Experimental Study On The Treatment Of Avascular Necrosis Of Femoral Head In Pets By Hip Preservation And Total Hip Replacement

Avascular necrosis of femoral head(ANFH),also known as Legg Calvé Perthes disease(LCPD),mainly causes partial or complete ischemia of the femoral head and apoptosis and necrosis of osteoblasts,and finally leads to collapse and deformation of the femoral head.Alendronate sodium and platelet rich plasma(PRP)can promote the formation of osteoblasts and accelerate the apoptosis of osteoclasts.They are widely used in the hip preservation treatment of human early anhf,as well as in the treatment of osteoporosis and the prevention of alveolar osteolysis.The surgical treatment of total hip replacement(THR)is usually selected for human end-stage anhf,but the veterinary clinical treatment of pet ANFH is mainly femoral head and neck resection(FHNE).In order to study the effect of hip preservation treatment and total hip replacement surgery on ANFH in dogs,and find a new way for clinical treatment of ANFH,the following experiments were carried out.Experiment 1: Establishment of ischemic femoral head necrosis modelTwelve 6-month-old dogs with similar body weight were selected to establish ANFH model by liquid nitrogen modeling method,and the modeling results were evaluated and staged by DR image as well as Ficat and arlet classification(Ficat)staging system.The experimental results showed that 8 dogs belonged to phase I,1 dog belonged to phase II and 3 dogs belonged to phase 0 in Ficat staging system.12 dogs’ 0-II ANFH model was successfully established.Experiment 2: hip preserving treatment of ischemic femoral head necrosisNine ANFH models in phase I-II were randomly divided into three groups a,B and C.group A was treated with alendronate at a dose of 3mg / kg per week for 12 weeks;Group B received intra-articular injection of 1ml calcium gluconate activated platelet rich plasma every two weeks,three times in total;Group C was used as the blank control group,and no treatment measures were taken.Three months later,the treatment effect was evaluated by X-ray scanning and anatomy of the femoral head of the affected limb.The X-ray image shows no phase III and IV pathological features and anatomical results,and the surface of the femoral head is smooth without collapse.It is considered that the treatment is effective,otherwise it is invalid.SPSS statistics 17.0 software package was used for data statistical analysis to evaluate the treatment effect.The results showed that two dogs in group A were effective and one was ineffective.Three rats in group B were effective and three rats in group C were ineffective.There was significant difference between a and C(P = 0.05),no significant difference between a and B(P = 0.267),and extremely significant difference between B and C(P = 0.01),indicating that alendronate and Pr P can effectively treat ANFH disease in dogs,but there was no significant difference between alendronate and PRP.Experiment 3: Study on the treatment of total hip arthroplasty in ANFH casesTwo cases of ANFH were selected and confirmed by clinical basis,imaging and hematological examination.Case 1 was a hairless cat with femoral head dislocation caused by falling paralysis and ANFH,and case 2 was a Samoye dog with bilateral ANFH and hip degenerative lesions.After 3 weeks of thr treatment,the motor function of case 1 basically recovered and the claudication disappeared;In case 2,the weight-bearing of the operative limb was enhanced and the range of joint movement was significantly larger than that on the left,indicating that tr has a significant effect on ANFH.