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Bulletin UASVM, Veterinary Medicine 65(2)/2008

pISSN 1843-5270; eISSN 1843-5378

RESEARCHE RELATING TO THE USE OF THE 50-DEGREE PLATE

IN THE TPO TECHNIQUE IN 3- AND 4-DEGREE HIP DYSPLASIA IN

DOGS.

Elefterescu H.

Faculty of Veterinary Medicine, Bucharest

Keywords: hip dysplasia, TPO, 50-degree plate.

Abstract: The triple osteotomy of the pelvis is a choice technique in curing the dysplasia of 1, 2 and 3 degreesby using different plates of 20, 30 and 40 degrees as the angle of dysplasia requires. In the 3 to 4 degrees

dysplasia, where the luxation or subluxation of the femoral head is present, the specialized literature

recommends total hip prosthesis. Doing lots of anatomical research, I succeeded to avoid the use of total hipprosthesis by using the TPO with the 50-degree plate.

INTRODUCTION

Total prosthesis, although it is the last solution in the 3-degree dysplasias with

subluxation or luxation of the femoral head, is an extreme option. The implantation of the

Teflon artificial cavity and the metallic articular head cause irremediable tissue destruction.

When it may be applied, the TPO is a method using exclusively the patient's tissues and, in

my opinion, it is an ideal technique. Using the 50-degree plate, we can bring the articular head

of the femur into the acetabular cavity by twisting the latter.

RESULTS AND DISCUSSIONSIn the 3- to 4-degree dysplasias (Fig. 1) with the subluxation or luxation of the

articular femoral head irremediable alterations are produced, like the round ligament raveling

or breaking (10, 11).

Figure 1. Dysplasia of 3 to 4 degree with a slight subluxation. Female Golden, 7 months.

The increase of the intra-articular liquid quantity, as well as the articular cavity

capsula relaxation, are significant. Such alterations normally lead to the decision of applying

the hip prosthesis (12, 13). However, by using a TPO plate of minimum 50 degrees, in the

situation that the articular cavity was still manifest (4. 5. 6. 7. 8), has been a salutary option.

By twisting the articular cavity over the articular head so that the Norberg's angle should be of

minimum 110 degrees has resulted in a recovery of 95% (a case not recovered after 20

operations) (Fig. 2 and 3) out of the operated patients having a prescription for hip prosthesis.

During surgery, I have mandatorily extracted intra-articular liquid to allow the articular cavityto relax and, in time, to fibrosys, thus contributing to a more durable co-optation of the

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articular head into the cavity. By its body weight in quadrupedal position, the animal

participates in the femoral articular head thrust into the cavity and facilitates the healing and

the recovery of the articulation.

Figure 2. Male Golden Retriever, 7 months. 3 to 4 degrees dysplasia with subluxation. Postoperative aspect after

the second surgical operation. Plate of 50 degrees applied bilaterally at 2 moths intervals. Noteworthy recovery,

close to 100 %.

Figure 3. Caucazian Shepard, 8 months. 3 to 4 degrees dysplasia with subluxation. Postoperative aspect after the

second surgical operation. Plate of 50 degrees. Noteworthy recovery, close to 100 %.

In bilateral dysplasias, in the situation of applying the TPO with 50-degree plate, the interval

for the second articulation surgery shortens by far as it may be performed after a period of 1.5

months, unlike the prosthesis case in which the minimum interval between operations is of 6 months.

Consequently, the motor recovery of the animal is much better and shorter (1, 2, 3).

Hip prosthesis application may only be done after the completion of the animal's body growth

and, depending on the breed, over 1 year of age. In the case of the 50-degree plate application, the

operation may be performed starting with the age of 6 months, which means a noticeable benefit to the

recovery of the animal.

The postoperative attendance in case of application of the 50-degree plate is much easier,

while the animal's recovery is much more rapid compared to the total hip prosthesis.

CONCLUSIONS.

Through the improvement of the Norberg's angle over 110 degrees, the dysplasticarticulation becomes perfectly functional.

The 50-degree plate applied in the dysplasia with luxation avoids the application of theprosthesis and allows an almost perfect motor recovery of the afflicted articulation.

The increasing weight of the operated animal favours the better co-optation of the articularhead after the application of the 50-degree plate.

The avoidance of the total hip prosthesis and the application of the 50-degree plate offerthe animal an improved, physiological solution.

In bilateral dysplasias, in the situation of applying the TPO with 50-degree plate, theinterval for the second articulation surgery shortens by far as it may be performed after aperiod of 1.5 months, unlike the prosthesis case in which the minimum interval between

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operations is of 6 months. Consequently, the motor recovery of the animal is much better

and shorter.

The motor deficiencies remedy by application of the TPO with the 50-degree plate ismuch more precocious, that is, starting with the age of 6 months, unlike the hip prosthesiswhich may only be applied after 1 year of age.

BIBLIOGRAPHY

1. Baciu,Cl.,Dobre I.,Ciobanel Gh.,Aldea AL.:Chirurgia si protezarea aparatului locomotor.Ed.Medicala,Bucuresti,1986

2. Brinker,Piermattei&FloS Handbook of Small Animal Orthopedics & Fracture Repair,4th Edition Ed WBSounders,2006

3. Cornila,N.,Manolescu N.,:Structura si ultrastructura organelor la animalele domestice,EdCeres,Bucuresti,1995

4. Elefterescu H.,C.Dragomir:Displazia de sold(HD)o maladie grava in atentia proprietarilor si crescatorilor decaini.Revista Cainele meu Nr.7,Bucuresti,1998.5. Elefterescu H.,C.Dragomir:Displazia de sold(HD)o maladie grava in atentia proprietarilor si crescatorilor decaini. TPO-Osteotomia tripla a pelvisului-metoda de ameliorare a displaziei de sold(HD)Revista Cainele

meu Nr.8,Bucuresti,1998.6. Elefterescu H.,C.Dragomir:Displazia de sold(HD)o maladie grava in atentia proprietarilor si crescatorilor de

caini.Alte metode de ameliorare a displaziei de sold.Revista Cainele meu Nr.9,Bucuresti,1998.

7. Elefterescu H.:TPOBilateral repair in the same surgical intervention World Small Animal VeterinaryCongres,Vancouver,Canada,2001.

8. Elefterescu H.:Metode chirurgicale de ameliorare a displaziei coxofemurale.Revista Ghidul Canin,Nr4,20019. Elefterescu H.:Displazia luxanta a soldului-Studiu comparativ la caine si om,Ed.Curtea Veche 2007.10. Miller E.M.:Anatomy of the Dog,WB Saunders Company,196411. Ortolani .M.:Simptomele si evolutia maladiei luxante de sold Rev.Chir.Orthop,44:75-78,1958.12. Piermattei D.L.,Brinker D.,Flo L.:Handbook of Small Animal Orthopedics and Fracture repair Ed.Saunders

199713.Slatter D.:Textbook of Small Animal Surgery vol 1,2 Ed.Saunders 2003.