Search

To report outcomes and complications associated with total hip replacements (THR) using a multiuser canine hip registry (CHR) and owner-administered questionnaire.Prospective longitudinal clinical study.Dogs (n = 1852).Total hip replacement cases submitted to a CHR were reviewed. An online questionnaire including an adapted "Liverpool Osteoarthritis in Dogs" (LOAD) score was e-mailed to owners. Data were analyzed to determine associations between clinical variables and the agreement by veterinary surgeons and owners for complications.A group of 1329 (72%) dogs had unilateral THRs and another group of 523 (28%) dogs had bilateral THRs, resulting in 2375 THRs. Indications included hip dysplasia and osteoarthritis (n = 2028/2375, 85%). Implants were manufactured by Kyon (n = 1087, 46%), BioMedtrix CFX (n = 514, 22%), BioMedtrix hybrid (n = 264, 11%), BioMedtrix BFX (n = 221, 9%), and Helica (n = 107, 4.5%). Median veterinary surgeon and owner follow up were 1328 and 900 days respectively. Postoperative LOAD scores (21 ± 9) reported by 461 owners improved compared to preoperative scores (11 ± 9) (P .001). Veterinary surgeons reported complications in 201/2375 (8.5%) THRs and owners in 107/461 (23%) THRs, with moderate agreement (weighted kappa = 0.44). No associations were identified between complications and weight, age, sex, or breed. BioMedtrix BFX and Helica implants were associated with increased complications (P = .031) when used for revisions of femoral head and neck excisions.Excellent outcomes, including improved canine mobility, were reported after THRs. Complications were underreported by veterinary surgeons compared to owners in this first multiuser CHR.Canine THRs are safe, effective procedures but THR implants should be carefully selected when revising femoral head and neck excisions.

A 2-year-old male neutered crossbreed was presented with a 7-month history of left pelvic limb lameness. Following a diagnosis of bilateral hip dysplasia, staged hybrid total hip replacements (THR) were performed 16 months apart. An ipsilateral grade II lateral patellar luxation (LPL) developed within 24 hours after each THR. Both LPLs were successfully treated by block recession sulcoplasty. Subjective gait analysis showed an abnormal pelvic limb gait following each THR. Clinical examination detected a grade II LPL on each operated limb. Computed tomography of both pelvic limbs revealed mild trochlear sulcus hypoplasia but no other skeletal abnormalities. Trochlear block recession sulcoplasty was performed 10 and 4 weeks respectively after THR. Long-term follow-up 12 months after the last surgery found minimal (0–1/10) lameness, no pain on clinical examination in both PLs and an overall low client-based metrology instrument mobility score of 2 (Liverpool Osteoarthritis in Dogs). This case report documents that in predisposed dogs, with hypoplastic trochlear ridges, LPL can occur secondary to THR and can be successfully managed by standard techniques to address the luxation. Furthermore, despite anecdotal verbal reports of medial patellar luxation occurring secondary to THR in dogs, this is the first published report of the management of any patellar luxation subsequent to THR.

An adult neutered male cocker spaniel was presented with a 2-3week history of left pelvic limb lameness, stifle effusion, general malaise and pyrexia. Computed tomography (CT) imaging revealed an irregular tubular tract, extending from the stifle distally to the level of the mid tibial diaphysis, associated with the long digital extensor muscle. Ultrasonography revealed the tract had echogenic contents, however no foreign body could be identified. Following surgical exploration, a grass seed was identified in the medial compartment of the left stifle. Culture of the grass seed and joint capsule tissue yielded growth of Pantoea agglomerans. Following the surgery and subsequent antibacterial and non-steroidal anti-inflammatory medication, the dog made a full recovery to normal activity.

Objective To report overall rate and type of complications and outcomes of cats with coxofemoral luxation managed with hip toggle stabilization (HTS), to compare rate of postoperative complications and outcomes of cats treated with ultrahigh-molecular-weight-polyethylene (UHMWPE) or nylon, and to identify risk factors for reluxation and non-excellent outcomes. Study design Multi-institutional retrospective cohort study. Sample population Forty-eight client-owned cats. Methods Medical records of cats that underwent HTS from 2008-2018 using UHMWPE or nylon were reviewed. Univariable and multivariable logistic regression was performed to assess for factors associated with reluxation and non-excellent outcome. Final outcome was obtained from owner questionnaire. Results Intraoperative and postoperative complications were recorded in two (4.2%) and 11 (24.4%) cats, respectively. The most common postoperative complication was reluxation (n = 5 [11.1%]). Outcome was classified as excellent in 81.1% and good in 16.2% of cats after a median of 445.5 days (range, 53-3720). No difference in rate of complications or outcomes was identified between UHMWPE and nylon. Performance of additional orthopedic procedures, occurrence of intraoperative complications, and non-performance of capsulorrhaphy were associated with reluxation. Performance of additional non-hip procedures (orthopedic/nonorthopedic) was associated with non-excellent outcome. Conclusion Hip toggle stabilization was associated with a low rate of intraoperative complications and reluxation and excellent long-term outcomes in most cats. No difference in rate of postoperative complications or outcomes of cats treated using UHMWPE or nylon was identified. Cats that underwent additional orthopedic procedures had greater risk of reluxation. Clinical significance Hip toggle stabilization is an effective technique for management of coxofemoral luxation in cats. Comparable results are expected using UHMWPE or nylon.

