Ventral femoral head and neck ostectomy: Standard versus novel K-wire guided technique using a premeasured ostectomy angle in canine cadavers.

Abstract

OBJECTIVE\nTo assess the accuracy and efficiency of performing ventral FHO (vFHO) after measuring the ideal femoral head and neck ostectomy angle (iFHOA), with and without guidance of a K-wire. To compare the iFHOA to the previously accepted 45° angle to guide vFHOs.\n\n\nSTUDY DESIGN\nRandomized, controlled, ex vivo study.\n\n\nANIMALS\nTen mixed-breed canine cadavers.\n\n\nMETHODS\nA routine un-guided and guided vFHO was performed on each cadaver. A single unmodified ostectomy was performed on all hips. The pre- and postoperative iFHOA and postoperative residual femoral neck were radiographically assessed. Subjective intraoperative palpation and postoperative radiographic ostectomy completeness (OC) scores were assigned.\n\n\nRESULTS\nSubjective OC scores (p\u2009>\u2009.63) did not differ between techniques, and guided vFHOs were as good or better for 7/10 dogs assessed via intraoperative palpation, and 9/10 dogs assessed radiographically. Residual femoral neck measurements were similar in both groups (p\u2009>\u2009.75). The average iFHOA in this study was 38.5°, with no significant difference between limbs of the same cadaver (p\xa0=\xa0.34). Guided vFHO took longer (294.5\xa0s, p\xa0=\xa0.002) than unguided vFHO (166.7\xa0s).\n\n\nCONCLUSION\nThe mean iFHOA of 38.5° was less than the previously published 45° angulation for vFHOs. Subjectively, use of a K-wire guide improved soft tissue retraction, neck visualization, and confidence in cut angulation.\n\n\nCLINICAL SIGNIFICANCE\nPreoperative iFHOA measurement may minimize the risk of inappropriate vFHO angles.