Alexandre Schmaedecke

Denervação acetabular cranial e dorsal no tratamento da displasia coxofemoral em cães: 360 dias de evolução de 97 casos

The aim was to evaluate the clinical results of cranial and dorsal acetabular denervation using curettage in dysplastic dogs. Ninty seven dogs without distinction of breed and sex, 1 to 7 years of age, were analyzed for diagnosis and treatment of hip dysplasia, based on physical examination, clinical signs and radiographic findings. For evaluation of results of the surgical denervation technique, clinical examinations were performed preoperatively (initial exam) and postoperatively at days 2, 7, 14, 21, 30, 60 180 and 360. All animals were evaluated for lameness, pain to movement and touch, muscular atrophy degree, pain sensivity to Ortolanis test and assessment of life quality. The surgical denervation procedure decreases lameness, pain to movement and touch after 2 days of procedure, decreases muscular atrophy after 60 days of procedure, and improves quality of life from the owners and veterinarians point of view even after 1 year of the treatment. Dorsal acetabular denervation is a feasible surgical technique in treatment of pain secondary to hip dysplasia in dogs, with significant decrease of pain after 2 days of treatment, improvement of quality of life, decrease of lameness, and consequently joyful animals and owners extremely satisfied with the results obtained by the proposed treatment. The surgical technique must include the curettage of nerve fibers from the cranial-dorsal and dorsal region of the acetabular periosteum.

A quantitative analysis of the nerve fibres of the acetabular periosteum of dogs

There are many techniques for the treatment of hip dysplasia, and novel research is currently being undertaken in the hope of obtaining more efficient and less traumatic techniques. The denervation of the hip joint capsule is a simple and effective technique that allows recovery of the functional activity of the affected limbs in significantly less time than other techniques. This surgical procedure consists of removing the acetabular periosteum, thus eliminating the nerve fibres with consequent analgesia. The aim of this investigation was to quantify the number of nerve fibres present in different regions of the acetabular periosteum. The knowledge of regional differences is potentially valuable for the refining of the denervation technique of the hip joint capsule. Thirty canine acetabular fragments were used to compare the nerve fibre density of the periosteum. The results showed a significant difference between the mean density of nerve fibres at the cranial and dorsal-lateral portion (approximately 75 fibres/mm2) and caudal lateral portion (approximately 60 fibres/mm2) of the acetabulum. Those fibres at the periosteum are almost positioned in a sagittal plane, pointing towards the joint capsule, suggesting the same density in the latter region. These results indicate a new approach to the articular denervation technique, thus obtaining even better results for the treatment of hip dysplasia in dogs.

Abordagem cirúrgica inédita para denervação acetabular em cães

The purpose of this study is to demonstrate a new surgical approach for the selective denervation of the sensitive fibers of the acetabular periosteum, for the treatment of hip dysplasia in dogs, conducted in 189 joints.The surgical approach of the cranial and dorso-lateral regions of the acetabular joint in dogs, by moon-shaped incision of approximately 3cm in extension, starting from the greater trocanter of the femur, in direction of the ileum body. After dorsal opening of the middle gluteal muscle, the insertion of the deep gluteal muscle is inserted for the access to the mentioned regions. With the help of a curette, the periosteum of the cranial and dorso-lateral acetabular margin was removed until the bone cortex was exposed, in all patients. In all animals, the approach was possible, both in the cranial as well as in the caudal faces for the access and curettage of the acetabulum, with the technique described, with a skin incision of about 3.2cm. The curettage of the cranial portion of the acetabulum was, in all cases, realized without the visualization of the bone, but of easy achievement and without intercurrences of nervous or muscular injuries. In all the approaches, it was possible to visualize the articular capsule of the coxo-femoral joint, and in none of the animals, this structure was incised for a technique mistake. The surgical approach described in the present study is feasible for this kind of surgical procedure in dogs, promoting adequate access, with minimal invasion and with no complications of any nature.

Análise biomecânica do joelho íntegro e com ruptura do ligamento cruzado cranial quanto ao grau de deslocamento cranial e rigidez articular em cães

PURPOSE: To analyse the biomechanical function of the knee joint in dogs, comparing the cranial translation degree and articular stiffness of the tibia in relation to the femur, in normal joints and joints with rupture of cranial crucial ligament. METHODS: Ten mongrel dog knees were analyzed, weighting more than 20 kg. Biomechanical analysis to the cranial translation degree of the knee joint with normal cranial cruciate ligament and surgically sectioned was made. Mechanical assays was realized by Kratos 5002 machine, and recorded in real time the parameters of force (N) and translation/deformation, in mm. The assay had consisted in to use a force(N) registering the cranial translation. RESULTS: To the normal knee, the deslocation media founded after 3 repetitions was 3,39 ; 3,47; 3,53. To the knee with surgical section was 12,96; 13,24; 13,34. The statistical analysis reveled significant diference between groups to the cranial tranlation e articular stiffness (p<0,05). CONCLUSION: These study allows to conclude that the cranial translation is added in four times and the articular stiffness is reduced one and a half times when statistically compared.

Treatment of ununited anconeal process in 8 dogs by osteotomy and dynamic distraction of the proximal part of the ulna

A surgical technique for the treatment of ununited anconeal process in dogs treated by osteotomy and dynamic distraction of the proximal part of the ulna using a linear external skeletal fixator was evaluated. In all cases the osteotomy was distracted 1mm each day after the surgery until desired distraction had been achieved. Eight dogs and 9 joints diagnosed with ununited anconeal process were treated. The success of the procedure was determined by comparing clinical signs of lameness and degree of arthrosis at the time of diagnosis to 6 months after the surgical intervention. Radiographic union occurred in 88.9% of the affected joints between 21 and 42 days after the surgical procedure. Clinically, six elbows were classified as good, two as satisfactory and one as unsatisfactory. Six months after surgery two elbows had no arthrosis, one had Grade 1, two Grade 2 and one Grade 3. It is concluded the combination of ulnar osteotomy and dynamic distraction of the olecranon by a linear external skeletal fixator is a feasible procedure for the treatment of ununited anconeal process in dogs.A surgical technique for the treatment of ununited anconeal process in dogs treated by osteotomy and dynamic distraction of the proximal part of the ulna using a linear external skeletal fixator was evaluated. In all cases the osteotomy was distracted 1mm each day after the surgery until desired distraction had been achieved. Eight dogs and 9 joints diagnosed with ununited anconeal process were treated. The success of the procedure was determined by comparing clinical signs of lameness and degree of arthrosis at the time of diagnosis to 6 months after the surgical intervention. Radiographic union occurred in 88.9% of the affected joints between 21 and 42 days after the surgical procedure. Clinically, six elbows were classified as good, two as satisfactory and one as unsatisfactory. Six months after surgery two elbows had no arthrosis, one had Grade 1, two Grade 2 and one Grade 3. It is concluded the combination of ulnar osteotomy and dynamic distraction of the olecranon by a linear external skeletal fixator is a feasible procedure for the treatment of ununited anconeal process in dogs.