DARthroplasty – brief history
In human medicine, the augmentation of the femoral head support by an extracapsular bone graft has been used for a very long time in the treatment of hip dysplasia. It was first described by König in 1891 and was the principal method of acetabular reconstruction during the first half of the 20 th century (1). Several techniques using this principle have been used. The main difference being the method used to stabilize the graft. This group of techniques are generally known by the term Shelf Acetabuloplasty, in the sense that the bone graft works as an extension of the true acetabulum. In recent decades the early diagnosis of the disease in humans permitting the correction by harnesses and by rotational osteotomies conferring hyaline cartilage coverage to the femoral head have reduced the number of shelf operations. Nevertheless, it is present in the armamentarium of many surgeons, being used mainly in late presentation cases (late childhood, adolescents and young adults) (1,2,3,4,5). It remains as one of the few alternatives in complex late presentation cases (1), as a rescue technique should the rotational osteotomies fail to correct the deficient coverage (6) and as probably one of the best options for severe late onset Legg-Calvé-Perthes disease (7,8,9,10,11,12,13). In recent years it has been performed using minimally invasive methods (14).
In 1998 Barclay Slocum and Theresa Devine Slocum published the description and results of a shelf surgical technique for dogs that was named DARthroplasty (15). The name signifies Dorsal Acetabular Rim plasty. More than 300 hips were operated in their 6 year experience with the technique before publication (15). The technique is indicated, according to these authors, for dysplastic hips too far advanced (in the disease process) for triple pelvic osteotomy (TPO) but not yet candidates for end-stage salvage procedures (15).
Since this publication very little has been written about the DARthroplasty. The data was never collected to clarify it’s definitive place in Veterinary Surgery.
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J Bone Joint Surg Am, 2006 Jul 01;88(7):1458-1466
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