Associação das técnicas tenectomia pectínea, tenotomia do iliopsoas e desnervação acetabular ventral e crânio lateral em cães com displasia coxofemoral

Abstract

The craniolateral denervation of the hip joint in dysplastic dogs has been performed and shows great results regarding pain control. Recently, the ventral denervation associated with the pectineal myectomy approach was studied. This work aimed to evaluate the pain’s relief in the postoperative period of the pectineus tenectomy, iliopsoas tenotomy, ventral and craniolateral acetabular’s denervation surgery approach, as well as to evaluate the efficacy of two methodologies to assess kinetic and kinematic functions. The methodology used was the craniolateral denervation of the right joint and the pectineal myectomy, iliopsoas tenotomy, and the craniolateral and ventral denervation of the left limb on 20 dysplastic dogs. The pain grading was done through specific tests. The modified kinematic evaluation was performed through video-analysis of the animals walking, while measuring the angles formed by the hip and scapuloumeral joints. The lameness were also analyzed. For modified kinetics the dogs were placed on four scales and the weight on each limb was measured. The improvement of the lameness, and the gain of lean body mass was statistically significant (p<0.05) on both limbs, but greater on the right. The evaluation of the abduction with external rotation, a decrease in pain was observed after 30 days on both limbs. On the other hand, the abduction with extension showed improvement in the right limb on the seventh day, whereas in the left limb a improvement was only noted after 30 days. Difference on pain intensity when these two exams were compared between both limbs was not relevant. Muscle pain relief was remarkable at the iliopsoas muscle’s insertion on both groups at 30 days. On the ventral aspect of the iliopsoas muscle, the relief was significant in all check-up visits, showing a mild improvement at 60 days of surgery. Lameness improvement was more significant on the right antimer as well as the head position suggested a weight redistribution. There was a significant angle increase of both joints due to the greater amplitude of the member during extension, which was more pronounced on the right limb. Thus, this result might suggest a greater ability of the limb to propel the body forward. The scales showed a redistribution of the weight, which in the preoperative was verified to be overloading the forelimbs (thoracic limbs - 73.8% and pelvic limbs - 26.2%). On the 60 day of the surgery we verified that the beared weight was, respectively, 68.6% and 31.4%. The right hindlimb had a greater increase on weight load (3.6%), compared to the contralateral limb (1.6%). The denervation of the acetabular nerves is enough to promote pain relief in dogs with hip dysplasia. Therefore, it is not required to associate the surgical techniques as proposed by this work. The kinematics and modified kinetic evaluations adapted with low cost materials are effective to evaluate the results of the lateral denervation approach as a therapy to treat pain in dogs with hip dysplasia.