Download PDF
Vet Comp Orthop Traumatol 2010; 23(06): 424-432
DOI: 10.3415/VCOT-09-07-0071
Original Research
Schattauer GmbH

Complications of cementless total hip replacement

A retrospective study of 163 cases
D. W. Hummel
1   Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, Virginia, USA
,
O. I. Lanz
2   Department of Small Animal Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, Virginia, USA
,
S. R. Werre
3   Department of Biomedical Sciences and Pathobiology Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Blacks-burg, Virginia, USA
› Author Affiliations
Further Information

Publication History

Received: 01 July 2009

Accepted: 23 June 2010

Publication Date:
19 December 2017 (online)

    Permissions and Reprints

Summary

Cementless total hip implants are relatively new to the veterinary market and therefore complication rates and prognostic indicators associated with the procedure have not been thoroughly documented. The objective of this study was to determine the prevalence of complications and identify prognostic indicators of success or failure for the Zurich cementless total hip replacement (THR). Medical records of 163 dogs that underwent Zurich cementless-THR were reviewed continuous and categorical variables, clinical outcomes and complications were recorded. Complications were separated into intra-operative (IOC), short-term (STC), and long-term (LTC). Bivariate and multivariate statistical analysis was used to compare complications. The clini-cal significance of this study was to provide surgeons with prognostic indicators of success or failure when evaluating prospective Zurich cementless-THR patients, and to report the complication rate of Zurich cementlessTHR. The complication rates of Zurich cementless-THR were then compared to previously-reported complication rates of cemented-THR and other cementless-THR systems. Short-term complications, LTC, and IOC rates of Zurich cementless-THR were found to be 6.75%, 10.4%, and 11.0% respectively. The most common complications were intra-operative femoral fracture, luxation of the implant, and septic loosening of the implant. Increased body weight and prior cemented-THR or fe-moral head and neck ostectomy of the contra-lateral hip were identified as negative prognostic indicators. The overall complication rate identified was greater than those previously reported for other cementless- and cemented-THR systems.

