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Canine hip dysplasia (CHD) is a polygenic and multifactorial developmental disorder characterized by coxofemoral (hip) joint laxity, degeneration, and osteoarthritis (OA). Current diagnostic techniques are largely subjective measures of joint conformation performed at different stages of development. Recently, measures on three-dimensional images generated from computed tomography scans predicted the development of OA associated with CHD. Continued refinement of similar imaging methods may improve diagnostic imaging techniques to identify dogs predisposed to degenerative hip joint changes. By current consensus, joint changes consistent with CHD are influenced by genetic predisposition as well as environmental and biomechanical factors; however, despite decades of work, the relative contributions of each to the development and extent of CHD signs remain elusive. Similarly, despite considerable effort to decipher the genetic underpinnings of CHD for selective breeding programs, relevant genetic loci remain equivocal. As such, prevention of CHD within domestic canine populations is marginally successful. Conservative management is often employed to manage signs of CHD, with lifelong maintenance of body mass as one of the most promising methods. Surgical intervention is often employed to prevent joint changes or restore joint function, but there are no gold standards for either goal. To date, all CHD phenotypes are considered as a single entity in spite of recognized differences in expression and response to environmental conditions and treatment. Identification of distinct CHD phenotypes and targeting evidence-based conservative and invasive treatments for each may significantly advance prevention and management of a prevalent, debilitating condition in canine companions.
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Open Access Full Text Article
Diagnosis, prevention, and management
of canine hip dysplasia: a review
Emma R Schachner
Mandi J Lopez
Department of Veterinary Clinical
Sciences, School of Veterinary
Medicine, Louisiana State
University, Baton Rouge, LA, USA
Correspondence: Mandi J Lopez
Department of Veterinary Clinical
Sciences, School of Veterinary Medicine,
Louisiana State University, Skip Bertman
Drive, Baton Rouge, LA 70803, USA
Tel +1 225 578 9918
Abstract: Canine hip dysplasia (CHD) is a polygenic and multifactorial developmental disorder
characterized by coxofemoral (hip) joint laxity, degeneration, and osteoarthritis (OA). Current
diagnostic techniques are largely subjective measures of joint conformation performed at dif-
ferent stages of development. Recently, measures on three-dimensional images generated from
computed tomography scans predicted the development of OA associated with CHD. Continued
refinement of similar imaging methods may improve diagnostic imaging techniques to iden-
tify dogs predisposed to degenerative hip joint changes. By current consensus, joint changes
consistent with CHD are influenced by genetic predisposition as well as environmental and
biomechanical factors; however, despite decades of work, the relative contributions of each
to the development and extent of CHD signs remain elusive. Similarly, despite considerable
effort to decipher the genetic underpinnings of CHD for selective breeding programs, relevant
genetic loci remain equivocal. As such, prevention of CHD within domestic canine popula-
tions is marginally successful. Conservative management is often employed to manage signs of
CHD, with lifelong maintenance of body mass as one of the most promising methods. Surgical
intervention is often employed to prevent joint changes or restore joint function, but there are
no gold standards for either goal. To date, all CHD phenotypes are considered as a single entity
in spite of recognized differences in expression and response to environmental conditions and
treatment. Identification of distinct CHD phenotypes and targeting evidence-based conservative
and invasive treatments for each may significantly advance prevention and management of a
prevalent, debilitating condition in canine companions.
Keywords: canine hip dysplasia, orthopedics, joint, osteoarthritis
Canine hip dysplasia (CHD) is a complex developmental disorder characterized by joint
laxity and osteoarthritis (OA) in one or both coxofemoral (hip) joints (Figure 1A–C).1
The polygenic, multifactorial etiology2 of CHD has challenged veterinarians and
researchers since the condition was described in the 1930s.3 Joint changes characteristic
of CHD are also associated with environmental factors such as nutrition,4–6 exercise,7
and the process of skeletal ossification.8,9 The condition affects essentially all breeds,
with an estimated prevalence ranging from 1% to 80% according to the Orthopedic
Foundation for Animals. It appears to occur at a relatively high rate in large-bodied
and brachycephalic dogs as well as those with high body length to height ratios.10,11
The periodic appearance of OA in joints other than the coxofemoral joint12,13 has led
some to propose systemic contributions to CHD expression.1 These complexities,
among others, complicate attempts to manage the CHD by selective breeding despite
strict reporting and guidelines.14
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Schachner and Lopez
There are many theories to explain CHD joint degenera-
tion, but joint laxity and irregular or delayed endochondral
ossification are among the most popular. The conditions are
not mutually exclusive, and their phenotypic expression is
variable within and among breeds.15 Partially ossified hip
structures may become distorted during development due
to mechanical stresses in joints with delayed endochondral
ossification.8,16 Joint components may be more vulnerable to
deformation and damage from normal joint kinetics before
they are fully ossified.8,9,17 Abnormal and delayed endochon-
dral ossification in the coxofemoral joint has been identified
in 15-day-old dogs that developed CHD by the time they were
12 months old,8,9,18 and in Great Danes with experimentally
induced hip dysplasia.19 In contrast, comparably earlier joint
ossification appears to occur in Greyhounds, a breed with
one of the lowest incidences of CHD. While it is clear that
variation in the process of endochondral ossification may play
a role in the development of CHD, the exact relationships
between ossification patterns, abnormal joint structure, and
development of OA remain unclear.20
Affected joints usually develop varying degrees
of synovial inflammation, articular cartilage damage
( Figure 1), osteophytes, and subchondral bone sclerosis and
remodeling.21–23 While there is no single, overarching descrip-
tion of the sequence of events in the process, there are changes
that occur in many forms of dysplasia. Recently, the dorsal
acetabular rim angle (a measure of the dorsal slope [angle] of
the subchondral articular acetabular surface relative to hori-
zontal) was reported to be significantly larger (less femoral
head coverage by the acetabulum) in dogs with coxofemoral
joint laxity versus normal dogs as early as 1 week of age.17
Subluxation of the femoral head and delays in ossification
Figure 1 Anatomy of canine hip dysplasia.
Notes: (AC) Canine hip-extended radiographs, and corresponding images of the joints (DF) from different individuals demonstrating mild (A and D), moderate (B and E),
and severe (C and F) joint changes. Light photomicrographs of normal (G) and brillated (H, arrow) articular cartilage.
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Canine hip dysplasia
of the craniodorsal acetabular margin are often visible by
8 weeks, and, in many cases, subluxation of the femoral
head increases by around 12 weeks of age.18 Degeneration
and microfractures of the articular cartilage, and thickening,
inflammation, and deterioration of the joint capsule, tendi-
nous insertions, and ligaments are often apparent by 5 months
of age.18 Despite the presence of these degenerative traits in
many dogs with degenerative coxofemoral joint changes,
clinical signs are variable.21
A direct relationship between joint capsular collagen
composition and mechanical properties was proposed over
30 years ago.24 Altered capsular collagen composition has
been identified in children with congenitally dislocated
hips25 and dogs with hip joint laxity.26 Joint capsular collagen
fibrils were found to be more heterogeneous in 8-month-old
Labrador Retriever puppies with severe coxofemoral joint
laxity than those with normal joints.15 Abnormal collagen
composition is thought to contribute to reduced joint capsule
stiffness, which contributes to excess femoral head motion
and abnormal mechanical stresses on the femoral greater
trochanter and acetabular margins and cartilage.15 Over time,
the abnormal forces are thought to result in deformation of
the articulating structures and an incongruous joint.18
Despite almost a century of work, many aspects of the
development and progression of joint changes and OA associ-
ated with CHD remain elusive. This makes establishment of a
gold standard for treatment a challenge. The lack of a single,
predictable pattern of joint degeneration is likely a reflection
of natural variability, including individual responses to exter-
nal environmental influences. However, ambiguity in disease
progression may also reflect distinct disease processes that
have yet to be recognized. Continued efforts to identify and
characterize patterns in joint changes may lead to identification
of CHD phenotypes, which will, in turn, contribute to earlier
disease identification and more effective targeted treatments.
