Ventral femoral head and neck ostectomy: Standard versus novel K‐wire guided technique using a premeasured ostectomy angle in canine cadavers

Abstract

Objective: To assess the accuracy and efficiency of performing ventral FHO (vFHO) after measuring the ideal femoral head and neck ostectomy angle (iFHOA), with and without guidance of a K-wire. To compare the iFHOA to the previously accepted 45 angle to guide vFHOs.Study Design: Randomized, controlled, ex vivo study. Animals: Ten mixed-breed canine cadavers.Methods: A routine un-guided and guided vFHO was performed on each cadaver. A single unmodified ostectomy was performed on all hips. The preand postoperative iFHOA and postoperative residual femoral neck were radiographically assessed. Subjective intraoperative palpation and postoperative radiographic ostectomy completeness (OC) scores were assigned.Results: Subjective OC scores (p > .63) did not differ between techniques, and guided vFHOs were as good or better for 7/10 dogs assessed via intraoperative palpation, and 9/10 dogs assessed radiographically. Residual femoral neck measurements were similar in both groups (p > .75). The average iFHOA in this study was 38.5 , with no significant difference between limbs of the same cadaver (p = .34). Guided vFHO took longer (294.5 s, p = .002) than unguided vFHO (166.7 s). Conclusion:The mean iFHOA of 38.5 was less than the previously published 45 angulation for vFHOs. Subjectively, use of a K-wire guide improved soft tissue retraction, neck visualization, and confidence in cut angulation.Clinical Significance: Preoperative iFHOA measurement may minimize the risk of inappropriate vFHO angles.

Comparison of intraoperative outcomes in excision arthroplasty with or without partial tenotomy of deep gluteal muscle in dogs

“…According to the study, isolation and cut angulation of the femur neck were improved by k-wire assistance (7). Craniolateral approach was utilized for all cases.…”

“…The ventral approach to the coxofemoral joint is rarely performed in veterinary practice (6). In addition, K-wire-assisted FHNE via the ventral approach is a recently described technique (7).…”

Iatrogenic Iliopsoas Tendon Injury May Occur during Femoral Head and Neck Ostectomy—An Ex-Vivo Study in Dogs

“…The Kirschner-wire guided ventral FHO method has subjectively shown to decrease regional soft tissue retraction and increase visualization of the femoral neck. 11,12 Future studies investigating the presence of iliopsoas damage with the ventral FHO approach should be considered. There is lesser concern for the surgical approach or soft tissue dissection causing iatrogenic damage when the procedure is performed by an experienced surgeon; however, it cannot be proven that experience or specialty training level plays a role in the possibility of iatrogenic damage to this structure.…”

Modified Ventral Femoral Head and Neck Ostectomy: A Canine Cadaver Study

“…W przypadku odejmowania głowy i szyjki kości udowej z dostępu pachwinowego, jego główną zaletą, w porównaniu z uznawanym za łatwiejszy, dostępem od strony doczaszkowo-bocznej, jest zachowanie ciągłości dogrzbietowej części torebki stawowej stawu biodrowego i ścięgna mięśnia pośladkowego głębokiego. To może ograniczać ryzyko pooperacyjnego dogrzbietowego przemieszczenia kości udowej i skrócenia operowanej kończyny (1,6,7).…”

“…w przypadku dużego kąta antewersji nieuwzględnienie go i poprowadzenie cięcia prostopadle do osi szyjki zwykle prowadzi do pozostawienia jej doogonowego fragmentu. Uważa się, że idealne cięcie powinno przebiegać na wysokości podstawy szyjki i łączyć wierzchołki krętarza większego i mniejszego (1,6,7). Blackford Winders i wsp.…”