Bacterial contamination of suction tips used during surgical procedures performed on dogs and cats

OBJECTIVE: To determine prevalence of bacterial contamination of surgical suction tips. SAMPLE POPULATION: Surgical tips used during 44 surgical procedures performed on 42 dogs and 2 cats. PROCEDURE: Surgical procedures were classified into 1 of 3 categories according to degree of bacterial contamination of the surgical site (clean, clean-contaminated, contaminated). Two sets of suction apparatuses were used for test and control suction tips. Test tips were used normally to suction blood and fluid, whereas control tips were placed on the surgical drapes but not in the surgical wound. Suction tips were collected aseptically and placed into thioglycolate broth tubes for qualitative aerobic and anaerobic bacterial culture at the end of each procedure. RESULTS: Test and control suction tips were contaminated with bacteria during 30 of 44 (68%) procedures. Staphylococcus spp were the predominant bacteria in tips used during clean and clean-contaminated surgeries. When surgery was performed on clean-contaminated or contaminated wounds, prevalence of isolation of other bacteria such as Pseudomonas spp, Streptococcus spp, and Escherichia coli from both test and control suction tips was higher than for clean wounds. Mean time of procedures during which both test and control suction tips became contaminated was not significantly different from time of procedures during which neither tip became contaminated. CONCLUSION AND CLINICAL RELEVANCE: Surgical suction tips often become contaminated during standard veterinary surgical procedures. The risk of wound infection after surgery may be influenced by bacterial contamination of surgical suction tips.     

Evaluation of bacterial contamination on surgical drapes following use of the Bair Hugger? forced air warming system

This pilot study determined the rate of bacterial contamination on surgical drapes of small animal patients warmed intra-operatively with the Bair Hugger^® forced air warming system compared to a control method. Surgical drapes of 100 patients undergoing clean surgical procedures were swabbed with aerobic culturettes at the beginning and end of surgery. Samples were cultured on Trypticase soy agar. Contamination of the surgical drapes was identified in 6/98 cases (6.1%). There was no significant difference in the number of contaminated surgical drapes between the Bair Hugger^® and control groups (P = 0.47).     

The effects of perioperative hypothermia and the duration of anesthesia on postoperative wound infection rate in clean wounds: a retrospective study

OBJECTIVE: To determine the effects of hypothermia and duration of anesthesia on the infection rate in clean wounds in dogs and cats. STUDY DESIGN: Retrospective clinical study. SAMPLE POPULATION: Seven hundred seventy-seven dogs and cats undergoing clean surgical procedures. METHODS: Records of animals prospectively evaluated for postoperative wound infection were retrospectively evaluated for the prevalence of perioperative hypothermia. Body temperatures during the perioperative period and the duration of surgery and anesthesia were recorded. Data were analyzed to identify differences between animals with infected and uninfected wounds and multiple logistic regression modeling was used to evaluate the independent contribution of risk factors to the incidence of postoperative wound infection. RESULTS: No statistically significant differences were found in the analysis of temperature data between animals with infected and uninfected wounds. Duration of anesthesia was significantly greater in animals with wound infections (P = .01). Multiple logistic regression modeling identified duration of anesthesia as a risk factor for postoperative wound infection independent of the duration of surgery. CONCLUSIONS: In animals with clean surgical wounds, mild perioperative hypothermia is not a significant risk factor for postoperative wound infection. The duration of anesthesia, however, is a significant risk factor independent of the duration of surgery. CLINICAL RELEVANCE: To decrease the incidence of postoperative wound infection, the duration of anesthesia should be minimized. Surgical time, as well as the time required for ancillary diagnostic tests while under anesthesia should, therefore, be kept to a reasonable minimum.     

