Poor success rates with double pelvic osteotomy for craniodorsal luxation of total hip prosthesis in 11 dogs

Abstract

Objective: To report the outcome of double pelvic osteotomy (DPO) for craniodorsal luxation of total hip replacement (THR). Study design: Retrospective case series. Animals: Eleven client-owned animals. Methods: Dogs with craniodorsal luxation of THR and high angle of lateral opening (ALO) were considered candidates for DPO. The ALO and the version angle (VA) were measured on pre- and post-DPO radiographs. Pre- and post-DPO ALO and VA were compared using a Wilcoxon signed-rank test. Clinical and radiographic outcomes were assessed at 2 and 6 months post-DPO. Results: Eleven DPOs were performed on 11 dogs after THR luxation. The ALO was reduced from a median of 66.2° (range 37.3–73.1°) to 55.9° (range 13.2–60.0°) (p ≤.001), and VA increased from a median of 25.6° (range 6.8–51.9°) to 35.3° (range 15.1–51.7°) (p ≤.03). Craniodorsal luxation recurred in five dogs and was managed with closed reduction (one dog), capsulorrhaphy (one dog), or repositioning of the acetabular cup (three dogs). The median clinical follow-up duration was 19.7 months (range 3.4–73.0). In the long term, seven dogs required explantation (five aseptic loosenings, two infections) (median 8.2 months, range 2.6–50.6). Conclusion: Reluxation was frequent after DPO, 5/11 dogs requiring additional procedures, including three cup revisions. The long-term outcome was considered to be poor due to frequent explantation. Clinical significance: Double pelvic osteotomy may be considered to avoid cup replacement when managing craniodorsal THR luxations in dogs but is not recommended due to high complication rates.