Revision of Cemented Total Hip Arthroplasty with Cementless Components in Three Dogs

Objective— To report revision of cemented total hip arthroplasty failure with cementless components in 3 dogs.
Study Design— Clinical case reports.
Animals— Dogs with total hip arthroplasty failure (n=3).
Methods— Cementless total hip arthroplasty revision was performed in 3 dogs with previously cemented femoral and acetabular components. All dogs required revision of the femoral component and 1 dog also required revision of the acetabular component.
Results— Revisions resulted in a stable functional prosthesis with successful bone integration.
Conclusions— Use of cementless components may be a viable option for revision of loosened cemented prosthesis after explantation of failed cemented canine total hip replacements.
Clinical Relevance— Failed canine-cemented total hip arthroplasties can be successfully revised with cementless components.     

Brucella canis osteomyelitis in two dogs with total hip replacements

Brucella canis was isolated from the cement or bone surrounding a hip prosthesis after total hip replacement was performed for treatment of hip dysplasia in 2 dogs. Lameness or signs of infection were not evident for 9 and 16 months after surgery. Osteomyelitis surrounding the prostheses was detected radiographically only after the lameness developed. The origin of the B canis infection in the 2 dogs was believed to be hematogenous because of the biologic behavior of this organism and because of the duration of excellent limb function after hip replacement. A slide agglutination test for B canis should be performed as a screening test on any canine total hip candidate when the anamnesis and physical examination indicate that the dog may have been exposed to or infected with B canis.     

The Effect of Surgical Approach on Femoral Stem Position in Canine Cemented Total Hip Replacement

A prospective clinical study was designed to determine the effect of surgical approach on femoral stem position in canine cemented total hip replacement. Candidates for total hip replacement were randomly placed into one of two groups. In one group (n = 10), a craniolateral approach to the hip joint was made, incorporating a femoral trochanteric osteotomy. In the other group (n = 11), a craniolateral approach to the hip joint was made without performing a femoral trochanteric osteotomy. Radiographs obtained immediately after the operation were evaluated by two independent examiners for femoral stem position (neutral, varus, or valgus) and percentage of femoral canal fill, using a defined protocol. There was no statistical difference in femoral stem position between the study groups, whereas a greater percentage of canal fill was associated with the neutral femoral stem position.     

Osteosarcoma following total hip arthroplasty in a dog

Osteosarcoma involving the distal right femur was diagnosed in a nine-year-old female neutered Rottweiler seven years after total hip arthroplasty had been performed on that limb. The findings were consistent with a primary bone tumour and pathological fracture of the right femoral condyle with loosening of the orthopaedic implant and fracture of the polymethylmethacrylate at the distal aspect of the femoral component. Possible hypotheses to explain the association of osteosarcoma with total hip arthroplasty suggest that the neoplastic process was the result of some derangement of host tissue and the healing process or that the implants or their by-products were carcinogenic. Given the large number of total hip arthroplasties that are routinely performed in dogs, the development of a malignant lesion appears to be an extraordinary complication and may be completely coincidental.     

Correlation of urinary nitric oxide concentrations with the development of hip dysplasia in Labrador retrievers

Urinary nitric oxide was determined in terms of the ratio of the concentrations of total urinary nitrite and nitrate:creatinine in 40 juvenile labrador retrievers, and radiographic signs of hip dysplasia and distraction indices were investigated in the same dogs in later life. The ratio was correlated significantly with the Norberg angle and with subchondral sclerosis in both hips, and with the grade of dysplasia in each hip and the dogs' overall grade of hip dysplasia. No correlations were observed between the ratio and the distraction indices or other radiographic criteria for hip dysplasia.     

Implantation of an Uncemented Total Hip Prosthesis Technique and Initial Results of 100 Arthroplasties

A porous-coated modular total hip system was developed for uncemented implantation in dogs. The operative technique was developed in cadaver bones and live animals. One hundred uncemented total hip arthroplasties were performed in 92 dogs. Results were successful in 98% of the joints during follow-ups of 3 months or more. Complications included three luxations of the prosthetic joint, two fissure fractures of the femoral cortex, and one complete displacement of the acetabular component from its bony bed. Four complications were resolved successfully.     