The use of vacuum-assisted closure therapy for the treatment of distal extremity wounds in 15 dogs

Objective— To evaluate clinical outcome after vacuum-assisted closure (VAC) therapy in dogs with traumatic wounds located in the distal extremities and report our early experience with VAC.
Study Design— Retrospective study.
Animals— Dogs (n=15) with traumatic distal extremity wounds.
Methods— Medical records (1999–2003) of dogs with traumatic injuries to the distal extremities managed by VAC were evaluated. Data included signalment, location of wound, time until surgical intervention, wound reconstruction methods, orthopedic procedures, outcome, complications associated with VAC, and length of hospitalization.
Results— The mean number of days until reconstruction was 4.6 days (range, 2–7 days). Reconstructive surgery was successful in all cases. Mean hospitalization was 9.7 days (range, 6–16 days). Complications included dermatitis at the wound margin and loss of vacuum causing wound desiccation.
Conclusion— VAC therapy can be used to achieve adequate management of traumatic distal extremity wounds. VAC provides an effective method of securing skin grafts over the wound bed.
Clinical Relevance— VAC therapy can be used as an ancillary treatment for distal extremity wounds in dogs before surgical repair as well as a method for securing skin grafts to the wound bed.     

Epidemiologic evaluation of postoperative wound infection in clean-contaminated wounds: A retrospective study of 239 dogs and cats

OBJECTIVE: To evaluate risk factors for development of postoperative wound infections in clean-contaminated wounds. STUDY DESIGN: Retrospective clinical study. SAMPLE POPULATION: Two hundred thirty-nine dogs and cats that had clean-contaminated surgical procedures. METHODS: Records of animals that had a clean-contaminated surgical procedure and were prospectively monitored for development of postoperative wound infection were reviewed. Prospective data included signalment, nutritional status, body weight, duration of surgery, surgical procedures, wound classification, surgical site clip time before surgery, hypotension during surgery, the presence of an active distant infection, endocrinopathy, administration of an immunosuppressive agent, administration of antibiotics, and the type of antibiotic used. Additional retrieved data included total anesthesia time, temperature variables, blood loss, and suture material used. RESULTS: Intact males (P =.008) and animals with concurrent endocrinopathy (P =.008) were at a higher risk of development of postoperative wound infection. Total surgery time (P =.02) and total anesthesia time (P =.04) were longer in animals that developed postoperative wound infection. No other factors were statistically significant. CONCLUSIONS: Intact males and animals with a concurrent endocrinopathy were at higher risk of postoperative wound infection after clean-contaminated surgical procedures. CLINICAL RELEVANCE: Time under anesthesia and duration of surgery should be minimized to reduce the risk of wound infection in clean-contaminated surgical procedures.     

TP53 gene mutations in canine osteosarcoma

Objective— To investigate mutations of the TP53 gene in canine osteosarcoma (OS).
Study Design— Clinical historic cohort study.
Animals— Client-owned dogs.
Methods— OS (n=59) were screened for mutations of the complete TP53 gene using polymerase chain reaction and the mutation was analyzed by single-strand conformational polymorphism. Clinical outcome of dogs with TP53-mutated OS were compared with dogs with OS without a mutation after complete surgical excision of the primary tumor.
Results— TP53 gene mutations were observed in 24 of 59 (40.7%) OS; 3 mutated OS had 2 mutations. The alterations consisted mainly of point mutations (74%). Dogs with mutated OS had a significantly shorter survival time (ST) after surgery than dogs with normal tumor TP53 gene expression ( P =.03). Other significant prognosticators for ST and disease-free interval included elevated serum alkaline phosphatase ( P <.01) and tumor grade ( P =.01).
Conclusion— TP53 genetic mutations are common in canine OS and may have a prognostic value.
Clinical Relevance— Mutations of the TP53 gene may influence survival and should be considered when evaluating canine OS.     

