Retrospective Multi-Center Analysis of Canine Socket Prostheses for Partial Limbs

Abstract

Introduction: Socket prostheses for treatment of distal limb pathology are becoming increasingly prevalent in veterinary medicine, however, limited objective data is available. Objectives of the present study were to retrospectively evaluate owner satisfaction, clinical outcomes, and prognostic factors associated with dogs receiving socket prostheses for partial limbs in a larger patient population. Materials and Methods: Client databases of a single prosthesis provider were reviewed to identify owners whose dogs had received a prosthetic device within the last 10 years. An online survey was developed to evaluate owner-reported outcomes. The survey inquired about anatomy of the residuum, concurrent disease, prosthesis use, rehabilitation, activity, complications, and owner satisfaction. Medical records and radiographs were requested from all participants. Radiographs were used to confirm level of amputation and evaluate for osseous complications. Survey responses were analyzed by assigning author-defined numeric scores defining clinical outcome and owner satisfaction. Results: One-hundred thirty-seven owners were contacted. The response rate was 50/137 (37%); 47 responses were analyzed. Forty-six of 47 owners reported positive satisfaction; 1/47 was displeased. Forty-two of 47 dogs were scored to have acceptable to full function; 5/47 had unacceptable clinical function using the author-defined scoring system. A 62% short-term complication rate and a 19% long-term complication rate were reported. Skin sores were the most common short and long-term complication. There was a significant correlation between both clinical outcome scores and owner satisfaction with days per week spent in the prosthesis. Additionally, clinical outcome scores and owner satisfaction significantly varied between dogs with different durations of prosthesis wear with a trend toward better outcomes associated with longer prosthesis wear. Radiographs were obtained for 23/47 dogs to further define level of defect. The most proximal level of defect was mid-radius for the forelimb and mid-tibia for the hind limb. There was no correlation between level of defect and either owner satisfaction or clinical outcome. Discussion/Conclusion: Results of this survey suggest a high degree of owner satisfaction despite substantial complication rates. Based on preliminary data, further evaluation of socket prostheses as a limb-sparing option for treatment of distal limb pathology should be considered. Prospective clinical trials with objective outcome measures are required to draw firm conclusions.

New technologies applied to canine limb prostheses: A review

“…Another investigation indicated that 87.5% of patients (21/24) had the same to improved quality of life as they did prior to receipt of a prosthesis [16]. A third work reported that 89.3% of owners (42/47) said to have accepted to full function following prosthesis placement [78]. Although owner survey-based instruments can be used to evaluate owner perceptions of a canine quality of life and owner expectations regarding canine mobility, The change in the ability to jump up and down compared to before fitting of the stump socket prosthesis (n=12) [79].…”

“…An acceptable function defined as restoration to, or maintenance of, intended activities and performance from pre-injury or pre-disease status that is limited in level or duration (12-22 points). The unacceptable function was defined as all other outcomes (≤ 11 points) with a possible score range of−13-34 [78]. no investigation has been conducted on overall owner satisfaction with prostheses as a treatment option [78].…”

Test of Designing and Manufacturing a Polyether Ether Ketone Endoprosthesis for Canine Extremities by 3D Printing

“…For contraindicated cases of full-limb amputation or when owners are reluctant for such a procedure to be carried out, a distal partial limb amputation could be considered for replacing that injured portion with a prosthetic device (Fitzpatrick et al, 2011;Séguin and Weigel, 2012;Farrell et al, 2014;Mich, 2014;Phillips et al, 2017;Golachowski et al, 2019;Wendland et al, 2019). Prosthetic devices could be a socket prosthesis or exoendoprosthesis (Mich, 2014).…”

“…Prosthetic devices could be a socket prosthesis or exoendoprosthesis (Mich, 2014). Recently, more socket prosthesis studies have appeared with variable results about owner's satisfaction and complications related to these devices (Phillips et al, 2017;Wendland et al, 2019). Some ruminant patients have also been reported (Desrochers et al, 2014).…”

“…Socket prosthesis advantages are limited to avoiding a new surgical procedure, and the device could be removed easily when required. Some complications for this type of prosthesis are skin-prosthesis interface issues (poor attachment, stump pain, skin sores, swelling, dermatitis, and pressure necrosis), loss of mechanical integrity, repeated adjustments for patient's whole life, and perception of foreign body (Phillips et al, 2017;Wendland et al, 2019).…”