Effects of Femur Position on Radiographic Assessment of Femoral Head and Neck Excision Completeness in Cats

Abstract

Objective The aim of this study was to determine the effect of femoral position on radiographic assessment of completeness of femoral head and neck excision (FHNE) in cats.

Study Design The study included 20 femurs from adult cats. Complete FHNE was performed on 10 femurs and incomplete excision consisting of inadequate excision of the distal medial femoral neck was performed on 10 femurs. The lesser trochanter was maintained in all femurs. Each femur was positioned through a predetermined set of eight radiographic views about the long axis. Sensitivity (SE), specificity (SP) and accuracy were calculated for each femoral position.

Results Craniocaudal views of the femur in external rotation (30° and 45°) had the highest SE, SP and accuracy (SE: 97.5% and 97.5%; SP: 92.5% and 95%; and accuracy: 95% and 96%, respectively) followed by external rotation of 15 (SE: 92.5%, SP: 87.5% and accuracy: 90%) relative to standard craniocaudal (SE: 57.5%, SP: 72.5%, accuracy: 65%) and lateromedial (SE: 2.5%, SP: 0%, accuracy: 1%) radiographic views.

Conclusions Evaluation of craniocaudal radiographic views with the femurs in external rotation can increase the ability to assess the adequacy of the FHNE in cats.

Keywords

femoral head and neck excision - FHNE outcome - radiography - hip - cats

Authors' Contributions

Alicia L. Howser and Arathi Vinayak contributed to conception of study, study design, acquisition of data, data analysis and interpretation and drafting the manuscript. Michael P. Ward contributed to study design, data analysis and interpretation, and drafting the manuscript. JongMin Kim, Peter L. Vogel, and Courtney L. Ikuta contributed to acquisition of data. All authors revised and approved the submitted manuscript.

• References

• 1 Yap FW, Dunn AL, Garcia-Fernandez PM, Brown G, Allan RM, Calvo I. Femoral head and neck excision in cats: medium- to long-term functional outcome in 18 cats. J Feline Med Surg 2015; 17 (08) 704-710
• 2 Harasen G. The femoral head and neck ostectomy. Can Vet J 2004; 45 (02) 163-164
• 3 Harper TAM. Femoral head and neck excision. Vet Clin North Am Small Anim Pract 2017; 47 (04) 885-897
• 4 Liska WD, Doyle ND, Schwartz Z. Successful revision of a femoral head ostectomy (complicated by postoperative sciatic neurapraxia) to a total hip replacement in a cat. Vet Comp Orthop Traumatol 2010; 23 (02) 119-123
• 5 Fitzpatrick N, Pratola L, Yeadon R, Nikolaou C, Hamilton M, Farrell M. Total hip replacement after failed femoral head and neck excision in two dogs and two cats. Vet Surg 2012; 41 (01) 136-142
• 6 Johnson KA. Outcome of femoral head ostectomy in dogs and cats. Munich publication reprinted. Vet Comp Orthop Traumatol 2010; 23 (05) III-IV
• 7 Off W, Matis U. Excision arthroplasty of the hip joint in dogs and cats. Clinical, radiographic, and gait analysis findings from the Department of Surgery, Veterinary Faculty of the Ludwig-Maximilians-University of Munich, Germany. 1997. Vet Comp Orthop Traumatol 2010; 23 (05) 297-305
• 8 Berzon JL, Covell SJ, Trotter EJ, Dueland R. A retrospective study of the efficacy of femoral head and neck excisions in 94 dogs and cats. Vet Surg 1980; 9: 88-92
• 9 Basher AWP, Walter MC, Newton CD. Coxofemoral luxation in the dog and cat. Vet Surg 1986; 15 (05) 356-362
• 10 Daly W. Femoral head and neck fractures in the dog and cat: a review of 115 cases. Vet Surg 1978; 7 (02) 29-38
• 11 Queen J, Bennett D, Carmichael S. , et al. Femoral neck metaphyseal osteopathy in the cat. Vet Rec 1998; 142 (07) 159-162
• 12 Spreull J. Excision arthroplasty as a method of treatment of hip joint diseases in the dog. Vet Rec 1961; 73: 573-576
• 13 Liska WD, Doyle N, Marcellin-Little DJ, Osborne JA. Total hip replacement in three cats: surgical technique, short-term outcome and comparison to femoral head ostectomy. Vet Comp Orthop Traumatol 2009; 22 (06) 505-510
• 14 Forterre F, Tomek A, Rytz U, Brunnberg L, Jaggy A, Spreng D. Iatrogenic sciatic nerve injury in eighteen dogs and nine cats (1997-2006). Vet Surg 2007; 36 (05) 464-471
• 15 Vinayak A, Kerwin SC, Ward MP, Bahr A, Peycke LE, Mertens WD. Effects of femur position on radiographic assessment of completeness of femoral head and neck excision in medium- to large-breed dogs. Am J Vet Res 2006; 67 (01) 64-69
• 16 Lippincott CL. Femoral head and neck excision in the management of canine hip dysplasia. Vet Clin North Am Small Anim Pract 1992; 22 (03) 721-737
• 17 Perry K. Feline hip dysplasia: a challenge to recognise and treat. J Feline Med Surg 2016; 18 (03) 203-218
• 18 Keller GG, Reed AL, Lattimer JC, Corley EA. Hip dysplasia: a feline population study. Vet Radiol Ultrasound 1999; 40 (05) 460-464
• 19 Schulz KS, Vasseur PB, Stover SM, Kass PH. Transverse plane evaluation of the effects of surgical technique on stem positioning and geometry of reconstruction in canine total hip replacement. Am J Vet Res 1998; 59 (08) 1071-1079
• 20 Ruff CB, Hayes WC. Cross-sectional geometry of Pecos Pueblo femora and tibiae--a biomechanical investigation: I. Method and general patterns of variation. Am J Phys Anthropol 1983; 60 (03) 359-381
• 21 Rémy F, Chantelot C, Fontaine C, Demondion X, Migaud H, Gougeon F. Inter- and intraobserver reproducibility in radiographic diagnosis and classification of femoral trochlear dysplasia. Surg Radiol Anat 1998; 20 (04) 285-289