Outcome of femoral head ostectomy in dogs and cats

The advent of the electronic age has really facilitated immediate, rapid exchange of information. This development revolutionised the exchange of information and networking amongst colleagues in all scientific disciplines including veterinary orthopaedics, as well as between readers, contributors and referees of VCOT. However, some barriers to this easy communication that still remain are foreign language, culture, economic hardship and lack of internet connectivity. Thus, due to these barriers, it is possible for one to remain blissfully ignorant of the existence of new information and developments being generated in remote scientific enclaves. Our Emeritus Editor-in-Chief, Geoffrey Sumner-Smith had the idea to reprint in VCOT certain selected, previously published papers that might have otherwise escaped our attention. Of course this was done with full consent of the authors and editors of the journal in which the publication appeared originally. The idea was to highlight orthopaedic publications considered to be of significant scientific and educational value that might be largely unknown to readers of VCOT. An important first was a paper by Weller, originally published in ‘Asia Traumatologica Orthopaedica’ in the Orient (1). In his review paper, Weller warned of the potential dangers of precise anatomical reconstruction of shaft fractures, while introducing for the first time the concept of ‘biological osteosynthesis’ (1). This was 1989, and the concept was somewhat new and inflammatory because it seemingly challenged one of the four principles of the Arbeitsgemeinschaft für Osteosynthesefragen (AO), namely ‘anatomical reduction of fracture fragments, particularly in joint fractures’. In retrospect, the introduction of this concept of biological osteosynthesis by Weller proved to be a critical stepping stone in the right direction for the improved management of diaphyseal fractures. Following this concept, we are reprinting a peer-reviewed publication that was originally written in German (2). This study of outcome after femoral head ostectomy (also known as excision arthroplasty of the hip) was performed at the LudwigMaximilians University of Munich under the direction of Professor Ulrike Matis. The surgical procedure of femoral head ostectomy was first introduced to orthopaedics by Gathone Robert Girdlestone around 1945. Originally the Girdlestone procedure was performed to treat persons suffering from tuberculosis and other septic diseases of the hip joint. Following the Girdlestone procedure, patients had significantly impaired limb function and often could only walk with the assistance of a cane or walking stick. Not long after Girdlestone, Sir John Charnley in the United Kingdom pioneered total hip arthroplasty using polymethylmethacrylate cement as the preferred option for surgical management of hip osteoarthritis in humans. After successful total hip arthroplasty, almost normal function is restored to the joint. For this reason, Girdlestone’s femoral head ostectomy has never been a popular surgical procedure in human orthopaedics. However femoral head ostectomy was quickly accepted in veterinary surgery as a surgical treatment for painful conditions of the hip joint in dogs and cats (3, 4). Paradoxically, sepsis was actually an uncommon indication for femoral head ostectomy in dogs and cats. The principle indications for this surgery were hip dysplasia, traumatic dislocation and irreparable fractures of the hip joint. Although femoral head ostectomy was promoted as being an easier and less expensive option than total hip arthroplasty for animals, the long-term function could be unpredictable. According to several retrospective studies, the functional results of femoral head ostectomy were better in cats and small dogs, than they were in large dogs. doi:10.3415/VCOT-10-08-0125 Kenneth A. Johnson Editorial