This document discusses juvenile pubic symphysiodesis (JPS), a minimally invasive surgical procedure to alter pelvic conformation in dogs. JPS involves cauterizing the pubic symphysis to arrest pubic growth and change the orientation of the acetabulum. Studies have shown JPS can partially or completely close the pubic symphysis, shorten and broaden the pubic ramus, and widen the obturator foramen. JPS has also been shown to decrease acetabular angle, reduce hip laxity, decrease osteoarthritis scores, and lower the probability of developing hip dysplasia in select dysplastic dogs between 16-20 weeks old with distraction indices of 0.
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Surgical Technique
• Midline Approach to pubis
• Cauterization of symphysis with monopolar cautery
– 40W
– 10-30 seconds at each point
– Repeated every 2-3mm
– Cranial 1/3->1/2 of symphysis
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Surgical Technique
• Pelvic structures, particularly urethra, must be
protected from excessive heat
– Trans-rectal retraction
– Malleable retractor or tongue
depressor through pre-pubic incision
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Surgical Technique
• Pelvic structures, particularly urethra, must be
protected from excessive heat
– Trans-rectal retraction
– Retractor/ tongue depressor
– Surgeon’s digit through pre-pubic
incision
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Radiographic changes after JPS
• XXXXX
JPS Group
Radiographic changes of the pelvis in Labrador and Golden Retrievers after juvenile pubic symphysiodesis Objective and subjective evaluation
S. Boiocchi et al Vet Comp Orthop Traumatol 2013
Control group
(good hip conformation)
Comparison of radiographic evaluation:
+Partial or complete closure of the cranial part of the
pubic symphysis- 2
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Radiographic changes after JPS
• XXXXX
JPS Group
Radiographic changes of the pelvis in Labrador and Golden Retrievers after juvenile pubic symphysiodesis Objective and subjective evaluation
S. Boiocchi et al Vet Comp Orthop Traumatol 2013
Control group
(good hip conformation)
Comparison of radiographic evaluation:
+Shortening and broadening of the pubic ramus- 4
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Radiographic changes after JPS
• XXXXX
JPS Group
Radiographic changes of the pelvis in Labrador and Golden Retrievers after juvenile pubic symphysiodesis Objective and subjective evaluation
S. Boiocchi et al Vet Comp Orthop Traumatol 2013
Control group
(good hip conformation)
Comparison of radiographic evaluation:
+Widening of the obturator foramen- 5
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CT changes- Acetabular Angle
• XXXXX
R. T. Dueland et al.: Pt. I – Canine hip dysplasia treated by juvenile pubic symphysiodesis
VCOT 2010
15 weeks 2 years
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CT changes- Acetabular Angle
• XXXXX
R. T. Dueland et al.: Pt. I – Canine hip dysplasia treated by juvenile pubic symphysiodesis
VCOT 2010
15 weeks 2 years
JPS
Control
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Ortolani
• 77% of ortolani + hips treated by JPS became ortolani – by 2 yrs
• 8% of ortolani + hips not treated by JPS became ortolani – by 2 yrs
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In summary
• JPS is minimally invasive
• Changes pelvic conformation
– Large body of literature documenting the capacity of JPS to
alter pelvic growth and acetabular orientation
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In summary
• JPS is minimally invasive
• Does change pelvic conformation
• Can decrease development of DJD in a SELECT
group of dysplastic patients
– Age 16 (12?) to 20 weeks
– DI 0.4 – 0.7