Despite some recognized patterns of joint degeneration
characteristic of CHD, there is significant variability in the
progression and ultimate severity of the disease as well as
inconsistent relationships between gross and radiographic
joint changes and clinical signs.21 There are, however, two
general behaviors often attributed to CHD, including lame-
ness in young dogs (under 1 year), that increases with activity
or trauma, and gait abnormalities and hind limb muscle atro-
phy in older dogs.27 Notably, hind limb lameness can be due
to reasons other than CHD joint changes, including pelvic,
distal hind limb, and neurological pathologies, metabolic
bone disease, ligament rupture, patellar luxation, and spine
disorders.27 Hence, a thorough, comprehensive assessment is
paramount to identification of the source of discomfort.
Subjective laxity examinations
The Ortolani test is a subjective evaluation of coxofemoral joint
laxity originally designed for diagnosis of human congenital
hip dislocation in the 1930s.28,29 The test is also used as a CHD
screening test.28 Dogs are placed in lateral recumbency; one
hand of the examiner is used to apply force along the length of
the femur from the stifle toward the pelvis as the other braces
the back just above the sacrum (Figure 2).27 This maneuver is
intended to displace the femoral head. The stifle is then slowly
abducted to reduce the joint.29 An audible or palpable pop as the
femur slips back into the acetabulum is considered a positive
Ortolani sign indicative of joint laxity. Lack of an Ortolani
sign does not necessarily mean that the hip is normal. Joint
changes associated with dysplasia, like thickening of the joint
capsule and joint tissue, may interfere with the displacement
required for a positive sign.28,30 Bardens’ test,31 an examination
technique designed to evaluate the hips of babies (aged younger
than 6 months), is thought to be more sensitive for detecting
coxofemoral joint laxity and/or shallow acetabula in puppies
6–8 weeks of age.29 With the dog in lateral recumbency, the
proximal femur is elevated laterally from the body. With the
femur elevated, the index finger of the other hand is used to
push the femur away from the joint in a dorsal direction with
pressure on the greater trochanter. More than 2 mm of displace-
ment is considered a positive sign.31 In general, these and other
palpation techniques may be used as part of a comprehensive
examination on puppies or dogs suspected to have excessive
joint laxity characteristic of CHD. However, the tests alone are
not sufficient for diagnosis of CHD.
Radiography has long been the gold standard to assess
and quantify joint changes associated with CHD joint
remodeling.32,33 Worldwide, there are five popular, standard-
ized evaluation systems with distinct metrics that are used to
grade canine radiographic coxofemoral joint conformation
and degenerative changes.
Orthopedic Foundation for Animals
The Orthopedic Foundation for Animals evaluation is
performed on hip-extended radiographs performed under
heavy sedation or general anesthesia by three independent
board-certified radiologists.10 Based on subjective assess-
ment of nine joint parameters (Figure 3A), conformation
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Schachner and Lopez
is categorized as excellent, good, fair, borderline, mild,
moderate, or severe. The first three categories are considered
to be normal while the last three are dysplastic.10 Metrics
are largely subjective assessments of hip conformation and
evidence of degenerative joint disease.
British Veterinary Association/Kennel Club
The British Veterinary Association/Kennel Club maintains a
“pass/fail” evaluation system that was instituted in 1965 and
updated in 1984.34 For scoring, dogs must be at least 1 year
of age, microchipped (or tattooed), and, if registered with the
Kennel Club, the registration number must be included on the
radiograph.35 Each dog has one opportunity to be scored by the
system. Joints are individually scored on nine criteria from 0 to
5 or from 0 to 6 on hip-extended radiographs by two qualified
radiologists on a British Veterinary Association/ Kennel Club
panel, with 0 being the best score and 106 the worst (53 possible
points for each hip).34 The nine criteria ( Figure 3B) include the
Norberg angle (Figure 3C) and subjective assessments includ-
ing subluxation, dorsal acetabular edge, cranial acetabular
edge, cranial effective acetabular rim, acetabular fossa, femoral
head recontouring, and femoral head and neck exostosis.34,35
An average score for each individual dog breed is published,
ie, the breed mean score, and it is recommended that only
animals with total scores well below the breed mean be used
for breeding purposes.35
Fédération Cynologique Internationale
The Fédération Cynologique Internationale (FCI)36 is one
of the largest canine organizations in the world and includes
kennel clubs from across Europe, Asia, Africa, and South
America. Extended hip and abducted hind limb radiographs
performed at 1 year of age (18 months for large breed dogs)
are scored according to the official FCI system by radiologists
approved by breed-specific kennel clubs.36 Scoring includes
the Norberg angle, formed by a horizontal line connecting
the centers of the right and left femoral heads and a line con-
necting each center to the cranial margin of the corresponding
acetabulum (Figure 3C)37 as well as subjective hip conforma-
tion parameters. Each joint is assigned a grade of A–E, with
A representing healthy and E representing severe dysplasia.
The more dysplastic of the two joint scores is considered the
Cartilaginous labrum
Femoral head
Joint capsule
Figure 2 Schematic illustration of the Ortolani test.
Notes: Image demonstrates the coxofemoral joint prior to distraction (A), while force is applied from the stie toward the hip along the axis of the femur to displace the
femoral head (B), during abduction of the femur to reduce the joint (C), and with the femoral head snapping back into place with an audible click, ie, the Ortolani sign (D).
Arrows indicate the direction of the applied force. Adapted from Chalman JA, Butler HC. Coxofemoral joint laxity and the Ortolani sign. Journal of American Animal Hospital
Association. 1985;21:671–676.28
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Canine hip dysplasia
final score for the individual dog. The same grading scale can
also be applied to computed tomography (CT) scans.
Pennsylvania Hip Improvement Program
University of Pennsylvania researchers developed a quantita-
tive method to evaluate canine hip conformation38–40 that was
implemented in 1994.41 The primary distinction of the Penn-
sylvania Hip Improvement Program (PennHIP) method is that
passive hip joint laxity is measured in addition to subjective
radiographic conformation.38–40 Three radiographic views
are evaluated by PennHIP-certified radiologists: a standard
hip-extended view for evidence of degenerative joint disease;
a compression view for congruity between the femoral head
and acetabulum; and a distraction view, for joint laxity. The
distraction index is the ratio of the distance between the
centers of the femoral head and acetabulum (d) and the radius
of the femoral head (r), as shown in Figure 3D. The closer the
score is to 0, the better the fit, ie, minimal femoral distrac-
tion, but a score of 1 indicates severe laxity and associated
femoral distraction.41 Recently, the PennHIP distraction index
and OA scores were found to have strong correlations with
microstructural changes in the articular cartilage,42 potentially
indicating a relationship between joint laxity measured by
this technique and articular surface degeneration.
Dorsolateral subluxation
Dorsolateral subluxation is used to quantify joint laxity in
a position to simulate weight-bearing (Figure 3E). During
Figure 3 Representations of anatomical landmarks and evaluation mechanisms to assess canine hip dysplasia.
