Total hip arthroplasty to address chronic hip luxation with pseudoacetabulum formation in seven dogs

Total hip arthroplasty for femoral fractures other than capital physeal fractures in dogs: 14 cases (2012-2020)

OBJECTIVES

The goals of this retrospective study were to assess the clinical and radiographic outcomes in dogs with proximal femoral fractures, other than capital physeal fractures, treated via total hip arthroplasty.

MATERIALS AND METHODS

Medical records as well as pre-operative, immediate post-operative and 2 to 3 months post-operative radiographs of 14 dogs with femoral head and neck fractures treated via total hip arthroplasty were reviewed. A Liverpool Osteoarthritis in Dogs questionnaire was completed by owners to assess long-term outcomes.

RESULTS

Seven femoral head fractures, and seven femoral neck fractures were included. Four of the femoral head fractures were acute in nature, the three remaining femoral head fractures and all seven femoral neck fracture cases were chronic fractures. Malorientation of the femoral stem was more common in the chronic femoral fracture cases when compared to the acute femoral fracture cases. Two of the acute fracture cases and five chronic fracture cases experienced a change in femoral stem position post-operatively. One femoral fissure fracture occurred and was repaired intraoperatively. One case had a post-operative complication that resulted in implant removal. All dogs had good to excellent owner-perceived outcome.

CLINICAL SIGNIFICANCE

Femoral head and neck fractures, and in particular the chronic cases, represented a challenging subset of cases presenting for total hip arthroplasty, resulting in suboptimal stem alignment in many cases. However, clinical outcomes were considered good to excellent in all dogs in the study, indicating that total hip arthroplasty is a viable treatment option for these types of fractures.

Complications and outcomes of total hip arthroplasty in dogs with luxoid hip dysplasia: 18 cases (2010-2022)

OBJECTIVE

To describe the complications and outcomes in dogs with luxoid hip dysplasia (LH) undergoing total hip arthroplasty (THA) and compare complication rates with THA in non-LH dogs.

STUDY DESIGN

Retrospective study.

SAMPLE POPULATION

Client-owned dogs (n = 217) undergoing primary THA (n = 238).

METHODS

Medical records (2010-2022) of dogs undergoing THA were reviewed, and LH was defined as complete dorsal displacement of the femoral head from the acetabulum on lateral projection radiographs. Major or catastrophic complications, revisions, and outcomes were recorded for all dogs and they were compared between LH and non-LH groups.

RESULTS

Eighteen cases met the subcriterion for the LH group and 220 cases met the subcriterion for inclusion in the non-LH group. There were 14 complications in 13/18 dogs with LH; seven were intraoperative (femoral fissure/fracture) and seven were postoperative (dorsal luxation, n = 5; femoral fracture, n = 1; acetabular cup septic loosening, n = 1). Revisions were performed for all LH dogs that encountered complications; satisfactory outcomes were achieved in 12/13 dogs. Overall, LH dogs had a higher risk of developing complications (p < .001), including intraoperative fracture (p < .001) and postoperative dorsal luxation (p = .019) when compared with non-LH dogs.

CONCLUSION

Luxoid hip dysplasia was associated with a higher risk of major complications following THA in dogs, specifically intraoperative fissure/fracture and postoperative dorsal luxation. Despite the increased risk, revisions typically yielded satisfactory outcomes.

CLINICAL SIGNIFICANCE

Luxoid hip dysplasia is an important risk factor for the development of major complications in dogs undergoing THA.

A case report of a cementless total hip replacement performed in a pelvic limb amputee after a failed surgical reduction of a traumatic coxo-femoral luxation with a toggle rod

Coxo-femoral luxation is the most common luxation seen in dogs after road traffic accidents. There are multiple surgical techniques to repair the luxation. These range from a capsular reconstruction to a total hip replacement. This case report describes a total hip replacement to repair a failed toggle rod repair of a coxo-femoral luxation in a Greyhound pelvic limb amputee. The dog returned to normal activity as a household pet three months post-surgery and at the last follow-up consultation at 12 months post-surgery the dog was able to maintain an acceptable activity level as an amputee with no radiographic signs of complications.

Case report: Total hip replacement using Innoplant system in a dog with chronic hip luxation and contralateral pelvic limb amputation

A 6-year-old female neutered Border Collie presented with an inability to walk. The patient had undergone pelvic limb amputation over a year prior. Orthopedic examination revealed discomfort during hip manipulation, and radiographic examination revealed chronic hip luxation. Total hip replacement was performed using the InnoPlant system, which includes modular screw-in cementless pieces to improve implant stability. Cage rest was for the first four postoperative weeks. Subsequently, assistance was provided while standing until the patient could stand unassisted at 10 postoperative weeks. The clinical and radiological outcomes were excellent 3 months postoperatively. Since it is a new system, there are no data regarding the use of the components of the Innoplant system in dogs with a contralateral amputated pelvic limb. This is the first report describing the use of the Innoplant system for total hip replacement in a dog with a contralateral amputated pelvic limb. Based on the clinical outcomes of this case, the use of an Innoplant prosthesis can be an effective treatment option for dogs with contralateral amputated limbs.

