Veterinary Medicine - December 2008 - (Page 644)

Practical Matters 2. A ventrodorsal hip-extended pelvic radiograph of a young dog reveals subluxation of the femoral head (solid white arrow), little if any dorsal rim of the acetabulum (solid black arrow), early osteoarthritic changes (dashed arrow), and shallow acetabuli (dotted arrows). 3. The harvested cortical-cancellous strips of bone from the ilium have been sutured into a cup and are ready to be placed under the deep gluteal and gemelli muscles directly over the joint capsule. The heavy suture, which has been preplaced in the joint capsule, when tied, will hold the implant in place. The patient is in lateral recumbency. The access incision to the wing of the ilium for harvesting the bone grafts is seen on the left. DARTHROPLASTY: AN OVERVIEW You will most likely refer patients for DARthroplasty. The procedure involves harvesting autogenous bone grafts from the wing of the ilium and placing them to fuse over the deﬁcient dorsal acetabular rim. 6,7 A caudodorsal approach to the coxofemoral joint is used. The exposed bony portion of the dorsal rim of the acetabulum is prepared to accept bone grafts by the drilling of multiple holes along the bony portion of the dorsal acetabulum, exposing activated cancellous bone. The cortical-cancellous strips harvested from the ilium through a separate incision are formed into a cup, tucked under the muscle separation between the deep gluteal muscle and the gemelli muscle, and tied to the joint capsule with a preplaced suture (Figure 3). A cancellous bone graft from the ilium is packed into the area of the drill holes in the acetabular rim and covered with additional pieces of cortical graft from the ilium (Figure 4). 6,7 Sutures are placed between the deep gluteal and gemelli muscles to help hold the free graft in place, and the two surgical wounds are closed with a standard layered protocol. 4. A transection view of the coxofemoral joint shows the relative position of the harvested graft (free cortical-cancellous strips) sutured to the joint capsule, the layering of the cancellous bone graft into the drill holes along the dorsal rim of the acetabulum, and the blocking strips (cortical graft from the ilium) holding the cancellous graft in place. 644 December 2008 VETERINARY MEDICINE

Table of Contents Feed for the Digital Edition of Veterinary Medicine - December 2008

Veterinary Medicine - December 2008 Contents Letters Thanking Our Valued Reviewers Practical Matters Idea Exchange Why Do Dogs and Cats Eat Grass? Managing Atypical and Critical Cases of Primary Hypoadrenocorticism in Dogs Behaviors Suggestive of Postoperative Pain in Cats What to Consider When Considering Digital Radiography Avoid Common Bandaging Mistakes in Dogs and Cats IMHA: Diagnosing and Treating a Complex Disease CE Form/Advertiser Index Marketplace/Classifieds Mind Over Miller

Veterinary Medicine - December 2008

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