Notes: Coxofemoral joint anatomical characteristics considered by the Orthopedic Foundation for Animals (A): craniolateral acetabular rim (1), cranial acetabular margin
(2), femoral head (3), fovea capitis (4), acetabular notch (5), caudal acetabular margin (6), dorsal acetabular margin (7), junction of femoral head and neck (8), and trochanteric
fossa (9). (B) British Veterinary Association/Kennel Club canine coxofemoral joint characteristics scored during evaluation.10,34 Schematic superimposed on a hip-extended
radiograph demonstrating the Norberg angle (C, arrow). Illustration of the Pennsylvania Hip Improvement Program (distraction index, the distance between the centers of
the femoral head and acetabulum during distraction (D) divided by the radius (r) of the femoral head (d).41 Depiction of the dorsolateral subluxation score (E) calculated as
100 multiplied by the percentage of femoral head medial to the cranial acetabular rim (d) divided by the femoral head diameter (θ), d/θ ×100%).
Abbreviations: AF, acetabular fossa; An, acetabular notch; CaAE, caudal acetabular edge; CrAE, cranial acetabular edge; CrEAR, cranial effective acetabular rim; DAE, dorsal
acetabular edge; Fh, femoral head; Fv, foveal defect.
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Schachner and Lopez
general anesthesia, pressure is applied to the femur at the level
of the stifle while imaging the dog in ventral recumbency.43
Joints with less than 45% coverage of the femoral head
by the lateral aspect of the cranial acetabular rim have an
increased chance of developing joint changes and OA over
time compared with those with a higher percentage (.55%)
of coverage.43
Subjective radiographic evaluations are limited by
the inherent variability associated with examiners, image
quality, and differences between animals including periar-
ticular soft tissue changes and muscle atrophy. Variation in
the degree of muscle relaxation associated with sedation
or anesthesia during imaging can influence the ability to
identify joint abnormalities by as much as 50%.44 Further,
each evaluation system is distinct, so results are based on
slightly different criteria. Recently, the Orthopedic Founda-
tion for Animals score was reported to underestimate the
likelihood of developing coxofemoral joint OA compared
to the PennHIP distraction index.45 Reporting mechanisms
also vary widely in public access to individual scores for
reproduction decisions. As with any measure, radiographic
hip scores should not be used in isolation to evaluate and
predict current and future joint structure and function. It
is possible that the presence of OA at a young age may be
indicative of rapidly progressive joint disease, and, given
recognition of the genetic basis for the disease, consider-
ation of the presence and extent of CHD signs in related
individuals is likely warranted. Based on this information,
it is clear that continued efforts to identify mechanisms for
early and accurate CHD diagnosis are of utmost importance.
Adaptation of knowledge from decades of research to emerg-
ing imaging modalities will, no doubt, continue to improve
upon current standards.
Computed tomography
CT technology for pelvic imaging has improved consider-
ably over the past few decades. While radiographs remain
the primary method used to image canine coxofemoral
joints, CT is becoming increasingly popular. Using three-
dimensional CT models, a recent longitudinal study showed
that volumetric changes in the acetabulum and proximal
femur occurred in a predictable manner during skeletal
growth in a colony of dogs with coxofemoral joint laxity.46
Another study demonstrated that two-dimensional CT images
and three-dimensional models created from CT images
can be used to predict the presence of joint OA at matu-
rity.47 Two-dimensional CT measures included the percent
femoral head coverage, acetabular index, and the following
angles: acetabular anteversion, ventral, dorsal, and horizontal
acetabular sector, center edge, and horizontal toit externe
(Figure 4). Measures on three-dimensional models included
femoral head and neck volumes, femoral head and neck radii
and femoral neck angle (Figure 4). The 16-week distraction
index and center edge angle combination was the best pre-
dictor of mature OA, whereas the 32-week dorsal acetabular
sector angle and Norberg angle combination was the most
effective predictor of the presence of OA at maturity. Hence,
combined measures were the best mechanism for predicting
development of OA, and the combinations varied with age.
In a separate study, numerous measures were performed on
pelvic CT scans of beagles and mixed breed dogs at various
time points between the ages of 2 months and 1 year to assess
the relationship of the measures with joint laxity.17 The dorsal
acetabular rim angle and center distance index (the distance
between the femoral head and the center of the acetabulum,
divided by the radius of the femoral head, or the PennHIP41
distraction index) were found to be good indicators of joint
laxity and dysplastic changes.17 Magnetic resonance imag-
ing is used to evaluate the three-dimensional structure of
human articular soft tissues, and relatively recently, canine
articular soft tissues,48 but CT is best for bone structure,49
and the cost of magnetic resonance imaging for screening
may be prohibitive. As technology advances, and CT and
magnetic resonance imaging become more readily available
and affordable, use of three-dimensional imaging method-
ologies will likely become an integral part of diagnosis and
assessment of CHD.
Therapeutic management
and intervention
Conservative management
There are numerous descriptions of multifactorial systems,
with numeric, visual analog, and descriptive scales to repro-
ducibly evaluate joint pain associated with CHD.50 Many of
the assessments within the systems are subjective evalua-
tions of individual behavior or responses, and there is no
single gold standard with which to quantify hip pain in the
dog.50 While efforts continue to establish a uniform, standard
evaluation system for canine hip joint pain, those systems
that include multiple subjective and objective assessments
by individuals who are not aware of specific treatments or
conditions, are often informative.
Conservative management of CHD generally consists
of a combination of mechanisms to reduce progression of
joint damage and alleviate discomfort.51 Nonsteroidal anti-
inflammatory drugs are commonly used for pain associated
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Canine hip dysplasia
Figure 4 Measurements and three-dimensional models for evaluating the dysplastic canine hip.
Notes: (A) Volume rendered model of the canine pelvis generated from two-dimensional computed tomography images (B and C). The blue line in (A) indicates the level
of the cross-sectional image in (B) and (C). (B) and (C) Representative measures performed on two-dimensional computed tomographic images of the canine coxofemoral
joint. Acetabular index is the ratio between the width and the depth of the acetabulum; d/w ×100. For further information see Lopez et al42 and Andronescu et al.47 For
details on these measures see Lopez et al.42
Abbreviations: AAA, acetabular anteversion angle; AI, acetabular index; CEA, center edge angle; CPC, percentage of femoral head coverage; DASA, dorsal acetabular
sector angle (dorsal coverage of the femoral head); HASA, horizontal acetabular sector angle (total acetabular coverage of the femoral head); HTEA, horizontal toit externe
angle (orientation of the acetabulum); VASA, ventral acetabular sector angle (ventral coverage of the femoral head).
with severely arthritic joints in dogs.52 Numerous studies
indicate that achieving and maintaining a healthy body
weight contributes to delayed onset and reduced clinical signs
associated with hip joint pain.4,5,53 Various food supplements
reported to alleviate signs of coxofemoral joint pain from OA
range from green-lipped mussels (Perna canaliculus)54 to
fish oil.55 Polysulfated glycosaminoglycan supplements and
injections have been recommended for prevention and treat-
ment of OA in dogs and other mammals.56–59 Intramuscular57
and intra-articular administration has also been reported,56
but responses vary.51 Alternative methods that have also been
investigated for the treatment of painful CHD joints include
acupuncture and gold bead implantation, among others. The
implantation of gold beads at acupuncture points was devel-
oped in the USA in the 1970s and implemented to a limited
degree in veterinary medicine in the 1990s for degenerative
joint disease pain.60,61 Results are mixed, with some studies
showing clinical improvement61,62 and others showing no
discernible effect.63
Maintenance of optimum body weight has long been
considered one of the most effective methods for reducing the
signs associated with dysplasia and OA.4 A lifelong dietary
restriction of 25% delayed the appearance of OA as well as the
intensity of clinical signs in Labrador Retrievers compared
with feeding ad libitum.53 Weight loss in conjunction with
physiotherapy that included transcutaneous electrical nerve
stimulation improved the clinical outcome for obese dogs
with radiographic signs of OA.64 Recently, intra-articular
botulinum toxin A was reported to reduce the pain associated
with OA based on improvements in limb use (ie, gait pat-
terns) measured with a force platform.65 At present, there are
few reports of long-term studies concerning the efficacy of
nonsurgical or conservative treatment of CHD joint changes.