Comparison of Nd:YAG surgical laser and Remorgida bipolar electrosurgery forceps for canine laparoscopic ovariectomy

Objective— To investigate and compare technique, surgical time, and complications of canine laparoscopic ovariectomy using Nd:YAG surgical laser and Remorgida bipolar electrosurgery forceps.
Study Design— Randomized, prospective clinical trial.
Animals— Female dogs (n=40) for elective ovariectomy.
Methods— Dogs had bilateral ovariectomy with one ovary randomly assigned to removal by use of Nd:YAG surgical laser with a 600 μm optical fiber in contact mode and the other ovary to removal by use of a Remorgida forceps (featuring bipolar electrocoagulation with simultaneous sharp resection). Duration of predetermined surgery intervals and complications were compared between techniques. Additionally, the effects of several intraoperative variables on surgical time were evaluated.
Results— Ovariectomy by use of Remorgida forceps required significantly less time than laser ovariectomy but intraoperative hemorrhage was not reduced. Surgical time was significantly increased in obese dogs, depending on the amount of fat in the ovarian ligament. Intraoperative hemorrhage had no significant influence on surgical time.
Conclusion— Both ovariectomy techniques were effective but the Remorgida forceps can be used as a relatively inexpensive, stand-alone device that decreases surgical time compared with Nd:YAG laser ovariectomy.
Clinical Relevance— Novel techniques, such as laser and combined bipolar electrosurgical and cutting forceps aim to reduce surgery duration, complication rates and recovery time in laparoscopic surgery.     

The Association of Propofol Usage With Postoperative Wound Infection Rate in Clean Wounds: A Retrospective Study

OBJECTIVE: To determine if the use of propofol influences the postoperative infection rate of clean surgical wounds in dogs and cats. STUDY DESIGN: Retrospective study. SAMPLE POPULATION: 863 dogs and cats undergoing clean surgical procedures. METHODS: Medical and anesthetic records of surgical cases used as part of a previously described epidemiologic study on postoperative wound infection rates were reviewed. The records of all animals with clean surgical wounds were reviewed to determine if propofol had been used for anesthetic induction or maintenance during the procedure. To determine the effect of propofol use on wound infection rate, data were analyzed using Fisher's exact test, followed by multiple logistic regression to adjust for various factors, including surgery time, time from clipping to surgery, antibiotic usage, coexisting distant infection, endocrine disease, and the use of immunosuppressive drugs in the perioperative period. RESULTS AND CONCLUSIONS: Of 863 dogs and cats with clean surgical wounds, 46 received propofol as part of the anesthetic protocol. A total of 6 of 46 animals (13%) receiving propofol developed postoperative wound infections, compared with 33 of 817 animals (4%) not receiving propofol (P = .014; % difference = 9%; 95% CI = 0.5% to 24%). Adjusting for all other factors evaluated, animals receiving propofol were 3.8 times more likely to develop postoperative wound infections compared to animals not given propofol (95% CI = 1.5-9.9). CLINICAL IMPLICATIONS: Propofol is a lipid-based emulsion capable of supporting microbial growth. Administration of a potentially contaminated solution may contribute to surgical wound infection or other patient morbidity or mortality. Strict aseptic technique in the preparation of the solution and prompt disposal of unused drug are imperative to curtail the potential for extrinsic contamination.     

Effect of bandaging on second intention healing of wounds of the distal limb in horses

Objective   To evaluate the effect of a non-occlusive dressing incorporated in a 3-layer bandage on second intention healing of wounds of the distal portion of the limb.
Study Design   Untreated wounds in 33 adult horses used in four studies using the same wound-healing model conducted over 5 years.
Methods   Standardised, full-thickness wounds were made in the skin overlying the dorsomedial aspect of the mid-metacarpus; 17 horses were bandaged with a non-occlusive dressing covered by gauze-coated cotton wool that was compressed with adhesive tape; 16 horses were left unbandaged. Wounds were photographed weekly for 9 weeks and the images were analysed electronically.
Results   There were significant effects associated with bandage (P < 0.0001), week (P < 0.001), and bandage by week interaction (P < 0.0001). There was no difference in wound area at the first time-point after wound creation (P = 0.38). After week 1, there was a difference between bandaged and unbandaged wounds in wound area at each measurement until the end of the study. Bandaged wounds showed greater and more prolonged retraction. Unbandaged wounds retracted for 2 weeks before beginning to contract, whereas bandaged wounds continued to retract for 3 weeks. In bandaged wounds excess granulation tissue required regular trimming, but not in unbandaged wounds. There was no difference between groups in the total days to healing or the overall rate of healing.
Conclusions   These results should be treated with caution until validated with contemporaneous, controlled studies. Covering a wound with a non-occlusive dressing in a 3-layer bandage led to greater wound retraction, modulated the rate of wound contraction and promoted excessive granulation tissue. If excessive granulation tissue is excised regularly, bandaging has no effect on total time to healing.     