Keywords

Cementless - total hip replacement - complications
 

  • References

  • 1 Olmstead ML, Hohn RB, Turner TM. A five-year study of 221 total hip replacements in the dog. J Am Vet Med Assoc 1983; 183: 191-194.
    PubMedGoogle Scholar
  • 2 Montgomery RD, Milton JL, Pernell R. et al. Total hip arthroplasty for treatment of canine hip dysplasia. Vet Clin North Am Small Anim Pract 1992; 22: 703-719.
    CrossrefPubMedGoogle Scholar
  • 3 DeYoung DJ, DeYoung BA, Aberman HA. et al. Implantation of an uncemented total hip prosthesis: technique and initial results of 100 arthroplasties. Vet Surg 1992; 21: 168-177.
    CrossrefPubMedGoogle Scholar
  • 4 Olmstead ML. Canine cemented total hip replacements: state of the art. J Small Anim Pract 1995; 36: 395-399.
    CrossrefPubMedGoogle Scholar
  • 5 Edwards MR, Egger EL, Schwarz PD. Aseptic loosening of the femoral implant after cemented total hip arthroplasty in dogs: 11 cases in 10 dogs (1991–1995). J Am Vet Med Assoc 1997; 211: 580-586.
    PubMedGoogle Scholar
  • 6 Bergh MS, Gilley RS, Shofer FS. et al. Complications and radiographic findings following cemented total hip replacement. Vet Comp Orthop Traumatol 2006; 19: 172-179.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 7 Conzemius MG, Vandervoort J. Total joint replacement in the dog. Vet Clin North Am Small Anim Pract 2005; 35: 1213-1231.
    CrossrefPubMedGoogle Scholar
  • 8 Marcellin-Little DJ, DeYoung BA, Doyhens DH. et al. Canine uncemented porous-coated anatomic total hip arthroplasty: results of a LT prospective evaluation of 50 consecutive cases. Vet Surg 1999; 28: 10-20.
    CrossrefPubMedGoogle Scholar
  • 9 Skurla CP, Pluhar GE, Frankel DJ. et al. Assessing the dog as a model for human total hip replacement. Analysis of 38 canine cemented femoral components retrieved at post-mortem. J Bone Joint Surg Br 2005; 87: 120-127.
    PubMedGoogle Scholar
  • 10 DeYoung DJ, Schiller RA. Radiographic criteria for evaluation of uncemented total hip replacement in dogs. Vet Surg 1992; 21 (02) 88-98.
    CrossrefPubMedGoogle Scholar
  • 11 Hanson SP, Peck JN, Berry CL. et al. Radiographic evaluation of the Zurich cementless total hip acetabular component. Vet Surg 2006; 35: 550-558.
    CrossrefPubMedGoogle Scholar
  • 12 Remedios AM, Fries CL. Treatment of canine hip dysplasia: a review. Can Vet J 1995; 36: 503-509.
    PubMedGoogle Scholar
  • 13 Nelson LL, Dyce J, Shott S. Risk factors for ventral luxation in canine total hip replacement. Vet Surg 2007; 36: 644-653.
    CrossrefPubMedGoogle Scholar
  • 14 Andrews CM, Liska WD, Roberts DJ. Sciatic neurapraxia as a complication in 1000 consecutive canine total hip replacements. Vet Surg 2008; 37: 254-262.
    CrossrefPubMedGoogle Scholar
  • 15 Liska WD. Femur fractures associated with canine total hip replacement. Vet Surg 2004; 33: 164-172.
    CrossrefPubMedGoogle Scholar
  • 16 Ota J, Cook JL, Lewis DD. et al. Short term aseptic loosening of the femoral component in canine total hip replacement: effects of cementing technique on cement mantle grade. Vet Surg 2005; 34: 345-352.
    CrossrefPubMedGoogle Scholar
  • 17 Tidwell SA, Graham JP, Peck JN. et al. Incidence of pulmonary embolism after non-cemented total hip arthroplasty in eleven dogs: computed tomo-graphic pulmonary angiography and pulmonary perfusion scintigraphy. Vet Surg 2007; 36: 37-42.
    CrossrefPubMedGoogle Scholar
  • 18 Montavon PM, Tepic S. Zurich Cementless – a new concept in canine total hip replacement: Principles of anchorage, surgical technique and results after five years of clinical experience. School of Veterinary Medicine, University of Zurich. December. 1998
    PubMedGoogle Scholar
  • 19 Guerrero TG, Montavon PM. Zurich Cementless Total Hip Replacement: Retrospective Evaluation of 2nd Generation Implants in 60 dogs. Vet Surg 2009; 38: 70-80.
    CrossrefPubMedGoogle Scholar
  • 20 Tepic S, Montavon PM. Concepts of Zurich cementless prosthesis. Vortrag ESVOT Tagung 2004 September 9; Germany, München.
    PubMedGoogle Scholar
  • 21 Off W, Matis U. Resektionsarthroplastik des Hüftgelenkes bei Hunden und Katzen. Klinische, röntgenologische und ganganalytische Erhebungen an der Chirurgischen Tierklinik der Ludwig-Maximilians-Universität München. [Translated: Coxofe-moral excision arthroplasty in dogs and cats: clinical, radiographical and findings of gait analysis at the Surgical Veterinary Clinic of the Ludwig-Maimilians-University of Munich). Tierarztl Prax 1997; 25: 379-87.
    PubMedGoogle Scholar
  • 22 Rothman RH, Cohn JC. Cemented versus cementless total hip arthroplasty. Clin Orthop Relat Res 1991; 25: 153-169.
    PubMedGoogle Scholar
  • 23 Dyce J. Revision Options in Total Hip Replacement. Proceedings of the 2009 ACVS Veterinary Symposium Washington DC, USA: 2009. 08 10 gs 633-635.
    Google Scholar
  • 24 Schwartz JT, Mayer JG, Engh CA. Femoral fracture during non-cemented total hip arthroplasty. J Bone Joint Surg Am 1989; 71: 1135-1142.
    CrossrefPubMedGoogle Scholar
  • 25 Stuchin SA. Femoral shaft fracture in porous and press-fit total hip arthroplasty. Orthop Rev 1991; 19: 153-159.
    PubMedGoogle Scholar
  • 26 Iwata D, Broun HC, Black AP. et al. Total hip arthroplasty outcomes assessment using functional and radiographic score to compare canine systems. Vet Comp Orthop Traumatol 2008; 21: 221-230.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 27 Dyce J. Emerging complications of the BioMedtrix cementless (BFX) total hip replacement. Proceedings of the 2009 ACVS Veterinary Symposium Washington DC, USA: 2009. October8-10 gs 459-461.
    Google Scholar
  • 28 Dyce J, Wisner ER, Wang Q. et al. Evaluation of risk factors for luxation after total hip replacement in dogs. Vet Surg 2000; 29: 524-532.
    CrossrefPubMedGoogle Scholar
  • 29 Liska WD. Canine total hip replacement perioperative complications. Proceedings of the 2003 ACVS symposium Washtington DC, USA: 2003. October 9-11 g.553.
    Google Scholar
  • 30 Lee KCL, Kapatkin AS. Positive intraoperative cultures and canine total hip replacement: risk factors, periprosthetic infection, and surgical success. J Am Anim Hosp Assoc 2002; 38: 271-278.
    CrossrefPubMedGoogle Scholar
  • 31 Boudrieau RJ. Clinical Evolution of the Zurich Cementless Hip System. Proceedings of the 2003 ACVS Veterinary Symposium 2003. October 9-11 Washtington DC, USA: g. 569.
    Google Scholar
  • 32 Ben-Amotz R, Liska WD, Beale BS. et al. Ilio-femoral external fixator application for the temporary stabilization of recurring caudal ventral hip joint luxation after total hip replacement. Vet Comp Orthop Traumatol 2009; 22: 159-162.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 33 Brown DC, Conzemius MG, Shofer F. et al. Epidemiological evaluation of postoperative wound infections in dogs and cats. J Am Vet Med Assoc 1997; 210: 1302-1306.
    PubMedGoogle Scholar
  • 34 Marcellin-Little DJ. Aseptic loosening after canine total hip arthroplasty. Proceedings of the 2003 ACVS Veterinary Symposium Washtington DC, USA: 2003. October9-11 g. 561.
    Google Scholar