These studies can be limited by the challenges of consistent
monitoring and reporting by multiple and individual owners,
as well as a wide range of disease severity and canine per-
sonalities.66 However, a recent retrospective report indicates
that conservative and nonsurgical management (ie, weight
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Schachner and Lopez
control, reduced exercise, and analgesics) of 74 dogs over the
span of 13 years did not improve quality of life as anticipated
from previous reports.66
There is significant interest in the use of regenerative
medicine to treat signs of CHD and OA; however, much of
the information reported is subjective in nature. Currently,
numerous controlled, preclinical and clinical trials are under-
way that may provide some perspective on the value of this
emerging technology. Intra-articular injection of adipose-
derived stem cells has been found to be a safe therapeutic
approach for the treatment of symptoms associated with
OA.67 Preliminary studies show that injection of adipose-
derived stem cells into affected joints may reduce clinical
signs of hip pain (ie, lameness) based on subjective clinical
evaluations67 and force platform gait analysis.68,69 A random-
ized comparison between a single intra-articular injection of
adipose-derived stem cells or plasma rich in growth factors
showed that both treatments reduced behavior associated with
pain, but that the adipose-derived stem cells appeared to be
more effective for up to 6 months post-treatment based upon
owner assessments.70 This information clearly demonstrates
that there is more work to be done on the efficacy of conserva-
tive and alternative methods to manage signs of CHD.
Despite the prevalence of CHD, a gold standard surgical pro-
cedure has yet to be identified.71 As such, there are numerous
surgeries to prevent progression of degenerative joint changes
or alleviate pain and restore joint function.
Some surgical procedures designed to prevent onset of OA
in hips identified as being predisposed to development of OA72
include double and triple pelvic osteotomy, acetabular shelf
and excision arthroplasty, femoral osteotomy, and juvenile
pubic symphysiodesis.73 Both juvenile pubic symphysiodesis
and triple pelvic osteotomy are designed to increase femoral
head coverage by ventrolateral rotation of the acetabulum. The
juvenile pubic symphysiodesis procedure involves premature
closure of the pubic symphysis.72,74 Resulting reduction in
the pelvic inlet width causes ventrolateral rotation of the
acetabulum during pelvic growth, and is thought to result in
a 40%–46% improvement in acetabular and dorsal acetabu-
lar rim angles compared to no treatment.73–75 Juvenile pubic
symphysiodesis appears to have the best outcomes when per-
formed in puppies that are 12–16 weeks old.73 Triple pelvic
osteotomy is a much more extensive procedure, and involves
osteotomies of the ilium, pubis, and ischium to allow manual
rotation of the acetabulum for better femoral head coverage.76
The ilial osteotomy is stabilized with bone plates customized
to accommodate the rotation.77 This procedure is generally
recommended for young dogs without irreversible (or with
mild) degeneration of the coxofemoral joint.77,78 Information
about long-term outcomes of the various surgical treatments
is limited. Preliminary reports indicate that juvenile pubic
symphysiodesis and triple pelvic osteotomy minimally affect
laxity and femoral head coverage when performed at 5 months
or older72 compared with earlier reports indicating that the
procedure performed slightly earlier (15 weeks) improved
acetabular coverage of the femur.75 Mechanisms to reduce the
OA characteristic of CHD will undoubtedly improve quality of
life for affected dogs. Long-term outcomes will help identify
treatments toward this end.
Total hip replacement (Figure 5) is often applied in
advanced cases of joint degeneration and is considered a
salvage procedure.79 There are no clear guidelines for the
best time to implement total hip replacement, but the aver-
age time between onset of signs and surgery is 10 months.80
Total hip replacement procedures in dogs began in the 1970s,
and a modular system was introduced in the mid 1990s that
coupled a fixed monobloc cobalt-chromium alloy femoral
implant with an acetabular cup for cemented fixation.81
Further refinements to total hip replacement implants have
contributed to a high clinical recovery rate, with loosening of
the acetabular cup and cup wear reported as some of the most
common complications.81 More recently, cementless fixation
has been developed, and is reported to have positive results.79
As the name implies, femoral and acetabular implants are
cemented to bone for cemented total hip replacement. In
contrast, cementless fixation or uncemented implants are
designed so that the bone grows into or onto the prosthesis
without the need for cement at the bone–implant interface.
Implant loosening is reported to be less than for cemented
implants.79,82 A primary concern associated with total hip
replacement is the potential for an inflammatory response
Figure 5 Radiograph illustrating a bilateral total hip replacement.
Notes: Blue line indicates femoral implant, pink line indicates acetabular implant.
Image courtesy of Dr Jeffrey D Brourman.
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Canine hip dysplasia
to implant particulate wear debris from aseptic implant
loosening.83 Another consideration is that the persistence
of joint laxity may influence the outcomes of total hip
replacement.84 Efforts continue to improve upon available
total hip replacement implants for dogs. A hybrid system of
a cementless acetabular cup and a cemented femoral implant
has been successfully applied in dogs relatively recently.85
Hip resurfacing to replace only joint surfaces versus the
entire joint86 in dogs is under development, but clinical
trials have yet to be reported.81 Unfortunately, large-scale,
prospective randomized studies have yet to be conducted
for comparison of long-term outcomes for various surgical
procedures and nonsurgical management. Hence, individu-
alized care remains largely based on clinician preference
and experience.71
While diagnosis and treatment of CHD are central to indi-
vidual patient care, prevention by selective breeding will help
obviate the presence of a debilitating condition in canine
companions. With this in mind, there has been significant
effort focused on identifying specific genes, genetic muta-
tions, and quantitative trait loci (regions of chromosomes
containing DNA for a specific trait), to use in conjunction
with standard imaging methods for identification of CHD
carriers.87,88 Genetic screening programs are complicated
by the polygenic nature of CHD and related OA, as well as
environmental influences on phenotypic expression. A few
promising quantitative trait loci for OA associated with
CHD89 and the CHD phenotype in German shepherds90
have been identified relatively recently. Additionally, several
chromosomal markers for CHD have been reported for a
population of cross-bred Labrador Retriever–Greyhounds.91
Notably, several specific single nucleotide polymorphisms
and positional candidate genes in dogs with CHD have been
found to correlate with genes associated with the expression
of OA and developmental dysplasia of the hip in humans.87
While the genomic underpinnings of CHD remain largely
elusive, significant progress has been made and will continue,
with expanding knowledge of the canine genome and interac-
tions among genes that influence their expression.
Future directions
Despite almost a century of research, the complex etiology
and optimal treatment paradigm for CHD remain elusive.
