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

Abstract

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.

Greater trochanter morphology and association with patient demographics, surgical factors, and post-operative stem position: a retrospective assessment of 150 cementless THRs in 135 dogs

“…The lack of association of trochanter grade and underlying diagnosis was noteworthy. A recent study described a high incidence of medialization of the trochanter in dogs with chronic capital physeal fractures (range: 45–2920 days) treated with a non-press fit cementless THR system [ 40 ]; however, that study contained some cases with fractures of several years duration prior to THR, and cases were not evaluated in the context of other pathologies of the hip as was performed in the present study. Additionally, the study by Alvarez-Sanchez and colleagues assessed trochanter position using a THR system-specific “25° of supination” lateral femoral radiograph, whereas in the present study trochanter grade was determined from traditional craniocaudal radiographs.…”

“…In another study, Alvarez-Sanchez and colleagues described the pre-operative radiographic abnormalities and outcomes in dogs with capital physeal fractures treated with a cementless THR system. The position of the greater trochanter was radiographically assessed for medial overhang relative to the central axis of the medullary canal on oblique lateral radiographs in 25° of supination, which is unique radiographic projection to the cementless THR system used in that study [ 40 ]. Therefore, the objectives of the present study were to classify frontal plane greater trochanter morphology using traditional radiographic views in a cohort of dogs undergoing cementless THR and to identify potential associations between trochanter morphology and patient demographics, femoral geometry, surgical time, technique modifications, and post-operative stem position.…”

Fluoroscopic Categorization of Cementless Acetabular Component Positioning

“…1 2 3 4 5 Indications for THA include coxofemoral subluxation and luxation, chronic osteoarthritis, fractures of the femoral head and neck, avascular necrosis of the femoral head and revision of femoral head and neck ostectomy. 1 2 3 5 6 7 8 9 10 11 Prior studies evaluating the clinical outcome of THA in dogs have reported a complication rate ranging from 4 to 34%. 1 2 3 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 Postoperative luxation is the most widely reported complication of THA, occurring in 1 to 20% of cases.…”

“…1 2 3 5 6 7 8 9 10 11 Prior studies evaluating the clinical outcome of THA in dogs have reported a complication rate ranging from 4 to 34%. 1 2 3 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 Postoperative luxation is the most widely reported complication of THA, occurring in 1 to 20% of cases. 2 6 13 15 19 21 24 25 26 27…”

“…[1][2][3][5][6][7][8][9][10][11] Prior studies evaluating the clinical outcome of THA in dogs have reported a complication rate ranging from 4 to 34%. [1][2][3][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] Postoperative luxation is the most widely reported complication of THA, occurring in 1 to 20% of cases. 2,6,13,15,19,21,[24][25][26][27] Improper orientation of the acetabular component has been identified as an important contributing factor for postoperative luxation in THA in the dog.…”