evaluation of ilial screw loosening after triple pelvic osteotomy in dogs: 227 cases (1991-1999). J Am Vet Med Assoc 2006; 229 (04) 535-541
    CrossrefPubMedGoogle Scholar
  • 14 Vezzoni A, Boiocchi S, Vezzoni L, Vanelli AB, Bronzo V. Double pelvic osteotomy for the treatment of hip dysplasia in young dogs. Vet Comp Orthop Traumatol 2010; 23 (06) 444-452
    Article in Thieme ConnectPubMedGoogle Scholar
  • 15 Simmons S, Johnson AL, Schaeffer DJ. Risk factors for screw migration after triple pelvic osteotomy. J Am Anim Hosp Assoc 2001; 37 (03) 269-273
    CrossrefPubMedGoogle Scholar
  • 16 Koch D, Hazewinkel H, Nap R. et al. Radiographic evaluation and comparison of plate fixation after triple pelvic osteotomy. Vet Comp Orthop Traumatol 1993; 06 (01) 9-15
    Article in Thieme ConnectPubMedGoogle Scholar
  • 17 Hosgood G, Lewis DD. Retrospective evaluation of fixation complications of 49 pelvic osteotomies in 36 dogs. J Sm Anim Pract 1993; 34: 123-130
    CrossrefPubMedGoogle Scholar
  • 18 Remedios AM, Fries CL. Implants complications in 20 triple pelvic osteotomies. Vet Comp Orthop Traumatol 1993; 06 (04) 202-207
    Article in Thieme ConnectPubMedGoogle Scholar
  • 19 Sukhiani HR, Holmberg DL, Hurting MB. Pelvic canal narrowing caused by triple pelvic osteotomy in the dog. Part I: the effect of pubic remnant length and angle of acetabular rotation. Vet Comp Orthop Traumatol 1994; 07 (03) 110-113
    Article in Thieme ConnectPubMedGoogle Scholar
  • 20 Schrader SC. Triple osteotomy of the pelvis and trochanteric osteotomy as a treatment for hip dysplasia in the immature dog: the surgical technique and results of 77 consecutive operations. J Am Vet Med Assoc 1986; 189 (06) 659-665
    PubMedGoogle Scholar
  • 21 Dejardin LM, Perry RL, Arnoczky SP. The effect of triple pelvic osteotomy on the articular contact area of the hip joint in dysplastic dogs: an in vitro experimental study. Vet Surg 1998; 27 (03) 194-202
    CrossrefPubMedGoogle Scholar
  • 22 Schulz KS, Dejardin LM. Surgical treatment of canine hip dysplasia. In: Slatter D. ed. Textbook of Small Animal Surgery. 3rd edition. Philadelphia: W. B. Saunders; 2003: 2029-2056
    Google Scholar
  • 23 Petazzoni M, Tamburro R, Nicetto T, Kowaleski MP. Evaluation of the dorsal acetabular coverage obtained by a modified triple pelvic osteotomy (2.5 pelvic osteotomy): an ex vivo study on a cadaveric canine codel. Vet Comp Orthop Traumatol 2012; 25 (05) 385-389
    Article in Thieme ConnectPubMedGoogle Scholar
  • 24 Tamburro R, Petazzoni M, Carli F, Kowaleski MP. Comparison of rotation force to maintain acetabular ventroversion after double pelvic osteotomy and 2.5 pelvic osteotomy in a canine cadaveric model. Vet Comp Orthop Traumatol 2018; 31 (01) 62-66
    Article in Thieme ConnectPubMedGoogle Scholar
  • 25 Legarde F. CNVSPA Proceedings (Congres National Veterinaire Sur les Petits Animaux) Parigi. 1997
    PubMedGoogle Scholar
  • 26 Haudiquet PH, Guillon JF. “Radiographic evaluation of double pelvic osteotomy versus triple pelvic osteotomy in the dog: an in vitro experimental study” Proceedings of 13th ESVOT Congress, Munich, 7th-10th September 2006.
    PubMedGoogle Scholar
  • 27 Haudiquet PH. “Other strategies for HD: DPO vs TPO” Proceedings of 14th ESVOT Congress, Munich, 10th-14th September 2008.
    PubMedGoogle Scholar
  • 28 Punke JP, Fox DB, Tomlinson JL, Davis JW, Mann FA. Acetabular ventroversion with double pelvic osteotomy versus triple pelvic osteotomy: a cadaveric study in dogs. Vet Surg 2011; 40 (05) 555-562
    CrossrefPubMedGoogle Scholar
  • 29 Zanetti EM, Terzini M, Mossa L. et al. A structural numerical model for the optimization of double pelvic osteotomy in the early treatment of canine hip dysplasia. Vet Comp Orthop Traumatol 2017; 30 (04) 256-264
    Article in Thieme ConnectPubMedGoogle Scholar
  • 30 McCartney W, MacDonald B, Ober CA, Lostado-Lorza R, Gómez FS. Pelvic modelling and the comparison between plate position for double pelvic osteotomy using artificial cancellous bone and finite element analysis. BMC Vet Res 2018; 14 (01) 100
    CrossrefPubMedGoogle Scholar
  • 31 Jenkins PL, James DR, White JD. et al. Assessment of the medium- to long-term radiographically confirmed outcome for juvenile dogs with hip dysplasia treated with double pelvic osteotomy. Vet Surg 2020; 49 (04) 685-693
    CrossrefPubMedGoogle Scholar
  • 32 Smith GK, Mayhew PD, Kapatkin AS, McKelvie PJ, Shofer FS, Gregor TP. Evaluation of risk factors for degenerative joint disease associated with hip dysplasia in German Shepherd Dogs, Golden Retrievers, Labrador Retrievers, and Rottweilers. J Am Vet Med Assoc 2001; 219 (12) 1719-1724
    CrossrefPubMedGoogle Scholar
  • 33 Cook JL, Evans R, Conzemius MG. et al. Proposed definitions and criteria for reporting time frame, outcome, and complications for clinical orthopedic studies in veterinary medicine. Vet Surg 2010; 39 (08) 905-908
    CrossrefPubMedGoogle Scholar
  • 34 Robinsons D. Osteomyelitis and implant-associated infections. In: Johnston SA, Tobias KM. eds. Veterinary Surgery Small Animal. 2nd edition. St Louis: Elsevier; 2018: 775-783
    Google Scholar
  • 35 Vezzoni A. Complications of double and triple pelvic osteotomies. In: Griffon D, Hamaide A. eds. Complications in Small Animal Surgery. 1st edition.. Wiley Blackwell; 2016: 759-777
    Google Scholar
  • 36 Turk R, Singh A, Weese JS. Prospective surgical site infection surveillance in dogs. Vet Surg 2015; 44 (01) 2-8
    CrossrefPubMedGoogle Scholar