Greater trochanter osteotomy as a component of cementless total hip replacement: Five cases in four dogs

OBJECTIVE

To describe the surgical technique and report the long-term outcome of greater trochanteric osteotomy (GTO) as a component of cementless total hip replacement (THR) in dogs with severe medialization of the greater trochanter or chronic craniodorsal hip luxation.

STUDY DESIGN

Short case series.

ANIMALS

Four dogs treated with five THRs.

METHODS

Data collected from medical records included signalment, indication for THR, duration of clinical signs, body weight, pre- and post-operative radiographic assessment, surgical templating, osteotomy technique, THR implant selection, surgical time, complications, and long-term clinical and radiographic follow-up. Clinical outcomes were determined based on in-hospital history, orthopedic examination, and radiographic evaluation.

RESULTS

All five surgical procedures resulted in satisfactory long-term clinical results at follow-up a median of 48.2 months (range, 34-56 months) after THR. There were no minor complications and one major complication. One dog experienced post-operative luxation unrelated to the GTO and was successfully treated with a cup revision.

CONCLUSION AND CLINICAL RELEVANCE

GTO was effective in facilitating cementless THR in dogs with either severe medialization of the greater trochanter or chronic craniodorsal luxation.

Zürich cementless total hip arthroplasty as a treatment option for capital physeal fractures in dogs: Outcome in 53 cases

OBJECTIVE

To review the outcome of dogs that underwent Zürich cementless total hip arthroplasty (Z-THA) for the repair of acute and chronic capital physeal fractures (CPF) and document the CPF-related hip remodeling.

STUDY DESIGN

Retrospective study.

SAMPLE POPULATION

Fifty-three Z-THA in 53 dogs.

METHODS

Medical records of dogs (2006-2019) that underwent Z-THA for CPF management were reviewed. Dogs were divided into two groups on the basis of the days elapsed between CPF diagnosis and Z-THA, acute (≤30 days) and chronic (>30 days). Hip remodeling variables were determined from preoperative radiographs or intraoperatively. Descriptive statistics were performed, and the complication rates, outcome, and coxofemoral remodeling were recorded. Comparisons of remodeling variables and rates between groups were performed by using Fisher's exact test.

RESULTS

In total, 23 of 53 (43.4%) cases were acute, and 30 of 53 (56.6%) cases were chronic. There was no difference in the femoral remodeling rates between the acute and chronic groups (P = .184), whereas acetabular remodeling was more prevalent in the chronic group (P < .001). Intraoperative complications occurred in four of 53 (7.5% [1/23 acute, 3/30 chronic]) cases, and postoperative complications occurred in six of 53 (11.3% [2/23 acute, 4/30 chronic]) cases. Good clinical outcomes were achieved in 51 of 53 (96.2% [21 acute, 30 chronic]) cases.

CONCLUSION

Complication rates of Z-THA for CPF repair were similar to the complication rates reported for Z-THA of dysplastic hips. Hip remodeling was common regardless of CPF chronicity.

CLINICAL SIGNIFICANCE

Zürich cementless total hip arthroplasty is viable for surgical management of CPF. There is a high likelihood that hip remodeling will be encountered, even in fractures treated within 30 days of presenting for hind limb lameness.

Total hip replacement in dogs with contralateral pelvic limb amputation: A retrospective evaluation of 13 cases

OBJECTIVE

To report the clinical characteristics, surgical management, and medium-term outcomes of total hip replacement (THR) performed in dogs with previous contralateral pelvic limb amputation.

ANIMALS

Thirteen client-owned dogs.

STUDY DESIGN

Multi-institutional retrospective clinical study.

METHODS

Data recorded from medical records included signalment, indication for amputation and THR, and surgical complications. Implant positioning and complications were assessed on radiographs. Clinical outcomes were evaluated during follow-up examinations by one of the authors and through a mobility- and lifestyle-based questionnaire completed by owners.

RESULTS

All 13 dogs had satisfactory clinical results at follow-up a median of 3 months (range, 2-36) after THR. No postoperative luxation was recorded. Four dogs had minor complications that did not require additional treatment. The only major complication was one failure of osseointegration of a cementless acetabular cup, and it was successfully revised.

CONCLUSION

Total hip replacement resulted in satisfactory clinical results and acceptable morbidity in this population.

CLINICAL SIGNIFICANCE

Total hip replacement should be considered in dogs with severe coxofemoral joint disease and contralateral pelvic limb amputation.