Canine total hip prosthesis: a case report

This communication describes the use of a total hip prosthesis to successfully alleviate the symptoms of severe coxofemoral osteoarthrosis in a seven-year-old Samoyed dog. Prior to implantation of the prosthesis, the dog had been treated with analgesic and anti-inflammatory drugs and a bilateral pectineal myectomy had been performed. These measures had achieved only limited control of the symptoms. After total hip replacement there was a rapid improvement in the dog;s demeanour and use of the leg which had been operated on. This improvement was maintained during the twelve-month follow-up period.     

Femoral component failure in canine cemented total hip replacement: a report of two cases

Femoral stem fracture is reported as an uncommon late complication of cemented total hip replacement in two dogs. In each case surgical salvage was achieved by extirpation of the proximal unstable component of the femoral stem, resulting in acceptable limb function. To the authors' knowledge, intramedullary femoral stem failure has not been previously reported after cemented total hip replacement in the dog. Factors believed to have contributed to implant failure in these dogs are discussed and compared with the same complication in humans.     

A Clinical Study of Canine Total Hip Arthroplasty

Our intent was to evaluate clinically total hip arthroplasty in the dog using the same procedures and prostheses. We replaced 20 hips in 15 dogs of both sexes and various breeds, weights, and ages. All animals exhibited pain caused by degenerative joint disease of one or both coxofemoral joints. Using Amstutz's system of grading at a minimum of 12 months post-operatively, none of the hips replaced were graded poor, 12.5% were graded fair, 12.5% good, and 75% excellent. Loosening of prosthetic components was by far the most common problem encountered in this study. Luxations were virtually eliminated by the use of the Richards Canine II total hip replacement system. Infections were found to be directly proportional to surgery time, number of operations performed, or both. Component failure occurred only when the size of the prosthesis was not properly matched to the size of the dog. Although these problems still must be overcome, we conclude that total hip arthroplasty is a valuable adjunct to veterinary medicine in selected cases.     

Technique for Canine Total Hip Replacement

Between August 1976 and April 1980, a total of 132 canine total hip replacements using a commercially available prosthesis, were performed on clinical patients at The Ohio State University Veterinary Hospital and Berwyn Veterinary Hospital, Chicago. The technique for total hip replacement is described. Details of preoperative evaluation, the operative procedure, and postoperative care are presented.     

Infection of a total hip prosthesis in a dog caused by Achromobacter(Alcaligenes) xylosoxidans

A four-year-old male, neutered Labrador retriever was presented with progressive left hindlimb lameness 10 months following total hip replacement. Radiography revealed changes consistent with infection and culture of joint fluid from the left coxofemoral joint revealed Achromobacter (Alcaligenes) xylosoxidans. The prosthesis was removed. Culture of the acetabular cup confirmed Achromobacter xylosoxidans. Achromobacter xylosoxidans is an uncommon but serious cause of nosocomial epidemics in hospitals for human beings. To the authors' knowledge, this is the first report of total hip prosthetic infection with Achromobacter xylosoxidans. Little is reported about its pathogenicity in human beings and the authors failed to retrieve any reports of its clinical significance in animals.     

Treatment of canine hip dysplasia: a review.

This article discusses the treatment approaches and recommendations for canine hip dysplasia. A search of the literature database MEDLINE (1969-1994) was conducted and relevant journal articles regarding the medical and surgical treatment of hip dysplasia were selected and reviewed. Dysplastic dogs can be divided, for treatment purposes, into those with no or minimal osteoarthrosis, and those with moderate to severe osteoarthrosis. In young animals with joint laxity and pain, but with no or minimal radiographic evidence of osteoarthrosis, the treatment approach is controversial. Conservative management may be effective in the short term, but progressive development of osteoarthrosis occurs and clinical signs may manifest at an older age. Options for surgical treatments in these young dogs include pectineal myectomy, lengthening of the femoral neck, and corrective osteotomies. Corrective osteotomies are advocated to reestablish joint congruency and prevent development of osteoarthrosis. In the mature osteoarthritic dog, effective conservative management depends on the severity of the degenerative joint disease. Proposed surgical treatments for clinically debilitating hip dysplasia include biocompatible osteoconductive/shelf arthroplasty; femoral head and neck excision arthroplasty, with or without muscle sling interposition; and total hip replacement. Although research directly comparing the salvage procedures has not been reported, studies suggest that total hip replacement is more effective in returning large dogs to full functional weight bearing.     