As originally proposed by Schnelle at a meeting of the
Veterinary Medical Society of New York City in the 1930s,92
CHD is not likely a single affliction but an array of heritable
and environmentally induced degenerative disorders that
differentially affect the morphology and function of the
canine hip. The variable phenotypic expression of CHD
makes development and implementation of standard iden-
tification procedures difficult. It may be possible to identify
specific phenotypes within the broad spectrum of CHD
similar to those of the human hip, like acetabular rim syn-
drome, acetabular retroversion, and femoral head necrosis.
The relationship between articular damage in the human
hip with morphology suggests a need to evaluate similar
relationships in the dog.93 Identification and characteriza-
tion of CHD phenotypes at the genetic, microstructural, and
macrostructural levels will likely contribute to early detec-
tion and informed breeding decisions. Another area that will
continue to promote progress in both imaging and treatment
is development of novel measures on images obtained with
contemporary imaging modalities like CT and magnetic
resonance imaging. As evidence-based assessments of CHD
prevention and treatment strategies become available, their
selection and implementation will improve and facilitate
the development of novel clinical approaches and surgical
procedures. Incremental advances in the diagnosis, treat-
ment, and prevention of the joint degeneration and pain
associated with CHD through focused research and clinical
evidence will continue to progress toward diminishing and
eradicating CHD from our canine companions.
The authors report no conflicts of interest in this work.
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Schachner and Lopez
... Hip dysplasia (HD) is a hereditary disease characterized by abnormal development, instability, and varying degrees of looseness in the hip joints (GENEVOIS et al., 2020, SCHACHNER & LOPEZ, 2015. It is a limiting condition that causes pain and physical disability, which over time, leads to wearing of the joint surfaces, progressive remodeling of the hip structures, and subsequent development of osteoarthritis (OA) (GINJA et al., 2010). ...
... Siqueira et al. includes exercise restriction, weight loss, analgesics, and chondroprotective agents, focuses on controlling pain and delaying degenerative changes. However, its effectiveness is controversial (SCHACHNER & LOPEZ, 2015). Surgical treatment is performed when OA is present, and procedures include hip replacement, acetabular denervation, and femoral head and neck excision. ...
... Surgical treatment is performed when OA is present, and procedures include hip replacement, acetabular denervation, and femoral head and neck excision. However, these procedures are costly and have varying degrees of success (GINJA et al., 2010, BERGH & BUDSBERG, 2014, SCHACHNER & LOPEZ, 2015. ...
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This study assessed the efficacy of an intra-articular injection of allogeneic adipose tissue-derived from mesenchymal stem cells (AD-MSCs) for the treatment of hip dysplasia in dogs. The study group included 12 otherwise healthy dogs of different breeds, ages, weights, and degrees of hip dysplasia diagnosed using radiography. An orthopedic assessment was performed on all dogs before and at 30, 60, and 90 days after infusion of AD-MSCs(2 × 106cells). On the same days, each dog’s owner answered a questionnaire based on theHelsinkiChronic Pain Index. The data were converted to ordinal data based on the score for each variable, and the Friedman test for multiple comparisons was used to verify the results. Compared with the corresponding values on day 0, orthopedic and gait assessments and owners’ reported pain indexes improved over the 90-day observation period. These results suggested that treatment with allogeneic AD-MSCs significantly reduced the clinical signs associated with hip dysplasia during the study period. However, long-term studies are needed to determine the optimal therapeutic protocol for routine clinical use of AD-MSCs in hip dysplasia.
... Radiography has remained the established imaging technology for diagnosing CHD, as it plays an important role in the selection of breeding stock with the aim of reducing the incidence of the disease in offspring [1,2]. In general, there is not a consistent relationship between clinical signs and radiographic joint changes [5,6]. The ventrodorsal hip extended (VDHE) view is recommended worldwide for CHD screening [7]. ...
... However, in young animals, a ventrodorsal hip stress view can also be used to evaluate the hip joint laxity [1,2]. Hip laxity is considered a main risk factor for CHD, but there are some important differences in the progression and final severity of CHD [5,6]. An image of good technical quality of the VDHE view requires radiographic images without pelvic tilting and with adequate femur extension and alignment [7]. ...
... We strongly advocate that this parameter should never be used by itself to classify hips, but rather in complementarity with other parameters. On the other hand, given the recognized variability that exists in the progression of CHD, femoral neck bone modeling, and femoral head size, it is expected that more robust FNTi results will be obtained if a study is performed using only one breed in the sample [5]. ...
Full-text available
The alteration in the shape of the femoral neck is an important radiographic sign for scoring canine hip dysplasia (CHD). Previous studies have reported that the femoral neck thickness (FNT) is greater in dogs with hip joint dysplasia, becoming progressively thicker with disease severity. The main objective of this work was to describe a femoral neck thickness index (FNTi) to quantify FNT and to study its association with the degree of CHD using the Fédération Cynologique Internationale (FCI) scheme. A total of 53 dogs (106 hips) were randomly selected for this study. Two examiners performed FNTi estimation to study intra- and inter-examiner reliability and agreement. The paired t-test, the Bland-Altman plots, and the intraclass correlation coefficient showed excellent agreement and reliability between the measurements of the two examiners and the examiners’ sessions. All joints were scored in five categories by an experienced examiner according to FCI criteria. The results from examiner 1 were compared between FCI categories. Hips that were assigned an FCI grade of A (n = 19), B (n = 23), C (n = 24), D (n = 24), and E (n = 16) had a mean ± standard deviation FNTi of 0.809 ± 0.024, 0.835 ± 0.044, 0.868 ± 0.022, 0.903 ± 0.033, and 0.923 ± 0.068, respectively (ANOVA, p < 0.05). Therefore, these results show that FNTi is a parameter capable of evaluating proximal femur bone modeling and that it has the potential to enrich conventional CHD scoring criteria if incorporated into a computer-aided diagnosis capable of detecting CHD.
... It occurs under the influence of hereditary and environmental factors [2,3] and is more prevalent in medium-and large-sized dog breeds [4,5]. Affected animals may show clinical signs, such as lameness of the hind limbs, exercise intolerance, bunny hopping gait, and muscular atrophy [6]. ...
... The radiographic images were evaluated by three independent radiologists with extensive experience in the interpretation of hip dysplasia, who were blinded to the patient's history. The joints were classified individually according to the OFA grade: excellent (1), good (2), fair (3), borderline (4), mild (5), moderate (6), and severe (7). Joints were classified as non-dysplastic when two or three raters agreed to classify the joint as non-dysplastic (excellent, good, fair), or dysplastic when they agreed with the disease classification (mild, moderate or severe). ...