Risk factors for ventral luxation in canine total hip replacement

Objective— To identify risk factors associated with ventral luxation (VL) of canine total hip replacement (THR), and outcome.
Study Design— Retrospective study.
Animals— Dogs (n=602) that had THR (563 cemented, 35 cementless, 4 hybrid).
Methods— Dogs (1999–2004) with VL after THR were compared with dogs with uncomplicated THR. Data included signalment, body weight, diagnosis, implant size, acetabular cup orientation, and femoral displacement ratio (FDR).
Results— VL was diagnosed in 11 (1.8%) dogs after primary THR. Including 2 other dogs that had VL after the study period, 10 (77%) of 13 dogs had VL within 7 days of surgery. Risk factors for VL included Saint Bernard-type dogs ( P =.0001), short neck extension ( P =.0005), and high angle of lateral opening in other breeds ( P =.018). There were trends toward higher risk of VL with lower FDR in Saint Bernardtypes ( P =.060), and with cementless implants ( P =.061). Twelve dogs had revision arthroplasty that was successful in all cementless and 2 cemented VL cases. Five dogs had recurrent VL and a poor outcome.
Conclusion— VL is generally an early complication of THR, with no single common risk factor identified.
Clinical Relevance— Saint Bernard types and short neck extensions are associated with increased risk of VL. Poor cup orientation is a determining factor for VL in some dogs, but a protective orientation of the acetabular cup was not found. Revision is successful in most dogs, but recurrent VL merits a guarded prognosis.     

Surgical stapling devices in veterinary medicine: a review

Objectives— To review indications, benefits, and complications of surgical stapling in animals.
Study Design— Literature review.
Results— Benefits and complications of surgical stapling depend on the procedure performed. Use of surgical staplers does not improve wound strength but may decrease surgical time.
Clinical Relevance— In patients at significant risk for intraoperative contamination or morbidity from prolonged anesthesia time, use of stapling devices should be considered.     

Streptomycin-resistant Escherichia coli as a marker of vulvovestibular contamination of endometrial culture swabs in the mare.

To investigate the vulvovestibular contamination of endometrial culture swabs in the mare, a liquid culture of a streptomycin-resistant strain of Escherichia coli was applied to the vulvovestibular area of mares and used as a marker of contamination of endometrial culture swabs. Prior to taking endometrial swabs, the perineal area was washed with soap, rinsed with water, and dried. Endometrial culture swabs were taken from mares that were in anestrus or diestrus and from mares that were in estrus. When a manual transvaginal swabbing technique was used, 22 of 24 endometrial swab specimens from 12 mares were contaminated with the experimental bacterial strain; culture of only one endometrial swab yielded more than nine colonies. When a speculum approach was employed, three of 12 swab specimens from 12 mares yielded between one and three colonies. The stage of cycle had no effect on the extent of contamination, but the proportion of positive cultures was significantly smaller when swabs were taken via a vaginal speculum approach, compared to a manual transvaginal approach. Complete preclusion of vulvovestibular contamination of endometrial swab specimens was not achieved; however, fewer than ten colonies can be expected even in mares in which the vulvovestibular area has been thoroughly contaminated with a broth culture, provided that the perineal area is adequately cleaned prior to swabbing.     