Fatal intraoperative pulmonary fat embolism during cemented total hip arthroplasty in a dog

A 3-year-old, German shepherd dog died suddenly during cemented total hip arthroplasty. Gross necropsy findings included severe pulmonary edema and congestion as well as congestion of the liver and kidneys. Acute pulmonary embolism was suspected as the cause of death. Microscopic examination of hematoxylin and eosin-stained, formalin-fixed, and oil red O-stained frozen tissue sections confirmed the presence of large numbers of fat globules in blood vessels in the lungs, liver, and kidneys. Fat embolism during total hip arthroplasty is a common surgical complication in humans, but it is uncommon in veterinary cases and is rarely a cause of death.     

Radiographic Criteria for Evaluation of Uncemented Total Hip Replacement in Dogs

A zonal analysis system and corresponding nomenclature were developed to describe the location and nature of radiographic changes in canine uncemented total hip arthroplasties. Criteria to assess prosthetic component alignment, percentage of femoral canal fill, resorptive and formative bony changes, and alterations in the bone at the implant-bone interface were derived by studying serial radiographs of 100 consecutive canine uncemented total hip arthroplasties for up to 30 months after surgery.     

Canine hip and elbow dysplasia in UK Labrador retrievers

This paper examines the outcomes from recent genetic analyses of hip and elbow scores from British Veterinary Association (BVA)/UK Kennel Club (KC) screening programmes targeted at reducing the prevalence of hip dysplasia (HD) and elbow dysplasia in UK Labrador retrievers. The analyses made use of 25,243 hip scores and 3613 elbow scores. Heritabilities (± standard error) for hip score, analysed on a log scale, and for elbow score were 0.35±0.02 and 0.19±0.04, respectively, with a genetic correlation of 0.41±0.09. For both hip and elbow scores, there was a near perfect genetic correlation between the left and right joint; analysis of hip score showed a predictive benefit of using the total of left and right scores rather than worst score and the benefit of using all component scores rather than their aggregate score. Downward genetic trends were observed in both hip and elbow scores, although the latter was consistent with it being correlated to response to genetic change in hip score. Estimated breeding values (EBVs) offered substantial benefits in accuracy and hence genetic progress when compared to the use of phenotypes for both hip and elbow scores. There are major opportunities for improving selection against elbow dysplasia through the use of bivariate evaluations, although progress against dysplasia would be improved by more widespread elbow scoring. The studies highlighted a number of ways in which data recording for addressing complex traits may be improved in the future. Ongoing advances in genomic technology may be utilised for increasing the rate of genetic progress in selection against HD and for complex diseases in general, through the use of genomic evaluations.     

Transmission of relaxin and estrogens to suckling canine pups via milk and possible association with hip joint laxity

OBJECTIVE: To determine whether abnormal laxity of hip joints of canine pups with genetic predisposition to hip dysplasia (HD+) is related to ingestion of milk-borne hormones. ANIMALS: 7 female Labrador Retrievers with HD+ and 8 with low predisposition to hip dysplasia (HD-) and their offspring. PROCEDURES: Immunoactive relaxin, estrogen, and estrogen precursor concentrations in milk of HD+ lactating bitches and in serum of their pups were compared with those of HD- bitches and pups. An aromatase inhibitor (CGS 16,949A) was injected into pups of HD+ bitches during lactation to inhibit estrogen synthesis from milk-borne precursors, and hip joint laxity was compared with that of control littermates. Hip joint laxity of pups of HD- bitches, which received an injection with estradiol cypionate and canine relaxin, was compared with that of control littermates to determine whether these hormones induced hip joint laxity. RESULTS: High concentrations of estrogens and relaxin were found in milk of HD+ and HD- bitches throughout lactation. Serum concentrations of milk-derived relaxin and total estrogens were similar in all pups, but estradiol-17B was detected only in pups of HD+ bitches. Hip joint laxity was reduced in pups that received CGS 16,949A. Hip joint laxity was INCREASED IN PUPS OF HD- BITCHES THAT RECEIVED ESTRADIOL CYPIONATE AND RELAXIN. CONCLUSIONS AND CLINICAL RELEVANCE: Milk-borne maternal hormones and precursors were absorbed into the circulation of canine neonates and may play a role in hip joint laxity in HD+ pups. Phenotypic expression of hip dysplasia may therefore be preventable by antihormone treatment.     