Full-text available
Background Canine hip dysplasia is a common orthopedic disease in veterinary practice. The diagnosis is made by radiographic examinations that evaluate bone alterations associated with hip dysplasia. Although radiographic examination is the gold standard for diagnosis, it does not allow a detailed evaluation of soft tissues such as the joint capsule and periarticular muscles. This study aimed to evaluate the accuracy of B-mode ultrasonography and acoustic radiation force impulse (ARFI) elastography in assessing the joint capsule and periarticular muscles of dogs using the Orthopedic Foundation of Animals (OFA) classification and the distraction index (DI) in the early and late diagnosis of hip dysplasia. This study sought to propose a protocol for the ultrasonographic evaluation of the structures involved in canine hip dysplasia. Methods Radiographic and ultrasonographic evaluations were performed on 108 hip joints of 54 dogs. Thirty dogs were older than 2 years and 24 were aged between 4 and 10 months. Results It was verified that an increase in pectineus muscle stiffness (cutoff value > 2.77 m/s) by elastography in some dysplastic dogs and an increase in the thickness of the joint capsule (cutoff value > 0.9 mm) in B-mode ultrasonography, were associated with a distraction index > 0.5, with both having a positive correlation. In B-mode ultrasonographic evaluation, the presence of signs of degenerative joint disease, such as irregularities of the cranial edge of the acetabulum and femoral head, were associated with a distraction index > 0.5 in canines, with a specificity of 94%. In adult dogs, the findings of degenerative joint disease on ultrasound were associated with a diseased OFA classification (P < 0.05). Measurement of the joint capsule > 1.10 mm was diagnostic for dysplasia in unhealthy dogs by OFA. Conclusions ARFI elastography has shown that the pectineus muscle may experience changes in stiffness in dysplastic animals. Additionally, changes in joint capsule thickness can be identified in B-mode in young and adult dogs with dysplastic joints, which contributes to the diagnosis of hip dysplasia.
... the articulation area, which leads to the overloading of certain areas within the joint resulting in synovial inflammation, articular cartilage damage, osteophytes formation, subchondral bone sclerosis, and remodeling. 9 Since the joint's morphological, molecular, biochemical, and biomechanical abnormalities result in significant loss of articular cartilage components, these substances can be considered markers of osteoarthritis and a sign of hip dysplasia. 10,11 Biochemical markers represent a direct or indirect measure of the joint environment that reflects the metabolism (anabolism and catabolism) of tissue at the time of sample collection. ...
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OBJECTIVE Canine hip dysplasia (CHD) is a global disease and an improved diagnostic approach to this orthopedic condition is needed, with an emphasis on inexpensive and minimally invasive techniques. This research aimed to determine the differentiating potential of selected biochemical markers in serum between healthy dogs and dogs with hip dysplasia in a breed-specific study that involved the Tornjak dog population. ANIMALS 99 Tornjak dogs radiographically categorized (Federation Cynologique Internationale procedure and scoring scheme) between December 2019 and April 2021, as having no sign of hip dysplasia or near normal hip joints (nondysplastic group; n = 51) vs mild, moderate, or severe hip dysplasia (dysplastic group; 48). METHODS Serum concentrations and enzyme activity of the biochemical markers hyaluronic acid (HA), procollagen II C-terminal propeptide (PIICP), and metalloproteinase 9 (MMP9) were compared among adult dogs with or without radiographic hip dysplasia. Statistical tests used to examine the differentiating potential of biochemical markers in Tornjak dog groups were assessed using the Mann–Whitney U test, logistic regression, and receiving operating characteristics (ROC) analysis. RESULTS Tornjak dogs with radiographic CHD had significantly lower serum concentrations of HA and higher concentrations of PIICP and MMP9 activity compared to dogs with radiographically normal hips ( P < .05). Selected biochemical markers could distinguish dogs with radiographic CHD from those without CHD with high sensitivity and specificity. CLINICAL RELEVANCE These data suggest that the diagnostic technique of measuring serum concentrations of HA, PIICP, and MMP9 activity has a selective ability to distinguish dogs with dysplastic from dogs with normal hips.
... Osteoarthritis is one of the prevalent diseases in geriatric dogs, which usually results in chronic pain and decrease or loss of function (1)(2)(3). Conservative management of canine osteoarthritis uses long term non-steroidal anti-inflammatory drugs (NSAIDs) in order to reduce inflammation and control pain (4)(5)(6)(7). However, NSAIDs may not be sufficient to control pain and their long-term use can be associated with gastrointestinal, hepatic, and renal adverse effects (7)(8)(9). ...
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Introduction Osteoarthritis is a common disease in dogs resulting in chronic pain and decreased wellbeing. Common analgesics such as non-steroidal anti-inflammatories may fail to control pain and can produce major adverse effects. Study objectives were to evaluate pharmacokinetics, therapeutic efficacy, and safety of subcutaneous liposomal-cannabidiol (CBD) as an additional analgesic therapy in dogs suffering from naturally-occurring osteoarthritis. Methods Six such dogs were recruited following ethics approval and owner consent. Dogs were administered a single subcutaneous injection of 5 mg/kg liposomal-CBD. Plasma concentrations of CBD, blood work, activity monitoring collar data, wellbeing questionnaire (owners) and pain scoring (veterinarian) were performed at baseline and monitored up to six weeks following intervention. Data overtime were compared with baseline using linear-regression mixed-effects. P -value was set at 0.05. Results CBD plasma concentrations were observed for 6 weeks; median (range) peak plasma concentration (C max ) was 45.2 (17.8–72.5) ng/mL, time to C max was 4 (2–14) days and half-life was 12.4 (7.7–42.6) days. Median (range) collar activity score was significantly increased on weeks 5–6; from 29 (17–34) to 34 (21–38). Scores of wellbeing and pain evaluations were significantly improved at 2–3 weeks; from 69 (52–78) to 53.5 (41–68), and from 7.5 (6–8) to 5.5 (5–7), respectively. The main adverse effect was minor local swelling for several days in 5/6 dogs. Conclusion Liposomal-CBD administered subcutaneously produced detectable CBD plasma concentrations for 6 weeks with minimal side effects and demonstrated reduced pain and increased wellbeing as part of multimodal pain management in dogs suffering from osteoarthritis. Further placebo-controlled studies are of interest.
... Canine Hip Dysplasia (CHD) is a complex developmental disorder characterized by joint laxity and osseo Arthritis (OA) in one or both coxofemoral joints. The etiology of CHD is polygenic, multifactorial and occurs at a relatively high rate in large-bodied and brachycephalic dogs as well as those with high body length to height ratios (Schachner and Lopez, 2015). It is one of the most commonly diagnosed orthopaedic diseases in dogs. ...
Background: Most of the biomarkers used in joint disease are articular cartilage components such as chondroitin sulphate (CS), keratan sulphate (KS), hyaluronic acid (HA), or type II collagen. Some of these biomarkers, alone or together, could have the potential to provide clinically useful indices of the effects of isolated joint injury, the progression of joint changes and/or the response to therapy. Serum concentration of HA were elevated in human patients with osteoarthritis which increase is considered a reliable biomarker reflective of cartilage damage and synovitis in these patients. Methods: Blood samples were collected from all the dogs and serum concentration of hyaluronic acid was determined by Canine Hyaluronic Acid Elisa kit (catalogue No.ITE070452), SIZE -96T, Reactivity: Canine, Range: 2 ng/ml -700ng/ml and sensitivity: 1.04 ng/ml, supplied by G Biosciences. Result: Serum concentration of HA were lower in dogs aged between 0 to 12 months with CHD when compared to dogs of similar age with healthy hip joints and that this significant decrease in serum HA in dogs can be considered a reliable biomarker reflective of CHD and serum HA levels can be used as an effective biomarker for osteoarthritis in dogs with CHD.
... ischiofemorale) with fixation on the caudal side of the joint capsule and the pubofemoral ligament (Lig. pubofemorale) with fixation on the ventral side of the joint capsule; which are some soft tissue structures, deriving from the joint  PhD student capsule in the form of bundles of fibers with a role in the connection between bone surfaces [9,10]. ...
