Long-term follow up of 44 cats undergoing total hip replacement: Cases from a feline hip registry (2010-2020).

OBJECTIVE: To report indications, complications, and long-term outcomes following feline total hip replacement (THR) using a client-based clinical metrology questionnaire, the Feline Musculoskeletal Pain Index (FMPI), and owner satisfaction. STUDY DESIGN: Multi-institutional retrospective cohort study. ANIMALS: Cats (n = 44) that underwent THR (n = 56). METHODS: Feline THRs submitted to a registry over a 10-year period were reviewed. The FMPI and owner satisfaction surveys were used to assess outcome. RESULTS: Forty-four cats met the inclusion criteria. Median age was 2 years (range: 0.9-11), and median bodyweight 5 kg (range: 3.3-7.6). British Shorthair and Domestic Shorthair were the most frequent breeds. Most cats were neutered males (33/44) and slipped capital femoral epiphysis (SCFE) was the most common surgical indication (34/56). All implants were cemented micro and nano hip implants. Overall complications (11/56) included 9 major complications. The median duration of follow up was 752 days (range: 102-3089). No association was found between clinical variables and complications. The FMPI score improved from 0.111 (range: 0-1.222) to 2.111 (range: 0.888-3.666) postoperatively (P < .001). Owner satisfaction was reported as "very good" in 30/33 cases (90.9%). CONCLUSION: A validated client metrology questionnaire showed clinical improvement in cats following THR. The most common indication for THR in cats was SCFE occurring in young male neutered cats. Complication rates were comparable to previous reports. CLINICAL SIGNIFICANCE: Total hip replacement appears to be a successful surgical treatment for feline hip disease with very good owner satisfaction and acceptable complication rates.

Evaluation of variables influencing success and complication rates in canine total hip replacement: results from the British Veterinary Orthopaedic Association Canine Hip Registry (collation of data: 2010-2012).

The objective of this study was to assess the variables associated with complications of total hip replacement (THR) and report owner-assessed outcomes. Entries into the British Veterinary Orthopaedic Association-Canine Hip Registry (BVOA-CHR) between September 2011 and December 2012 were reviewed separately and in conjunction with previous data (January 2010-August 2011). An outcomes assessment questionnaire was used to collect data from owners. Incidences of surgeon-reported and owner-reported complications were 8.2 per cent and 4.3 per cent, respectively. THR using the BioMedtrix BFX cup/stem prosthesis had a greater incidence of complications compared with THR using the BioMedtrix CFX cup/stem prosthesis (P=0.002); complications were 4.48 times more likely when using the BioMedtrix BFX cup/stem prosthesis versus the BioMedtrix CFX cup/stem prosthesis. THR using the BioMedtrix BFX cup/stem prosthesis had a higher incidence of complications compared with THR using a hybrid prosthesis (BioMedtrix BFX cup/CFX stem, BioMedtrix CFX cup/BFX stem) (P=0.046); complications were 2.85 times more likely when using the BioMedtrix BFX cup/stem prosthesis versus a hybrid prosthesis. In 95 per cent of cases, owner satisfaction with the outcome of THR was 'very good' or 'good'. Complication rates from the BVOA-CHR are similar to previous studies. The data suggest that prosthesis type is associated with complication rate, with BioMedtrix BFX (circa 2012) having a high short-term complication rate.

Cementless total hip replacement in 20 juveniles using BFX™ arthroplasty.

OBJECTIVE: To describe outcome after a minimum of 1 year for total hip replacement (THR) using BioMedtrix BFX™ biologic fixation implants in skeletally immature dogs (6-10 months of age). STUDY DESIGN: Case series. ANIMALS: Dogs (n = 20). METHODS: Medical records (November 2007-June 2010) of 20 dogs, 6-10 months old that had cementless THR were reviewed. Preoperative, immediate, 6-week and >1-year postoperative radiographs were compared. Clinical examination was performed at 6 weeks and >1 year postoperatively. Owner questionnaire was obtained at final follow-up. RESULTS: Cementless THR using BFX™ implants was performed because of debilitating coxofemoral pain, resulting from canine hip dysplasia, after unsatisfactory outcome with medical management. Radiographs taken immediately, 6 weeks and at a mean of 29.8 months (range, 12-48 months) postoperatively revealed satisfactory implant positioning and stability. Significant change in measured cranial-caudal femoral stem fill and level (P < .001 and P = .006, respectively) were recorded at 6 weeks postoperatively without clinical significance. No further change in stem positioning occurred. Acetabular cup orientation remained unchanged throughout follow-up. Complications requiring further surgical intervention were not encountered. One minor superficial infection was recorded and treated. Lameness and pain on manipulation of the affected hip had greatly improved in all dogs by 6 weeks postoperatively. CONCLUSION: Cementless THR can safely be performed in skeletally immature dogs, providing satisfactory return to normal joint function and implant survivability for at least a mean of 29.8 months.

Complications and owner assessment of canine total hip replacement: a multicenter internet based survey.

OBJECTIVE: 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. STUDY DESIGN: Prospective case series ANIMALS: Dogs (n = 170) METHODS: 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. RESULTS: 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). CONCLUSIONS: 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.

Tibial plateau leveling and medial opening crescentic osteotomy for treatment of cranial cruciate ligament rupture in dogs with tibia vara.

OBJECTIVE: To report clinical application of a tibial plateau leveling and medial opening crescentic osteotomy (TPLMOCO) by a single blade cut to ameliorate lameness in dogs with cranial cruciate ligament (CCL) rupture (CCLR) and concurrent tibia vara. STUDY DESIGN: Case series. ANIMALS: Bullmastiff-type dogs (n=4; 5 stifles). METHODS: Dogs were evaluated clinically and radiographically and records retrospectively reviewed. Pins were driven through both cortices of the proximal and distal tibia and a multidirectional jig attached medially. Tibial plateau leveling osteotomy was performed with torsional realignment of the calcaneo-patellar axis. A rigid connecting bar applied to the pins laterally before distraction of the medial jig allowed medial opening of the osteotomy while maintaining contact on the lateral aspect of the osteotomy. A 3.5 mm plate was applied. RESULTS: Meniscal and articular cartilage pathology was identified in the medial joint compartment in 4 stifles, and in both medial and lateral compartments in 1 stifle. Postoperatively, subjectively assessed lameness resolved in 4/5 limbs and improved in 1 limb. All osteotomies healed uneventfully, with superficial wound infection being the only complication in 1 dog. CONCLUSIONS: TPLMOCO is a potential treatment methodology for dogs with CCLR and tibia vara with or without tibial torsion. Clinical lameness was successfully ameliorated. Intraoperative assessment and correction of sagittal and rotational malalignment was sufficient to achieve satisfactory clinical outcome in these 4 dogs. CLINICAL RELEVANCE: TPLMOCO offers a potential treatment option and warrants further investigation for use in selected cases.