Use of an Electron Beam Melting Manufactured Titanium Collared Cementless Femoral Stem to Resist Subsidence After Canine Total Hip Replacement

Liska, William D.; Doyle, Nancy

doi:10.1111/vsu.12353

Cited by 32 publications

(67 citation statements)

References 40 publications

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“…Because of the retrospective nature of the study, there was variability in the implants used. All dogs were implanted with BioMedtrix BFX implants; however, newer modified versions of the BFX stems were used in some dogs, including the use of a BFX stem with lateral locking bolt in two dogs and a collared stem in another two dogs, both designed to help prevent stem subsidence (Table ) . The only stem complication (subsidence) noted was in a dog with a stem not specifically modified to help prevent subsidence.…”

Section: Discussionmentioning

confidence: 99%

“…All dogs were implanted with BioMedtrix BFX implants; however, newer modified versions of the BFX stems were used in some dogs, including the use of a BFX stem with lateral locking bolt in two dogs and a collared stem in another two dogs, both designed to help prevent stem subsidence (Table 1). 30,31 The only stem complication (subsidence) noted was in a dog with a stem not specifically modified to help prevent subsidence. Assessment of dogs with pseudoacetabulum treated by THA with no variability in implants used may give a truer reflection of the complication rate associated with these cases.…”

Section: Discussionmentioning

confidence: 99%

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

2019

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Objective To compare the outcome of dogs treated with total hip arthroplasty (THA) for chronic hip luxation and pseudoacetabulum formation to that of dogs with simple hip dysplasia and secondary osteoarthritis. Study design Retrospective, case‐controlled study. Animals Seven dogs with pseudoacetabulum (group 1) and 21 matched control dogs (group 2). Methods Each dog in group 1 was matched with three control dogs, primarily according to similarity of THA implant type and size. Patterns of radiographic pathology were characterized in each dog. Outcome measures included operative time, acetabular cup position/orientation (inclination angle, angle of lateral opening, version angle) complications, and long‐term outcomes. Outcome measures were compared between groups using linear regression (P = .05). Results The presence of a pseudoacetabulum was associated with ilial remodeling and heterotopic bone formation concentric to the luxated femoral head. Exposing the native acetabulum and reducing the prosthesis were surgically challenging. The mean (SD) operative time of dogs in group 1 (96 [18] minutes) was longer than that of dogs in group 2 (63 [14] minutes; P = .00002). Cup position/orientation was not different between dogs in group 1 and group 2. One intraoperative complication and two minor postoperative complications occurred in group 1 dogs. All dogs had good long‐term outcomes. Conclusion Total hip arthroplasty in dogs with a pseudoacetabulum was more challenging than in control dogs. However, the procedure provided good to excellent long‐term clinical outcomes in all dogs. Clinical significance Surgeons should be prepared for the specific surgical challenges associated with THA in dogs with pseudoacetabulum formation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

2019

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“…During the study period, the ingrowth surface of the Biomedtrix acetabular cup was changed from cobalt chromium sintered beads to a titanium electron beam melted (EBM) surface. The EBM surface has a higher coefficient of friction and more closely imitates cancellous bone, improving the stability of the porous‐substrate interface and increasing removal torque . Improvements in implant technology and osseointegration may make cup revision of cementless THR more challenging …”

Section: Discussionmentioning

confidence: 99%

“…The EBM surface has a higher coefficient of friction and more closely imitates cancellous bone, improving the stability of the porous-substrate interface and increasing removal torque. 27,28 Improvements in implant technology and osseointegration may make cup revision of cementless THR more challenging. 28 Aseptic loosening of cemented implants is reportedly more frequent after revision surgery.…”

Section: Discussionmentioning

confidence: 99%

Management of total hip replacement luxation with triple pelvic osteotomy

Monotti

Ryan

Preston³

2018

Veterinary Surgery

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Objective To report the outcome of dogs treated with triple pelvic osteotomy (TPO) for dorsal luxation after total hip replacement (THR). Study design Retrospective clinical case series. Animals Seventeen client‐owned animals. Methods Medical records were searched at a single institution for dogs that had been treated with TPO for dorsal THR luxation. The angle of lateral opening (ALO), version angle (VA), and inclination angle (IA) were measured from radiographs after THR and TPO and corrected for pelvic rotation. A paired t test was performed to compare cup orientation after THR and TPO. Functional outcome was assessed at follow‐up examination and during telephone interviews. Results Eighteen TPOs were performed in 17 dogs, and radiographs were available for 15 cases. Open and/or closed hip reduction with additional stabilization was attempted unsuccessfully in 6 dogs prior to TPO. Triple pelvic osteotomy reduced the ALO by a mean of 23.0 ° ± 10.9 ° (P ≤ .001), increased VA by 9.0 ° ± 4.9 ° (P < .001), and increased IA by 2.9 ° ± 5.8 ° (P = .126). An excellent or good outcome was achieved in 12 dogs. Ventral luxation occurred in 3 dogs, and dorsal luxation occurred in 1 dog after TPO. Triple pelvic osteotomy excessively reduced ALO in 2 dogs with ventral luxation. Conclusion Triple pelvic osteotomy with cup retention is a viable alternative to cup revision for treatment of dorsal luxation of cemented and cementless THR. Triple pelvic osteotomy significantly reduces ALO and increases VA. Careful patient selection is recommended because excessive ventroversion can lead to ventral luxation. Clinical significance Triple pelvic osteotomy offers a revision option that preserves the implant–bone interface and significantly reduces ALO. This technique may be appropriate in dogs with high ALO, luxoid hips, and prior failed revision attempts.

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“…The intuitive reason for migration is insufficient initial fixation. Next day full weight‐bearing creates an unknown and variable degree of micromotion that could lead to early implant migration (settle into the bed preparation) and secondary stabilization in the same way as press‐fit femoral stems settle . In a study in man, 25% of 51 hip arthroplasties had a polar gap.…”

Section: Discussionmentioning

confidence: 99%

Polar gap after cementless total hip replacement in dogs

Liska¹,

Israel²,

Poteet³

2019

Veterinary Surgery

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Objective: To determine the incidence and outcomes of total hip replacements with polar gaps in dogs. Study design: Retrospective case series.Animals: One hundred fifty-five client-owned dogs.Methods: Serial postoperative and follow-up digital orthogonal radiographs of 200 hips in 155 dogs that underwent consecutive index total hip replacement (THR) were examined for the presence of polar gaps. Length and depth of polar gaps were measured and monitored on serial radiographs. Results: A polar gap was identified in at least 1 zone in 136 (68%) of the ventraldorsal (VD) radiographs and in 80 (40%) of the lateral radiographs obtained immediately after surgery. Gaps were more common in zones 2 and 5, measuring ≤1 mm in depth in 94 hips on the VD and in 78 hips on the lateral views. No gaps were radiographically visible after 5 weeks postsurgery. No continuous interface radiolucency or lysis was detected, and none of the THR required revision because of loosening. Conclusion: Polar gaps were identified on the majority of radiographs immediately after THR in our clinical setting and all resolved without complications. Clinical significance: Recognition and incidence of postoperative polar gaps after THR may vary among surgeons. Gaps do not warrant clinical intervention.

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Use of an Electron Beam Melting Manufactured Titanium Collared Cementless Femoral Stem to Resist Subsidence After Canine Total Hip Replacement

Abstract: A collar on a cementless femoral stem in contact with cortical bone resists subsidence.

Cited by 32 publications

References 40 publications

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

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

Management of total hip replacement luxation with triple pelvic osteotomy

Polar gap after cementless total hip replacement in dogs

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