Equis ISSN 2398-2977

Coxofemoral joint: disease - overview

Synonym(s): Hip disease, hip luxation, round ligament rupture

Contributor(s): Helen Herinckx, Graham Munroe, Vetstream Ltd

Introduction

  • Incidence: coxofemoral joint disease is an uncommon cause of hindlimb lameness.
  • Cause: direct trauma is the most common cause.
  • Signs: usuall sudden onset, variable, hindlimb lameness.
  • Diagnosis: investigative techniques include synovial anesthesia   Hindlimb: joint anesthesia  , synoviocentesis   Synovial fluid: collection  , radiography   Hindlimb: radiography  and bone scintigraphy   Bone: scintigraphy  . Diagnosis can be extremely difficult, time consuming and expensive.
  • Treatment: depends on the specific condition as well as the size of the animal.
  • Prognosis: depends on the specific condition as well as the size of the animal.

Pathogenesis

Etiology

Trauma

  • Most common cause of acquired hip conditions.
  • Fractures: of the acetabulum   Pelvis: fracture  caused by slipping over, being cast, falls.
  • Luxation/subluxation of the hip joint requires excessive trauma; usually secondary to fractures of the acetabulum, unstable fractures of the ilial shaft or rupture of the teres ligament; can be a primary injury; permanent upward fixation of the patella   Patella: upward fixation  may result; the head of the femur usually luxates craniodorsally; can result from immobilization of the tarsus in a cast   Musculoskeletal: external fixation - casts  preventing the distal limb from flexing.
  • Coxofemoral ligament rupture may occur without luxation, or secondary to primary luxation.
  • Teres ligament rupture can occur when horse tries to get up when limb is trapped +/- luxation of the hip joint.
  • Trochanteric bursitis.
  • Femoral head displacement is occasionally seen in young animals.

Congenital and perinatal conditions

  • Dysplasia: rare; usually bilateral; ? heritable.

Infectious

Multifactorial

Immune-mediated

Miscellaneous

  • Tumors are extremely rare.
  • Osseous cyst-like lesions of the hip joint are uncommon, but have been reported in young horses   Bone: osseous cyst-like lesions  .

Predisposing factors

General

Pathophysiology

  • The hip joint is the articulation between the acetabulum of the pelvis and the head of the femur.
  • The three bones comprising the pelvis (the ilium (cranial), ischium (caudal) and the pubis (medial)) meet at the acetabulum.
  • The teres ligament (accessory, round) is part of the prepubic tendon on the pelvis which passes through the prepubic notch and inserts on the humeral head, providing the primary stability of the hip joint.
  • The acetabulum is surrounded by a fibrocartilage ligament which also serves to stabilize the joint.
  • The mass of muscles and ligaments surrounding the hip joint ensure that injury to the joint from external trauma is uncommon, but also means that palpation and manipulation can be extremely difficult.
  • See also: Joint: synovial pathobiology   Joint: synovial pathobiology  .
  • Many conditions occur secondary to trauma.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent reference from PubMed and VetMedResource.
  • Amitrano F N, Gutierrez-Nibeyro S D & Joslyn S K (2014)Radiographic diagnosis of craniodorsal coxofemoral luxation in standing equids.Equine Vet Educ26(5), 255-258 Wiley Online Library.
  • Barr A R S & Fairburn A J (2014)Aspects of coxofemoral luxations in the horse.Equine Vet Educ26(5), 259-261 Wiley Online Library.
  • O'Neill H (2011)Case report: An ultrasound-assisted diagnosis of a coxofemoral luxation in a yearling.UK Vet16, 5-7 VetMedResource.
  • Gracia L Aet al(2011)Femoral head excision after coxofemoral luxation in and Arab filly: Four years follow-up.Equine Vet Educ23(7), 346-352 VetMedResource.
  • Garcia-Lopez J M (2010)Coxofemoral luxations in the horse: Surgical options and challenges.Equine Vet Educ22(11), 554-556 Wiley Online Library.
  • Garcia-Lopez J M, Boudrieau R J & Provost P J (2001)Surgical repair of coxofemoral luxation in a horse.JAVMA219(9), 1254-1258 PubMed.
  • Clegg P D & Butson R J (1996)Treatment of a coxofemoral luxation secondary to upward fixation of the patella in a Shetland pony.Vet Rec138(6), 134-137 PubMed.
  • Clegg P D (1995)Idiopathic infective arthritis of the coxofemoral joint in a mature horse.Vet Rec137(18), 460-464 PubMed.
  • Nixon A J (1994)Diagnostic and operative arthroscopy of the coxofemoral joint in horses.Vet Surg23(5), 377-385 PubMed.
  • Squire K R Eet al(1991)Femoral head ostectomy in horses and cattle.Vet Surg20(6), 453-458 PubMed.

Other sources of information

  • Dyson S J (2003)The Coxofemoral Joint.In:Diagnosis & Management of Lameness in the Horse. Eds: Ross M W & Dyson S J. Saunders, Missouri. pp 499-500.
  • Hendrickson D A (2002)The Coxofemoral Joint.In:Adams Lameness in Horses.5th edn. Lippincott, Williams & Wilkins, Baltimore. pp 1037-1043.


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