Osteotomia tripla da pelve através de acesso cirúrgico duplo em cães com displasia coxofemoral

Abstract

Hip dysplasia (HD) is a very common orthopedic alteration in dogs, which is characterized by laxity of the hip joint with consequent osteoarthritis of the constituent bone structures, generating from slight discomfort to acute or chronic pain. Triple pelvic osteotomy (TPO) is an orthopedic procedure eligible as treatment for HD, and aims to increase the angle of ventro-acetabular version, covering and thus minimizing the sub-dislocation of the femoral head through the osteotomies of the pubis, ischium and ileus. Because it requires three surgical approaches, TPO is considered a complex technique and presents a high degree of difficulty with postoperative care. The work aimed to report and evaluate the performance of TPO from the implementation of a new surgical methodology that also allows sciatic osteotomy through the ventral pubic access, minimizing the possible complications related to the posterior sciatic approach. Twelve joints of 10 dogs with clinical and radiological diagnosis of HD were used, able, based on the results of these exams, to undergo TPO surgery. The patients were submitted to the surgical procedure through a double approach, performing the sciatic osteotomy using a double guide rhinotomy chisel, from the ventral pubic access. To facilitate osteotomy of the ileum body, the approach to this bone followed a new path, through the fibers of the middle gluteal muscle, with such a pelvic position, that the lateral surface of this bone would be parallel to the operating table. Through this surgical technique, it was possible to perform the sciatic osteotomy by approaching the pubis in all the animals in the study, showing good post-operative bone healing, increased coverage and joint congruence with clinical improvement. Based on this, it is concluded that it is possible to perform ischial osteotomy in the TPO surgical procedure through the ventral pubic access with the aid of a double guide chisel, offering good clinical, therapeutic and radiological results, minimizing the surgical time and eliminating possible complications related to the posterior approach of the ischium.