... Osteoarthritis (OA) is a disease that causes pain in the synovial joints and its surrounding tissues, but it is most frequently linked to the degeneration and functioning of articular cartilage (1). Joint mobility and OA in one or both of the coxofemoral (hip) joints are hallmarks of the complicated developmental condition known as hip dysplasia (HD) (2). Painkillers such as anaesthetics/ opioids / NSAIDs are short-term solutions for reducing pain. ...
In veterinary medicine, Osteoarthritis, Hip Dysplasia and pain disorders are commonly diagnosed conditions, and it presents significant difficulties for the well-being of canines. The aim of this case series is to report the use of full spectrum medical cannabis (vijaya) for treating symptoms such as pain, inflammation, impaired mobility. Four Labrador breed patients between 6 years to 8 years, suffering from acute mobility issues were diagnosed with OA and HD. All patients were administered 4 drops of the full spectrum oil, orally, twice daily. After one month of the treatment, there was significant change in the pain markers with improved mobility. The recommended dose is 0.16 mg/kg/body wt for management of OA and HD related pain and inflammation. A boost in appetite and quality of life was also observed. In the future it is important to incorporate new treatment options in the medical practice and further research needs to be conducted on its use for other illnesses and animal species.
... Of the animals that practiced Canicross with some type of injury, only elbow dysplasia was mentioned in this study, contrary to the work of Lafuente & Whyle (2018) who pointed out four animals, out of a total of 160, that presented hip dysplasia (6.4%). Schachner & Lopez (2015) demonstrated that hip dysplasia is the most prevalent orthopedic disease and that elbow dysplasia can be an underreported comorbidity, so its diagnosis would be lower when compared to Hip Dysplasia. It is not possible to determine how this diagnosis of elbow dysplasia was reached since the questionnaire had no questions regarding radiographic examinations. ...
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The study analyzed the profile of Canicross practitioners in Brazil. A semi-structured questionnaire consisting of 33 questions was used: seven related to the handler and 26 to the dogs. Results: Of the total handlers, 53.3% are women, 64% have practiced the sport for at least 5 years and 52.3% trained with a personal trainer. Of the dogs, 62.6% were females, 60% were between one and four years old and the Mixed Breeds were the majority with 34.6%; as for the health of the animals, 80% of the handlers stated that they did not carry out veterinary monitoring aiming at the Canicross. 6.6% of the animals had sports-related injuries and 80% of these cases received veterinary treatment. It was clear that handlers know strategies to prevent and / or treat injuries caused by the sport, however this is not reflected in dogs. The unprecedented nature of the work will help handlers, veterinarians and sports lovers to draw up protocols so that dogs can practice Canicross safely. IDENTIFICAÇÃO DO PERFIL DOS PRATICANTES DE CANICROSS E SEUS CÃES NO BRASIL RESUMO: O estudo analisou o perfil dos praticantes de Canicross no Brasil. Foi utili-zado um questionário semiestruturado composto por 33 questões, sendo sete relacionadas ao condutor e 26 aos cães. Resultados: Do total de manipuladores, 53,3% são mulheres, 64% praticam o esporte há pelo menos 5 anos e 52,3% treinam com personal trainer. Dos cães, 62,6% eram fêmeas, 60% tinham entre um e quatro anos e os sem raça definida eram a maioria com 34,6%; quanto à saúde dos animais, 80% dos tratadores afirmaram não realizar acompanhamento veterinário visando o Canicross. 6,6% dos animais tiveram lesões esportivas e 80% desses casos receberam tratamento veterinário. Ficou claro que os tratadores conhecem estratégias para prevenir e/ou tratar lesões causadas pelo esporte, porém isso não se reflete nos cães. O caráter inédito do trabalho ajudará tratadores, veterinários e esportistas a traçarem protocolos para que os cães possam praticar Cani-cross com segurança. PALAVRAS-CHAVE: Lesão; Corrida; Handler; Esporte. IDENTIFICACIÓN DEL PERFIL DE LOS PRACTICANTES DE CANICROSS Y SUS PERROS EN BRASIL RESUMEN: El estudio analizó el perfil de los practicantes de Canicross en Brasil. Se utilizó un cuestionario semiestructurado compuesto por 33 preguntas, siendo siete relaci-onadas con el conductor y 26 con los perros. Resultados: Del total de manejadores, 53,3% son mu-lheres, 64% practican el deporte hace por lo menos 5 años y 52,3% entrenan con trainer personal. De los perros, 62,6% eran hembras, 60% tenían entre uno y cuatro años y los sin raza definida eran la mayoría con 34,6%; en cuanto a la salud de los animales, 80% de los manejadores afirmaron no realizar acompañamiento veterinario con vistas al Canicross. El 6,6% de los animales presentaron lesiones deportivas y el 80% de estos casos recibieron tratamiento veterinario. Quedó claro que los cuidadores conocen estra-tegias para prevenir y/o tratar lesiones causadas por el deporte, sin embargo esto no se refleja en los perros. El carácter inédito del trabajo aju-dará a cuidadores, veterinarios y deportistas a trazar protocolos para que los perros puedan practicar Canicross con segu-ridad.
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Background Established risk factors for DDH include female sex, breech presentation, family history, congenital malformations, oligohydramnios, and maternal hyperthyroidism. However, evidence for environmental factors that may contribute to DDH is limited and inconsistent. Methods A review of medical literature from 1956 to 2023 was conducted to collect data on environmental factors, including latitude, longitude, average yearly precipitation, average yearly temperature, minimum monthly temperature, and maximum monthly temperature, from all institutions that published articles on DDH. Univariate linear regression analysis was used to examine the correlation between environmental factors and DDH incidence, while multiple regression analysis was conducted to identify significant risk factors for DDH incidence. Results Data from a total of 93 unique manuscripts were analyzed, revealing a significant negative correlation between DDH incidence and temperature, including average yearly temperature (r = -0.27, p = 0.008), minimum monthly temperature (r = -0.28, p = 0.006), and maximum monthly temperature (r = -0.23, p = 0.029). Additionally, there was a significant positive correlation between DDH incidence and latitude (r = 0.27, p = 0.009), and a significant negative correlation between DDH incidence and average yearly precipitation (r = -0.29, p = 0.004). In the final multiple regression analysis, temperature, including average yearly temperature, minimum monthly temperature, and maximum monthly temperature, were identified as significant risk factors for DDH incidence. Conclusion The study findings suggest that temperature is the most significant predictor of DDH incidence, highlighting the potential impact of colder weather on DDH development in infants.
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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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Purpose: The aim of this study was to compare the efficacy and safety of a single intra-articular injection of adipose mesenchymal stem cells (aMSCs) versus plasma rich in growth factors (PRGF) as a treatment for reducing symptoms in dogs with hip osteoarthritis (OA). Methods: This was a randomized, multicenter, blinded, parallel group. Thirty-nine dogs with symptomatic hip OA were assigned to one of the two groups, to receive aMSCs or PRGF. The primary outcome measures were pain and function subscales, including radiologic assessment, functional limitation and joint mobility. The secondary outcome measures were owners' satisfaction questionnaire, rescue analgesic requirement and overall safety. Data was collected at baseline, then, 1, 3 and 6 months post-treatment. Results: OA degree did not vary within groups. Functional limitation, range of motion (ROM), owner's and veterinary investigator visual analogue scale (VAS), and patient's quality of life improved from the first month up to six months. The aMSCs group obtained better results at 6 months. There were no adverse effects during the study. Our findings show that aMSCs and PRGF are safe and effective in the functional analysis at 1, 3 and 6 months; provide a significant improvement, reducing dog's pain, and improving physical function. With respect to basal levels for every parameter in patients with hip OA, aMSCs showed better results at 6 months.