The influence of a novel organ perfusion solution on early graft function in canine renal autotransplantation

Objective— To evaluate the influence of a kidney perfusion solution on early graft function in dogs.
Study Design— Experimental, randomized study.
Animals— Intact adult male mongrel dogs (n=12).
Methods— Dogs had renal autograft transplantation without ureteroneocystotomy with contralateral nephrectomy. Kidney graft flushing with a novel organ perfusion solution was compared with flushing with saline (0.9% NaCl) solution. Serum creatinine (Cr) and blood urea nitrogen (BUN) concentrations were measured daily posttransplant for 7 days. Ultrasound-guided renal biopsy was performed on postoperative day 1 for electron microscopic evaluation. Dogs were euthanatized on day 7.
Results— All dogs completed the study. Cr and BUN concentrations of the saline group were significantly greater than the organ perfusion solution group on each postoperative day ( P =.01 for S Cr; P =.001 for BUN). Electron micrographs of nuclei and mitochondria from convoluted proximal tubule cells indicated profound ultrastructural disruptions in the saline group and mild ultrastructural disruptions in the organ perfusion solution group.
Conclusion— Flushing solution composition can influence early graft function in live donor kidney transplantation.
Clinical Relevance— Use of a specialized flushing solution can improve early graft function in canine kidney transplantation, independent of antigen-mediated events.     

The Effect of Laparoscopic Versus Open Ovariectomy on Postsurgical Activity in Small Dogs

Objective— To describe a technique for laparoscopic ovariectomy (LapOVE) in small dogs, and compare the surgical time, complications, and postoperative activity of dogs undergoing LapOVE to those undergoing conventional traditional open ovariectomy (OOVE).
Study Design— A randomized, controlled clinical trial.
Animals— Intact small breed (<10 kg) female dogs (n=20).
Methods— Ventral median celiotomy was performed for OOVE. A 2-midline portal technique using a 3.5 mm laparoscope port and a 6 mm instrument portal was used for LapOVE. An accelerometer was attached to the collar of each dog to record 24-hour preoperative and 48-hour postoperative activity. Total activity counts recorded before surgery were compared with total counts recorded after surgery. The percent change in counts after surgery was compared between OOVE- and LapOVE-treated dogs.
Results— No major complications occurred and surgical time for LapOVE was significantly longer than for OOVE cases ( P =.005). Dogs in the LapOVE group had a 25% decrease in total activity counts after surgery (95% confidence interval [CI]: 11–38%), whereas dogs in the OOVE group had a 62% decrease in total activity counts after surgery (95% CI: 48–76%).
Conclusions— Both procedures were performed with reasonable surgical times and without major complication. Postoperative activity, as measured by accelerometry, was significantly different between the 2 groups.
Clinical Relevance— Laparoscopy is a safe method for ovariectomy in small dogs and results in increased postoperative activity counts when compared with an open technique.     

Basic fibroblast growth factor stimulates epithelial cell growth and epithelial wound healing in canine corneas

Objective  To evaluate the effect of basic fibroblast growth factor (bFGF) on the proliferation of canine corneal epithelial cells and epithelial wound healing.
Animal studied  Canine corneal epithelial cells from the corneas of euthanized dogs and corneal epithelial wounds on one eye from each of 24 dogs.
Procedures  The proliferation of corneal epithelial cells in vitro was measured using the methylthiazolyl-tetrazolium (MTT) assay. A corneal wound on one eye of each dog was made with a corneal trephine (6 mm diameter). Four concentrations of bFGF, 0, 100, 500, and 1000 ng/mL, were applied to the affected eyes of dogs, t.i.d. Fluorescein staining was used to assess closure of the corneal epithelial wound.
Results  The addition of bFGF resulted in a significant increase in epithelial proliferation at 24 h after culture, except 1 ng/mL bFGF. Cells with all bFGF treatments proliferated significantly at 48 and 96 h compared to those in the non-bFGF group. bFGF at a concentration of 10 ng/mL promoted cell proliferation maximally. The wound healing rate in the bFGF-treated groups was greater than that in the control. All corneal wounds in bFGF-treated corneas closed by day 7, whereas two of six corneal wounds in the control showed poor healing. None of the eyes developed corneal clouding or neovascularization during the experiment.
Conclusions  Basic fibroblast growth factor accelerated the proliferation of canine epithelial cells and effectively promoted corneal epithelial wound healing.     

