Canine Hip Dysplasia: Reviewing the Evidence for Nonsurgical Management

Seattle Veterinary Specialists, Kirkland, WA.
Veterinary Surgery (Impact Factor: 1.04). 12/2011; 41(1). DOI: 10.1111/j.1532-950X.2011.00928.x
Source: PubMed


OBJECTIVE: To systematically review the evidence available for nonsurgical management of hip dysplasia (HD). STUDY DESIGN: Literature review. METHODS: Databases (Pubmed, Veterinary Information Network) were searched for clinical studies on nonsurgical management of HD in dogs. The evidence in each study was reviewed and assigned a score (I-IV) based on previously reported levels of evidence. RESULTS: Fourteen articles were identified that met the inclusion criteria, including 3 Level IV, 4 Level III, and 7 Level II studies. Methods of nonsurgical management reviewed included: activity restrictions, weight management, acupuncture, modulation of joint disease by polysulfated glycosaminoglycans, mesenchymal stem cell therapy, and extra corporeal shock wave therapy. CONCLUSION: Weight management is an effective and important component of managing dogs with HD and associated osteoarthritis. Techniques that modulate the progression of joint disease may also be beneficial for treating dogs with HD. Further studies are needed to investigate other methods of managing HD such as hydrotherapy and physical rehabilitation.

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    • "In this study, we propose the use of acupuncture points for stem cell therapy. The practice of acupuncture is very old in human medicine and is also a well-described veterinary procedure [14] [15], although some controversial opinions have been expressed [16]. Acupuncture has been used to treat dogs and cats for around 10 years, mainly for musculoskeletal problems [14], low back pain [17], knee osteoarthritis [18], tension-type headache, and migraine [19] [20]. "
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    ABSTRACT: Stem cells isolated from adipose tissue show great therapeutic potential in veterinary medicine, but some points such as the use of fresh or cultured cells and route of administration need better knowledge. This study aimed to evaluate the effect of autologous stromal vascular fraction (SVF, n = 4) or allogeneic cultured adipose-derived stem cells (ASCs, n = 5) injected into acupuncture points in dogs with hip dysplasia and weak response to drug therapy. Canine ASCs have proliferation and differentiation potential similar to ASCs from other species. After the first week of treatment, clinical evaluation showed marked improvement compared with baseline results in all patients treated with autologous SVF and three of the dogs treated with allogeneic ASCs. On days 15 and 30, all dogs showed improvement in range of motion, lameness at trot, and pain on manipulation of the joints, except for one ASC-treated patient. Positive results were more clearly seen in the SVF-treated group. These results show that autologous SVF or allogeneic ASCs can be safely used in acupoint injection for treating hip dysplasia in dogs and represent an important therapeutic alternative for this type of pathology. Further studies are necessary to assess a possible advantage of SVF cells in treating joint diseases.
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    ABSTRACT: Gold bead implantation/gold acupuncture is becoming increasingly used in veterinary medicine as a method of pain treatment in cases of osteoarthritic diseases. Part one of the overview dealing with the use of gold implants as a treatment of canine hip joint dysplasia (cHD) introduced the method of implanting gold in tissue and publications which investigated the subsequent effects of implantation. This article focuses on publications concerning the clinical effectiveness of gold implantation within the scope of pain therapy in cHD. Due to the study design, a classification using evidence-based levels (EbL) was carried out. Three double-blind, placebo-controlled randomised studies (EbL II) were considered together with three retrospective studies on own patients (EbL IV) and five case studies (EbL IV). While the case and retrospective studies reported impressive therapeutic success in treating cHD-incurred pain with gold implantation, a pain-reducing effect through gold implantation was only demonstrated in one of the three double-blind studies. The two remaining EbL II studies found no differences between the placebo-group and the group of dogs treated with gold implantation. In one of these two studies, kinematic and kinetic gait analyses were used for objective evaluation of the effects of the treatment. Thus, the only study that carried out an objective evaluation of the therapeutic result of gold implantation came to the conclusion that the method is ineffective. For a concluding assessment of gold implantation in the case of cHD, gait analysis studies investigating the effects of gold implantation in comparison to a standard treatment with nonsteroidal anti-inflammatory drugs are currently lacking.
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