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Bilateral Major DARthroplasties

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Case Information:  

Male Bernese Mountain Dog, 9 months old, 109 lbs., presented for hip evaluation. 

Evaluation and diagnosis:  

Owner reported that the dog was experiencing morning pain and diminished activity.  Physical examination revealed dog cantilevering to off-weight hind quarters.  Stand test positive, abduction external rotation test bilaterally severe.  Dog too painful to climb stairs or jump into car.  Right thigh circumference 48/32/39, left thigh circumference 50/32/44.  Right hip only reduces with lateral pressure, angle of subluxation 39°.  Left hip angle of reduction 51°, angle of subluxation 22°.  Radiographs reveal bilateral blunted dorsal acetabular rims, right side worse.   Bilateral acetabular filling, diminished joint congruency and femoral osteoarthritis.

AP Pelvis Pre Op ©Slocum Enterprises, Inc. (721510 bytes)  Lateral Pelvis Pre Op ©Slocum Enterprises, Inc. (563238 bytes) TOMO Pelvis and DAR Pre Op ©Slocum Enterprises, Inc. (26086 bytes)

Bilateral severe reducible hip dysplasia with very stretched joint capsules.

Treatment:  

Bilateral major DARthroplasties.

Pathologic notes:  Right joint capsule thickened and inflamed, femoral head dorsally and laterally displaced, femoral head even with acetabular rim, deep gluteal adhered to joint capsule.  Left joint capsule moderately thickened and inflamed, femoral head dorsally and laterally displaced.

Recheck Examination:

One year, one month follow-up.  Owner reports that dog has no morning pain and activity level is up.  On presentation dog walking with normal weight bearing and gait on both hindlimbs.  Physical examination reveals limited abduction on both hips, but stand test is normal.  Dog able to climb stairs and jump into car.  Right thigh circumference 51/38/49, left thigh circumference 57/34/49.  Bilaterally there is no angle of reduction or subluxation.  Palpation shows no bone on bone.  Radiographs indicate mature and fully functional bilateral major DARthroplasties.

AP Pelvis One year one month post Major DARthroplasty ©Slocum Enterprises, Inc. (792274 bytes) Lateral Pelvis One year one month post Major DARthroplasty ©Slocum Enterprises, Inc. (760022 bytes) TOMO Pelvis and DAR view One year one month post Major DARthroplasty ©Slocum Enterprises, Inc. (25693 bytes)

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