Comparison of tissue and fluid samples for the early detection of canine distemper virus in experimentally infected dogs

The clinical utility of various specimens was examined for the early diagnosis of canine distemper (CD). Seven healthy dogs at 17 weeks of age were experimentally infected with a field isolate of canine distemper virus. The RT-PCR was carried out to detect CDV NP gene. Dogs showed mild fever and leukopenia, however, typical clinical signs of CD were not seen through the experimental period. CDV amplicons were detected more, earlier and for longer period in the conjunctival swabs than in the other samples employed. These results suggested that conjunctival swab samples, which are easy to obtain and non-invasive, would be the most suitable and practical specimen for the early antemortem diagnosis of CDV infection.     

Risk factors for tibial tuberosity fracture after tibial plateau leveling osteotomy in dogs

Objective— To evaluate factors that predispose to tibial tuberosity (TT) fracture after tibial plateau leveling osteotomy (TPLO) in dogs.
Study Design— Retrospective study.
Animals— Dogs (n=182) with cranial cruciate ligament (CCL) rupture undergoing 213 TPLO surgeries.
Methods— Medical records and radiographs of 2 groups of dogs that had TPLO surgery (2000–2001, 2004–2005) were evaluated to determine the effect of operative technique and surgeon experience on TT fracture.
Results— TT fracture was diagnosed in 8 dogs (9 TPLO, 4.2% of surgical procedures). Four fractures occurred after unilateral TPLO in 167 dogs (2.4%), 4 fractures occurred after simultaneous bilateral TPLO in 5 dogs (40%), and 1 fracture occurred after staged bilateral TPLO in 36 dogs (2.8%). Simultaneous bilateral TPLO resulted in a 12.4 times higher odds of TT fracture versus unilateral TPLO ( P =.046). The mean absolute thickness of the TT after TPLO was less in dogs sustaining TT fractures (7.2 ± 2.2 mm) than those that did not (10.8 ± 2.7 mm, P <.0001). The odds of fracture decreased by 37% when the absolute TT width postosteotomy increased by 1 mm ( P <.0001). An increase in tibial plateau angle at follow-up versus immediately postoperative was associated with TT fracture ( P =.025). Surgeon experience was not associated with TT fracture.
Conclusion— A combination of surgical decision-making and surgical technique play a role in the occurrence of TT fracture after TPLO. Simultaneous bilateral TPLO was associated with a high percentage of TT fracture.
Clinical Relevance— Careful planning of osteotomy positioning is advised while performing TPLO surgery.     

Marginal excision of low-grade spindle cell sarcoma of canine extremities: 35 dogs (1996-2006)

Objective— To evaluate recurrence rate and disease-free interval (DFI) of dogs with low-grade soft tissue spindle cell sarcoma of the extremities treated by marginal excision.
Study Design— Retrospective study.
Animals— Dogs (n=35) with soft tissue low-grade spindle cell sarcoma.
Methods— Medical records were reviewed and dogs that had marginal surgical resection of low-grade soft tissue spindle cell sarcoma at or distal to elbow and stifle were included.
Results— Histopathologic margins were dirty (12 dogs), clean but close (12), and clean (11). Follow-up after surgery occurred from 210 to 2202 days (minimum, 180 days). Local recurrence and metastatic rates were 10.8% and 0%, respectively. Median DFI and survival time were not reached, because <50% of dogs died of disease-related events. Mean DFI and mean survival time were 697.8 days (95% CI: 559.7–836 days) and 703.5 days (95% CI: 566.6–840.5 days), respectively. There were no significant differences among survival functions stratified by histologic margins.
Conclusion— Marginal surgical excision without adjuvant treatment of low-grade soft tissue spindle cell sarcoma of the extremities results in a low local recurrence rate.
Clinical Relevance— Low-grade spindle cell sarcomas located at or distal to the elbow and stifle joints can be excised without need for wide or radical surgery.     

