December 12, 2017

Hip denervation– An option for advanced DJD

HIP DENERVATION: A SURGICAL OPTION FOR LONGTERM PAIN CONTROL OF THE ARTHRITIC HIP

Kinzel S. Von Scheven C. Buecker A. Stopinski T. Kupper W. Clinical evaluation of denervation of the canine hip joint capsule: a retrospective study of 117 dogs . Vet Comp Orthop Traumatol 2002: 15:51-6.

SUMMARY
It was the aim of this study to evaluate denervation of the canine hip joint capsule as a newly developed surgical method for treatment of hip joint dysplasia and arthrosis of dogs. Denervation by surgical deperiostation of the craniolateral acetabulum is the presumed mechanism. We performed the denervation in 117 cases between 1997 and 1999. Clinical evaluation was documented by physical examination by a veterinarian immediately before and two months after the operation and a questionnaire completed by the dog owners. 90/6% of the patients showed an improvement of the clinical signs yielding a significant treatment effect (p < 0.0001). 50.4% were completely free of signs. 56% of the patients showed clinical improvement within the first three days after surgery. We, therefore, conclude that denervation of the canine hip joint capsule is a successful surgical method for treatment of canine hip joint dysplasia and arthrosis.DISTRIBUTION OF STUDY DOGS Mean age 4.2; range 4mo-14yrs Weight range 14-58kg Breeds: German Shepherd, Retriever, Rottweiler, mixed breedsThis study and several German-language reports from the same and other authors published previously are very exciting. Heretofore, we in veterinary medicine have been limited in our treatment of degenerative joint disease of the hip in dogs. If we are lucky enough to catch our dysplastic patients younger than 4 months of age and still growing, we have the Pubic Symphysiodesis corrective option. If we are lucky enough to catch or dysplastic patients before a year of age and prior to significant DJD, we have the Triple Pelvic Osteotomy (TPO) option. If we are unlucky enough to see them after DJD has set in, we are left with the salvage procedures (total hip replacement or femoral head and neck excision arthroplasty) or chronic NSAID use. Sometimes we can delay or ameliorate DJD signs with chondroprotectants and high-dose fish oil too.But there are many dogs stuck in that late stage of DJD who might be helped quite substantially by the Coxofemoral Denervation technique. If these various study results pan out over larger populations of pets, we have something quite helpful to offer these dogs.The risks have yet to be officially evaluated. Intuitively, they are few and primarily related to standard anesthesia and surgery risks. The post-operative course of recovery is quite rapid based on personal conversations with the lead author above and my own experiences, and client satisfaction is quite high.Let me know if you would like to chat about this surgical option. I am happy to consult with your clients and review patients for candidacy.Lara Marie Rasmussen, DVM, MS Diplomate, American College of Veterinary Surgery

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