OCD happens on the femoral head too in dogs

J Small Anim Pract. 2025

P J Rocheleau 1, A E Yanchik 2

Background
Osteochondritis dissecans (OCD) is a condition characterized by the failure of endochondral ossification, leading to the formation of cartilage flaps that may detach, causing pain and lameness. OCD is commonly described in joints such as the shoulder, stifle, and elbow in dogs, but its occurrence in the femoral head is rare. This report details two cases of femoral head OCD diagnosed and treated using advanced imaging, arthroscopy, and surgical intervention, highlighting its clinical features and management strategies.

Methods
The study involved two canine patients presenting with pelvic limb lameness. Diagnostic evaluations included:

Radiography to identify joint abnormalities.
-Computed tomography (CT) to confirm OCD lesions and identify dissecting cartilage flaps.
-Arthroscopy (in one case) for direct visualization of the lesion. Both dogs underwent surgical interventions: one had an arthroscopic flap removal followed by total hip arthroplasty (THA), and the other underwent THA directly. Histopathological examination confirmed OCD in both cases.

Results
-Case 1: A 1-year-old Shih Tzu mix with non-weight-bearing lameness. Radiography and CT revealed flattening and hypoattenuation of the femoral head. Arthroscopy confirmed a large non-displaced cartilage flap, which was removed via abrasion arthroplasty. Due to residual lameness, a micro-THA was performed, leading to complete recovery at 12 weeks postoperatively.

-Case 2: A 2-year-old Indian Pariah dog with weight-bearing lameness. Radiographs showed a concave defect with possible osteochondral fragments. CT confirmed a dissecting flap. THA was performed without prior arthroscopy, resulting in full functional recovery by 12 weeks.

-Histopathology: Both cases demonstrated cartilage necrosis, subchondral bone collapse, fibrocartilage formation, and synovial ulceration, confirming OCD.

Limitations
This report is based on two cases, limiting the generalizability of findings. The distinction between OCD and avascular necrosis can be challenging, as imaging features overlap, necessitating histopathology for definitive diagnosis. Long-term outcomes of arthroscopic treatment alone were not assessed in one case due to early transition to THA.

Conclusions
Femoral head OCD is a rare but significant cause of lameness in dogs. Advanced imaging and histopathology are crucial for diagnosis, as traditional radiography may miss key features. Surgical intervention, including arthroscopy and THA, can achieve excellent outcomes, although the choice of procedure depends on lesion severity. Early recognition and treatment may improve prognosis in less severe cases.

Hip extended VD pelvic radiographs. (A) Patient 1 hip extendedVD view of the pelvis demonstrating flattening of the femoral head caudalto the fovea capitis, irregularity and flattening of the dorsal and cranialmargin of the femoral head, a small osteophyte along the cranial marginof the right acetabulum and widening of the right coxo-femoral joint.(B) Patient 2 hip-extended VD and lateral view of the right hemipelvisdemonstrating a large concave defect of the cranial and dorsal articularmargin of the right femoral head with a possible dissecting flap.



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