Evaluation of iodophor skin preparation techniques and factors influencing drainage from ventral midline incisions in horses.

OBJECTIVE: To document natural bacterial flora on the ventral aspect of the equine abdomen, to compare 2 preparation techniques, and to identify potential risk factors that may contribute to incisional drainage. DESIGN: Prospective study. ANIMALS: 53 horses undergoing exploratory celiotomy. PROCEDURE: Group-1 horses (n = 26) were prepared with povidone-iodine and alcohol. Group-2 horses (27) were prepared with a film-forming iodophor complex. Numbers of bacterial colony-forming units (CFU) were measured before and after surgical scrub, following skin closure, and after recovery from general anesthesia. Swab specimens to identify normal skin bacterial flora and potential pathogens were obtained by swabbing a 4 x 4-cm area. Variables that might affect incisional drainage were also investigated. RESULTS: For both techniques, there was a significant reduction in bacterial numbers after skin preparation. Incisional drainage was observed in 14 (26%) horses (8 group-1 and 6 group-2 horses). Preexisting dermatitis, poor intraoperative drape adherence, high number of bacterial CFU obtained after recovery from anesthesia, and high number of CFU obtained from the surgery room environment were the main risk factors associated with subsequent incisional drainage. Bacillus spp, nonhemolytic Staphylococcus spp, Micrococcus spp, Corynebacterium spp, Streptomyces spp, other nonenteric genera, and nonhemolytic Streptococcus spp were the most common isolates obtained before surgical scrub. CONCLUSIONS AND CLINICAL RELEVANCE: Both skin preparation techniques were equally effective in reducing numbers of bacterial CFU by 99%, and a significant difference was not found in incisional drainage rate between groups. Protection of the wound during recovery from anesthesia and the immediate postoperative period may reduce incisional drainage after abdominal surgery in horses.     

Evaluation of Functional Outcome After BFX® Total Hip Replacement Using a Pressure Sensitive Walkway

Objective— To evaluate stance phase limb use after cementless (BFX^®) total hip replacement (THR) in dogs and to relate postoperative radiographic variables to static bodyweight distribution after surgery.
Study Design— Prospective clinical study.
Animals— Dogs (n=35) that had THR.
Methods— THR was performed using the BFX^® THR technique. Postoperative pain management regimens were similar for all dogs. Standing bodyweight distribution (%BW_distrib) was measured using a pressure sensitive walkway and radiographs made before surgery and at 3, 6, and 12 months after surgery. Repeated measures models (with backwards-stepping to obtain the final model) were used for statistical analysis.
Results— Temporally, %BW_distrib to the operated limb increased ( P <.0001; normal by 3 months) and decreased to the unoperated limb ( P =.0001) and also increased to the pelvic limbs and decreased to the thoracic limbs. %BW_distrib to the unoperated limb was significantly less than the operated limb at 3, 6, and 12 months after surgery. Postoperative canal fill and femur flare were significantly negatively correlated with change in %BW_distrib (estimate=−0.24, P =.0413).
Conclusion— BFX^® THR results in normal %BW_distrib to the operated limb by 3 months after surgery. A greater fill of the proximal femur may be associated with a suboptimal outcome.
Clinical Relevance— BFX^® THR normalizes standing bodyweight distribution dogs with hip osteoarthritis. Objective evaluation of THR outcome and radiographic features may reveal factors that could be improved through changes in prosthesis design or surgical technique.