Juvenile Pubic Symphysiodesis and Juvenile Pubic Symphysiodesis Associated with Pectineus Myotomy: Short-Term Outcome in 56 Dysplastic Puppies

Objectives (1) To compare short-term outcome of juvenile pubic symphysiodesis (JPS) in puppies aged 12-17 weeks with lax hips (group JPS1), in puppies aged 18-22 weeks (group JPS2), and control (group C) puppies; and (2) to document outcome of bilateral pectineus myotomy (PM) associated with JPS in 18-22-week-old puppies (group JPS-PM). Study Design Prospective study. Methods Puppies (12-22 weeks) from large and giant breed dogs with a combination of a positive Ortolani sign, poor acetabular coverage (Norberg angle [NA]< 100 degrees), and a subluxation index (SI) > 0.5 for one or both hips were selected. Puppies aged < 18 weeks were randomly assigned to group JPS1 or C. Puppies aged 18-22 weeks were randomly assigned to group JPS2, JPS-PM, or C. Three to 4 months later, surgery was considered successful in pain-free dogs with negative Ortolani sign, normalized acetabular coverage (NA >= 105 degrees), and SI > 0.5. Success rates were compared using Fisher's exact tests: JPS1 versus JPS2 versus C; JPS2 versus JPS-PM. Significance was set at P <.05. Results All dysplastic hips from nonoperated (C) groups were dysplastic at follow-up, meaning that our criteria for case selection were accurate. JPS1 had significantly better success rate than JPS2 (85 versus 17.8%, respectively). JPS-PM dysplastic hips failed to demonstrate a better outcome than JPS2 hips. Clinical Relevance This study confirms, on a large series of dysplastic hips, the age-dependent effects of JPS, with better results if performed before 18 weeks of age. There is no benefit of adding PM to the procedure in candidates > 18 weeks at surgery.