Canis ISSN: 2398-2942

Hip: aseptic femoral head/neck necrosis

Synonym(s): Avascular necrosis of the femoral head, Perthes disease, Legg Perthes disease, Legg-Calves-Perthes disease, coxa plana, coxa magna, osteochondrosis of the femoral head

Contributor(s): Prof Walter Renberg, Prof Mark Rochat

Introduction

  • An aseptic necrosis of the femoral head of small breed juvenile dogs, particularly Terriers, Poodles, and Miniature Pinschers - associated with autosomal recessive gene. Males and females are equally affected.
  • Signs: gradually progressive unilateral or (less commonly -10-17%) bilateral hindlimb lameness, pain, restricted joint movement. Concurrent medial patellar luxation may be present.
  • Diagnosis: radiography.
  • Treatment: non-weight-bearing sling if identified prior to bony collapse; excision arthroplasty or total hip arthroplasty if identified after bony collapse.
  • Prognosis: good.
Print off the owner factsheet on Aseptic femoral head and neck necrosis (Legg Calvé Perthes disease) Aseptic femoral head and neck necrosis (Legg Calvé Perthes disease) to give to your client.

Pathogenesis

Etiology

  • Inherited predisposition associated with multifactorial pattern in Manchester terrier.

Pathophysiology

  • Infarction of epiphyseal and metaphyseal bone.
  • Ischemia of femoral head and neck followed by necrosis and trabecular collapse, and deformity of subchondral bone.
  • Articular cartilage cracks as its supporting bone deforms.
  • Results in articular incongruency and joint instability.
  • Later, highly vascular granulation tissue penetrates head and replaces dead bone by creeping substitution.
  • Finally, degenerative changes develop as a result of articular incongruency.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Scott H (1999) Non-traumatic causes of lameness in the hindlimb of the growing dog [Part 2]. In Practice 21 (4), 176-195 VetMedResource.
  • Gibson K L, Lewis D D, Pechman R D (1990) Use of external coaptation for the treatment of avascular necrosis of the femoral head in a dog. JAVMA 197 (7), 868-870 PubMed.

Other sources of information

  • Cook W T, Smith M M (2003)Perthes' Disease.In: Slatter D HTextbook of Small Animal Surgery. 3rd edn, pp 2260-2264.


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