Risk Factors for Femoral Fracture after Canine Press-Fit Cementless Total Hip Arthroplasty
ABSTRACT To evaluate risk factors for femoral fracture after porous-coated cementless total hip arthroplasty (THA).
Dogs (n=74) that had cementless THA (n=84).
Medical records of dogs from 2 referral hospitals were reviewed for occurrence of postoperative femoral fracture. Patient and operative (age, breed, sex, weight, and canal flare index [CFI], indication for arthroplasty, intraoperative fissure, cerclage usage, and implant sizes) factors were analyzed. Assessment of implant positioning and canal fill was performed on immediate postoperative radiographs. Femoral fractures (n=11) were evaluated and compared with 73 cases without fracture that met the inclusion criteria.
Mean (+/-SEM) age was 7.30+/-0.69 years for dogs with, and 4.77+/-0.37 years for dogs without femoral fracture. Age was positively associated with fracture (P=.022). Mean (+/-SEM) CFI was 1.80+/-0.09 for dogs with, and 1.98+/-0.04 for dogs without fracture. CFI was negatively associated with fracture (P=.045). Body weight, intraoperative fissure, cerclage use, implant size, position, and canal fill did not influence the occurrence of femoral fracture.
Older dogs and dogs with lower CFI may be at increased risk for femoral fracture after porous-coated cementless THA.
Risk factors exist for femoral fracture after cementless THA using porous-coated implants, and should be critically evaluated during the patient selection. These risks should be weighed against the benefits of the system, and measures to minimize femoral fracture in at-risk patients studied.
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ABSTRACT: Objective: To report use of, and outcome after, string-of-pearls (SOP(™) ) plate and multiple cerclage wire fixation for treatment of periprosthetic femoral fractures (PFF) associated with total hip replacement (THR) in dogs. Study Design: Case series. Animals: Dogs (n=6) with PFF after THR. Methods: Clinical records (2005-2010) and radiographic evaluations of dogs that had PFF associated with THR, treated with a SOP(™) plate and cerclage wires were retrospectively reviewed. Clinical and radiographic postoperative assessments were performed 4, 12, and 24 weeks postoperatively. Telephone follow-up was performed >12 months postoperatively. Results: Three fractures occurred intraoperatively and 3 occurred postoperatively. One SOP(™) failed at 2 weeks necessitating revision using 2 parallel SOP(™) implants. One dog was euthanatized because of quadriceps muscle tie-down at 6 weeks. Other dogs were free of lameness with full range of motion of the stifle and hip joints at final clinical examination, and positive outcomes were maintained at >12 month telephone questionnaire. There was no evidence of implant failure and positive evidence of fracture healing at final radiographic follow-up. Conclusions: Stabilization resulted in bone healing in 5 dogs; failure in 1 dog may be attributable to technical error. Optimal technical guidelines for use of the SOP(™) in this circumstance are unknown, particularly where fracture configuration varies.Veterinary Surgery 09/2011; 41(1). DOI:10.1111/j.1532-950X.2011.00870.x · 0.99 Impact Factor
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ABSTRACT: OBJECTIVES: To evaluate outcome of capital physeal fractures (CPFs) treated by total hip replacement (THR) in dogs and cats. STUDY DESIGN: Retrospective phase II nonrandomized efficacy study. ANIMALS: Dogs (n = 21), cats (n = 4). METHODS: Medical records (1991-2009) and radiographs of dogs and cats with CPF treated by THR were reviewed. Physical examination findings, radiographs, thigh circumference (TC), force plate gait analysis, and an owner questionnaire were reviewed. RESULTS: Signalment and median interval between CPF and THR of all 25 animals had no clinical correlation with post-THR outcome. Force plate gait analysis and TC were available for 12 dogs. No significant difference in TC or force plate analyses between the THR limb and the normal contralateral limb was identified. Owner questionnaires (13 dogs) revealed improvement after THR with minimal (n = 2) or no lameness (n = 11). CONCLUSION: Animals with CPF treated by THR did not have statistically significant differences in any subjective (21 dogs, 4 cats) or objective (12 dogs) variable when compared with the normal contralateral limb.Veterinary Surgery 11/2011; 41(1). DOI:10.1111/j.1532-950X.2011.00919.x · 0.99 Impact Factor