Risk Factors for Femoral Fracture after Canine Press-Fit Cementless Total Hip Arthroplasty
Fox Valley Animal Referral Center, Appleton, WI, USA. Veterinary Surgery
(Impact Factor: 1.04).
04/2010; 39(6):688-95. DOI: 10.1111/j.1532-950X.2010.00694.x
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.
Available from: Dilek Olgun Erdikmen
Available from: Dilek Olgun Erdikmen
Available from: fitzpatrickreferrals.co.uk
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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.
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