The document summarizes a study comparing the clinical outcomes of canine hip denervation to results from gait analysis in 9 dogs. Hip denervation aims to reduce pain from hip dysplasia by destroying the joint's nerve supply. Owners reported improvement in 87% of hips after surgery. Gait analysis found improvement in only 44% of dogs. This suggests hip denervation effectively reduces pain clinically but does not consistently improve gait, possibly due to residual discomfort or abnormal gait from laxity or osteoarthritis.

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PROCEEDINGS
MUNICH, GERMANY
10-14 September 2008
“The Cutting Edge in Veterinary Orthopaedics CE”
Ludwig
Maximilians
Universität
European Society of
Veterinary Orthopaedics
and Traumatology
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F. Collard 14th ESVOT Congress, Munich, 10th - 14th September 2008 • 46
Canine hip denervation: comparison between clinical
outcome and gait analysis (9 cases)
F. Collard, P. Maitre, T. Le Quang, D. Fau, C. Carozzo, J.P. Genevois, E. Viguier
Dept of Surgery, Veterinary school of Lyon, 1 av. Bourgelat, F-69280 Marcy l’Etoile
INTRODUCTION
Many procedures have been propose to manage the pain associated with hip dysplasia such as hip dener-
vation. This technique aims to destroy the sensitive innervation to the craniodorsal aspect of the cox-
ofemoral joint by selective destruction of the articular nerve supply. Our aim was to compare the owner’s
opinion to the result of the gait analysis with a walkway.
SMALL ANIMAL
MATERIALS AND METHODS
For our retrospective study, each dog presenting unilateral or bilateral hip dysplasia diagnosed after a clini-
cal and radiographic examination was included. All dogs were lame and painful during hip mobilisation.
The gait of each dog was analysed with a 4 meter-long walkway (GAITRite®) by studying the
forelimb/hindlimb symmetries with 2 parameters: the peak pressure and the number of activated sensors.
Both a medical treatment and some rest were prescripted during 3 weeks. Hip denervation was performed
on each dog that was still lame and painful. The dog was positioned in lateral recumbency, a craniodorsal
approach was realised. A Hohmann retractor was used to elevate the middle and the deep gluteal muscles
Table 1 - Preoperative and postoperative results of gait analysis
Sound
1 2 3 5 6 7 8 9
dog
Preoperative mean speed 113,80 107,5 117,00 122,25 111,77 160,67 127,67
193,00
values (cm/s) (SD 21,63) (SD 37,48) (SD 12,73) (SD 5,56) (SD 2,08) (SD 59,50) (SD 35,12)
pressure
(peak of pressure) 33,96 29,6 37,73 40,48 31,61 41,43 25,99
43,50 33,89
hindlimb (stance (SD 1,03) (SD 4,27) (SD 1,21) (SD 3,37) (SD 1,45) (SD 1,57) (SD 5,25)
distribution %)
surface (number of
activated sensors) 38,55 35,65 39,84 43,33 36,27 43,60 35,71
40,50 38,31
hindlimb (stance (SD 2,04) (SD 2,97) (SD 0,67) (SD 2,47) (SD 1,39) (SD 0,79) (SD 3,48)
distribution %)
Postoperative mean speed 132 137,67 153,67 164,33 114,33 110,50 106,33 205,33
values (cm/s) (SD 25,46) (SD 4,51) (SD 27,54) (SD 18,23) (SD 15,04) (SD 4,20) (SD 8,74) (SD 15,53)
pressure
(peak of pressure) 48,89 30,15 49,87 27,57 38,26 34,33 42,85 35,00
43,50
hindlimb (stance (SD 4,93) (SD 3,54) (SD 13,01) (SD 4,08) (SD 2,76) (SD 1,17) (SD 0,28) (SD 5,00)
distribution %)
surface (number of
activated sensors) 46,40 36,49 54,57 33,40 39,21 41,10 44,44 39,94
40,50
hindlimb (stance (SD 3,20) (SD 1,92) (SD 11,95) (SD 3,84) (SD 1,66) (SD 1,84) (SD 0,71) (SD 4,14)
distribution %)
Clinical
Yes Yes Yes Yes No Yes Partially Yes
improvement
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02) Small animal_08 29-08-2008 12:08 Pagina 47
47 • 14th ESVOT Congress, Munich, 10th - 14th September 2008 F. Collard
and a strip of periosteum was elevated with a curette on the dorsal and cranial aspect of the acetabulum.
Three months later, owners were questioned about the improvement of their dog and the dog was placed to
walk on the walkway to compare with the preoperative values.
RESULTS
Nine dogs were included in our study. Sixteen hip denervations were performed: 2 unilateral and 7 bilateral.
The mean weight was 28kg and the mean age was 25 months. The surgical duration was 28.5 minutes, the
minor complication encountered was a seroma on 2 active dogs and no major complication was observed.
Owners judged an improvement of the clinical signs on 14 hips (87%) and no difference on 2. Seven hips were
completely free of lameness. Eight out of 9 owners were very satisfied with the clinical improvement of their
dog. The results of the gait analysis revealed an improvement of both parameters only in four dogs and no
amelioration in the 4 others (Table 1). Dog 4 was excluded due to uninterpretable results.
SMALL ANIMAL
DISCUSSION
The most evident sign of hip dysplasia is lameness due to pain in the hip joint. The main cause of pain is
laxity, which is responsible for the stretching of the joint capsule. By removing the sensitive innervation of
the hip joint capsule, the dog might be less reluctant to walk. The branches of the nerves, which innervate
the capsule, run on the periosteum around the joint. Removing periosteum around the craniodorsal aspect
of the joint should relieve pain. All retrospective studies agree, as we do, that almost 90% of the cases were
clinically improved by this procedure. On the other hand, no gait analysis was performed in these studies.
Lincoln and others were the first to perform gait analysis after hip denervation They conclued it was not as-
sociated to gait improvement. Our gait analysis confirms an improvement only in 44% of the dogs. This dif-
ference could be due to a mechanical disconfort or an abnormal gait because of laxity or presence of os-
teoarthritis, but pain should not be ruled (pectineus muscle contracture, stretching of the ventral aspect of
the joint capsule).
CONCLUSION
Hip denervation is a simple method, which seems to clinically improve dogs by limiting hip pain. The vari-
ation in the results between clinical outcomes and the results of the gait analysis need other investigations
to know if this difference results from a persistent slight pain, a mechanical disconfort or an abnormal gait
due to osteoarthritis, laxity or from an other factor to determine.
REFERENCES
Kinzel S., Von Scheven C., A. Buecker & al: Clinical evaluation of denervation of the canine hip joint capsule: a retro-
spective study of 117 dogs. Vet Comp Orthop Traumatol, 2002; 15:51-56.
Kinzel S., Hein S., Von Scheven C. & al: 10 Jahre Erfahrung mit der Denervation der Hüftgelenkkapsel zur Therapie der
Hüftgelenkdysplasie und –arthrose des Hundes. Berl Münch Tierärztl Wschr, 2002; 115:53-56.
Kinzel S., Fasselt R., Prescher A. & al: Die sensible Innervation der Capsula articularis coxae beim Hund. Tierärztl Prax,
1998; 26:330-335.
Lincoln JD, Martinez SA, McCormick DJ et al. Partial sensory denervation – A treatment for the clinical signs of chron-
ic coxofemoral osteoarthritis. 34th Annual conference VOS, 2007:54.
Sneling S.R. & Wong W.T.: Denervation of the Craniodorsal Joint Capsule in Canine Hip Dysplasia: Initial Results in a
Pilot Trial. Aus Vet Practi, 2004t; 34:11.
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