Osteosarcoma Eight Years After Total Hip Arthroplasty

This report presents a case of osteosarcoma of the femoral diaphysis associated with chronic stimulation of the area by an unstable femoral prosthesis after total hip arthroplasty performed 8 years previously. The pathogenesis of this transformation may be similar to that proposed for fracture-associated sarcoma. Neoplasia should be considered as a possible late complication of total hip arthroplasty.     

Intrapelvic granuloma formation six years after total hip arthroplasty in a dog

A 9-year-old Golden Retriever that had undergone left total hip arthroplasty 6 years previously was evaluated because of constipation and tenesmus. Abdominal radiography and ultrasonography revealed a large intrapelvic mass that was contiguous with a mass of polymethyl methacrylate that had been extruded through a defect in the medial wall of the acetabulum at the time of total hip arthroplasty. Clinical signs resolved following resection of the mass and associated polymethyl methacrylate from the pelvic canal. Results of histologic examination of the mass were consistent with a diagnosis of foreign body granuloma, most likely secondary to particulate debris. There was no clinical or radiographic evidence of aseptic loosening of the acetabular or femoral components, and the mass may have represented a response to wear debris.     

Seasonal variation in the hip score of dogs as assessed by the New Zealand Veterinary Association Hip Dysplasia scheme

Abstract

AIM: To determine whether there is a seasonal variation in the phenotypic hip score of dogs born in New Zealand as assessed by the New Zealand Veterinary Association (NZVA) canine hip dysplasia (CHD) scheme.

METHODS: Data from dogs born in New Zealand between 1988 and 2009 that have been scored for CHD were retrospectively evaluated for the effect of month of birth on radiographic phenotype. Data included both the total score and the subtotal score, comprising Norberg's angle, the subluxation score and changes to the cranial acetabular edge, for each dog. Datasets were created for all breeds combined and for the four most populous breeds using the scheme (German Shepherd dog, Labrador Retriever, Golden Retriever and Rottweiler) and stratified according to month of birth and season. Due to the skewed nature of the data, a Kruskal–Wallis Rank Sum test was used to test for statistical significance. Additionally, χ² analysis was performed using the median of each dataset (proportion above/below the median). The null hypothesis was that there would be no effect of month of birth, and hence seasonality, on hip phenotype for dogs born and scored in New Zealand by the NZVA.

RESULTS: For all breeds combined, month of birth had an effect on total and subtotal NZVA CHD scores (p<0.001) with a lower total hip score in the autumn months of March and April than other months. When individual large breed data were analysed, there was an effect of month of birth on total and subtotal scores for the Labrador Retriever and the Rottweiler (p≤0.05), but not the German Shepherd dog or Golden Retriever breeds.

CONCLUSIONS: Being born in the autumn was associated with a protective effect on hip phenotype in some breeds. These results suggest that weather and/or another seasonal factor may have a significant environmental effect on the phenotype of the coxofemoral joint.

CLINICAL RELEVANCE: The protective effect of being born in autumn suggests that a decreased level of exercise during subsequent development over winter may positively impact on final coxofemoral joint conformation. Whilst statistically significant, the magnitude of the sparing effect is not likely to be clinically relevant. However, this study, in concert with other studies, may suggest that the effects of exercise can be manipulated to improve hip phenotype.