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Background Regenerative medicine using Mesenchymal Stem Cells (MSC) alone or combined with Plasma Rich in Growth Factors (PRGF) is a rapidly growing area of clinical research and is currently also being used to treat osteoarthritis (OA). Force platform analysis has been consistently used to verify and quantify the efficacy of different therapeutic strategies for the treatment of OA in dogs including MSC associated to PRGF, but never with AD-MSC alone. The aim of this study was to use a force platform to measure the efficacy of intraarticular ADMSC administration for limb function improvement in dogs with severe OA. Results Ten lame dogs with severe hip OA and a control group of 5 sound dogs were used for this study. Results were statistically analyzed to detect a significant increase in peak vertical force (PVF) and vertical impulse (VI) in treated dogs. Mean values of PVF and VI were significantly improved within the first three months post-treatment in the OA group, increasing 9% and 2.5% body weight, respectively, at day 30. After this, the effect seems to decrease reaching initial values. Conclusion Intraarticular ADMSC therapy objectively improved limb function in dogs with hip OA. The duration of maximal effect was less than 3 months.
A double-blind, randomised, controlled, multicentre field study was conducted to compare the safety and efficacy of firocoxib chewable tablets and carprofen tablets in 218 dogs with osteoarthritis. Firocoxib is a non-steroidal anti-inflammatory drug with more than 350-fold selectivity in dogs for the inducible isoform of the enzyme cyclo-oxygenase-2. The efficacy, tolerance and ease of administration of firocoxib (5 mg/kg/day) and carprofen (4 mg/kg/day) were assessed by the owners and the attending veterinarians during 30 days of treatment. The efficacy was assessed in terms of the dogs' overall scores at the end of the treatment, based on the veterinarians' assessment of lameness, pain on manipulation/palpation, range of motion, and joint swelling; 92.5 per cent of the dogs treated with firocoxib and 92.4 per cent of the dogs treated with carprofen had improved. The reduction in lameness in the dogs treated with firocoxib was significantly greater than in the dogs treated with carprofen. The owners' evaluations were that 96.2 per cent of the dogs treated with firocoxib and 92.4 per cent of the dogs treated with carprofen had improved, and this difference was statistically significant.
A “double blinded” prospective study was undertaken to determine whether gold bead implantation acupuncture alleviates lameness and pain in dogs, affected by moderate to severe hip dysplasia. Nineteen large-breed adult dogs, of various breeds with clinical and radiographic evidence of hip dysplasia, were randomly assigned to the acupuncture or the placebo group. The acupuncture treatment with gold bead implantation was performed by a licensed acupuncturist. Objective data were acquired, in the gait analysis laboratory, using kinetic and kinematic parameters before and at one and three months after treatment. In the acupuncture group there was a decrease in vertical and peak vertical impulse formation at one month, which indicated an increase in lameness, without any significant difference between groups at three months post-treatment. Subjective data were gathered by radiographs as well as serial complete physical examinations by an experienced clinician and an owner questionnaire, before and at one and three months after treatment. Subjective grading of hip dysplasia radiographs did not show any difference in severity between the two groups. According to the physical examination, one dog in the acupuncture group improved, five stayed the same and three worsened. In the placebo group two dogs improved, four stayed the same and three worsened. According to the questionnaire, three dogs in the acupuncture group improved, four stayed the same and two worsened. In the placebo group three dogs improved and six stayed the same. Serial blood analyses were performed and the results were within normal limits at all times.
Hip dysplasia is a potentially debilitating orthopaedic disease in which laxity of the coxofemoral joint often leads to secondary osteoarthritis, a reduction in joint function and pain. It has been recognised for many years as being of particular importance in pedigree dogs, especially in larger breeds, and is known to be partly governed by genetic factors. In order to try to control canine hip dysplasia and to reduce its incidence, a number of radiographic screening programmes have been developed worldwide. In 1983, a scheme was established by the British Veterinary Association and supported by the Kennel Club to examine radiographs of dogs' hips by assessing different anatomical features and giving them a numerical score. This article describes the process of scoring in this scheme, explains how to interpret the score and gives advice on the use of hip scores in the selection of breeding animals.
Objective: To evaluate associations of measures assessed by radiography, 2-D CT, and 3-D CT of the hip joints of immature dogs with osteoarthritis in the same joints at maturity. Animals: 46 hound-type dogs from a colony predisposed to osteoarthritis. Procedures: Images of hip joints (1/dog) were obtained at 16, 32, and 104 weeks of age. Radiographic measures included Norberg angle, distraction index, and osteoarthritis score. Two-dimensional CT measures included acetabular index, percentage of femoral head coverage, and center edge, horizontal toit externe, acetabular anteversion, and ventral, dorsal, and horizontal acetabular sector angles. Three-dimensional CT measures were femoral head and neck volume, femoral neck angle, and femoral head and neck radius. Differences among measures at 16 and 32 weeks in dogs with different osteoarthritis scores at later time points, relationships among variables at each time point, and relationships of single and combined measures with the presence of osteoarthritis at 104 weeks were evaluated. Results: The 16- and 32-week distraction index, center edge angle, dorsal acetabular sector angle, horizontal acetabular sector angle, percentage of femoral head coverage, acetabular index, and Norberg angle and the 32-week femoral neck angle varied significantly with osteoarthritis severity at 104 weeks. Presence of osteoarthritis in mature dogs was most strongly associated with 16-week combined measures of distraction index and center edge angle and 32-week combined measures of dorsal acetabular sector angle and Norberg angle. Conclusions and clinical relevance: Changes in hip joint morphology associated with radiographic signs of osteoarthritis were detectable as early as 16 weeks of age and varied with osteoarthritis severity in adult dogs. The use of combined hip joint measures may improve early identification of dogs predisposed to hip joint osteoarthritis.
Purpose The aim of this study was to obtain data on chondral damage and compare the damage patterns of various hip disorders. Methods Data were collected at 100 consecutive arthroscopies, and chondral lesions were recorded on anatomic articular maps divided into different anatomical zones. This geographic zone method made it possible to analyze the ICRS grade and location in relation to the hip morphology. Results The distribution and degree of the chondral defects showed a hip morphology-specific pattern. On the acetabular side, there were high incidences of full-thickness defects in the anterior–superior zone and the middle superior zone in patients with femoroacetabular impingement (FAI) (zone 2: 25.4 % grade 3, 35.5 % grade 4; zone 3: 20.3 % grade 3, 37.2 % grade 4) and borderline dysplasia (zone 2: 31.2 % grade 3, 12.5 % grade 4; zone 3: 18.7 % grade 3, 25 % grade 4). However, in patients with joint laxity, partial-thickness defects were dominant (zone 2: 50 % grade 1, 15 % grade 2; zone 3: 40 % grade 1). In patients with acetabular dysplasia, full-thickness defects extended even to the posterior superior zone (zone 4: 80 % grade 4). On the femoral head side, the incidence of full-thickness cartilage injuries was high in patients with FAI and borderline dysplasia compared to those with joint laxity and acetabular dysplasia. Conclusion Evaluation of chondral damage using the geographic zone method showed that the pattern of cartilage damage was influenced by hip morphology. Understanding of hip disorder-specific chondral damage patterns may be useful for the development of arthroscopic classification of hip disorders and may lead to the establishment of treatment guidelines. Level of evidence Diagnostic study, Level III.