Ventral Femoral Head Ostectomy: Standard versus Novel K-Wire Guided Technique Using a Premeasured Ostectomy Angle in Canine Cadavers

Introduction: There are several proposed clinical benefits of a ventral FHO (vFHO). A previous study comparing vFHO to a standard craniolateral approach noted that removal of additional bone after initial ventral osteotomy was challenging. In this study, a novel K-wire guide and preoperative ideal FHO angle (iFHOA) were used to improve the efficiency and accuracy of vFHO, and the previously accepted 45-degree angle to guide vFHO osteotomies was assessed.

Materials and Methods: A standard- and guided-vFHO were performed on each hip of 10 canine cadavers. A single unmodified osteotomy was performed in all cases. The pre- and postoperative iFHOA, and residual femoral neck were radiographically assessed. Subjective intraoperative palpation and postoperative radiographic scores were assigned.

Results: No significant difference was noted in subjective intraoperative osteotomy or radiographic scores (p > 0.63), and guided vFHO were as good or better for 9/10 cadavers. Residual femoral neck measurements were similar for both groups (p > 0.75). The average iFHOA in this study was 38.5 degrees, with no significant difference between sides of the same cadaver (p = 0.34). Guided vFHO took significantly longer (294.5 seconds, p = 0.002) than standard vFHO (166.7 seconds).

Discussion/Conclusion: Radiographic scores were as good or better for the guided vFHO group in 9/10 cadavers. Subjectively, the K-wire guide provided improved soft tissue retraction, neck visualization, and confidence in cut angulation. The mean iFHOA of 38.5 degrees is less than the previously published 45-degree angulation described for vFHO procedures. Preoperative iFHOA measurement may minimize risk of inappropriate vFHO osteotomy angle.

Acknowledgment: CSU Preclinical Surgical Research Laboratory and the CSU MacLaughlin fund.