This chapter provides a practical guide to performing, and interpreting the results of, a range of sampling techniques. The key techniques covered are synovial fluid collection and analysis, serological analysis, synovial membrane and periarticular tissue biopsy, bone biopsy and muscle biopsy.

Problems affecting bone growth and development are caused by abnormalities of cartilage formation, cartilage transformation, or bone formation. This chapter covers angular limb deformities and bone dysplasias in depth. Operative Techniques: Distal ulnar osteotomy/segmental ostectomy; Radial and ulnar corrective osteotomies; Dynamic lengthening of the radius using an external skeletal fixator; Tibial osteotomy for tarsal varus or valgus.

Two Rottweilers with cranial cruciate ligament (CCL) disease were referred for evaluation and treatment. Both patients underwent radiographs and examination under sedation, which confirmed CCL disease. Arthrotomy of the affected stifles revealed a partial CCL rupture in one patient and a complete CCL rupture in the other patient. The two patients underwent tibial tuberosity advancement (TTA) for treatment. In both cases, the TTA plate broke and the patients underwent a second operation to replace the broken plate. One patient was lost to follow-up after the second operation, while the other had acceptable function of the leg. Metallurgical analysis of the explanted plate in the second patient revealed corrosion as the predominant mechanism of plate failure. Despite the inherent resistance to corrosion presented by titanium implants, it is still possible for corrosion to lead to implant failure. However, replacement of the failed implant could lead to full recovery.

An orthopaedic examination should help to determine whether the cause of any lameness, weakness, lethargy, intolerance, ataxia or incoordination is due to an orthopaedic condition, to localise the orthopaedic condition, to formulate a plan of appropriate further diagnostic tests such as radiography, joint taps or computed tomography, and, subsequently, to plan treatment options. Part 1, published in the March issue of In Practice, discussed a systematic approach to the orthopaedic examination, from patient presentation to planning and procedure, and considered how this could be applied to the thoracic limb. This article describes how to perform an orthopaedic examination on the pelvic limb. An article published in the February issue of In Practice described the use of orthopaedic examination as part of an approach to hindlimb lameness.

Bone grafting is the transplantation or implantation of bone or a bone substitute into a site to replace missing bone or to enhance bone healing. This chapter looks at autografts; allografts; grow factors; mesenchymal stem cells and tissue engineering; alloplastic grafts; ideal bone graft properties. Operative technique: Harvesting of an autogenous cancellous bone graft.

To assess the variables associated with the complications of total hip replacement (THR) and report owner-assessed outcomes, through surgeon-based registration of cases via an online database, informed owner consent, and prospective outcomes assessment using a client-administered clinical metrology instrument.Prospective case seriesDogs (n = 170)Entries into the British Veterinary Orthopaedic Association-Canine Hip Registry (BVOA-CHR) between January 2010 and August 2011 were reviewed. Variables evaluated included dog age, body weight, breed, and indication for THR and prosthesis. Associations between each variable and the incidence of complications were assessed using logistic regression. Additionally, an on-line, owner-administered outcomes assessment questionnaire (modified from the Liverpool Osteoarthritis in Dogs (LOAD) questionnaire) was used to collect data from owners.One hundred and seventy cases met the inclusion criteria. Surgical indications included hip dysplasia and coxofemoral osteoarthritis (n = 150), Legg-Calves-Perthes disease (7), coxofemoral luxation (6), fracture (4), slipped capital physis (2), and femoral head and neck ostectomy revision (1). Surgical implants were from 4 systems. The incidence of surgeon-reported complication was 9.4%. No significant association was identified between weight, age, sex, breed, indication for THR, surgical technique and prosthesis, and the incidence of complications. In 82% of the cases, owners described their satisfaction with the outcome of THR as "very good" and a total of 20% complication rate was reported. There was a statistically significant improvement in owner-assessed questionnaire score before and after THR (P.001).The BVOA-CHR offers a novel framework for the prospective studies on THR and on a national/international scale. Initial complication rates from the BVOA-CHR are similar to previous studies.