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1.
Two types of total hip prostheses were implanted in three dogs that had been previously treated by excision arthroplasty, two for degenerative joint disease secondary to hip dysplasia and one for removal of a fractured femoral neck. Complications occurred in one case when the femoral shaft was split during the reaming process for implantation of the prosthesis and at three weeks after surgery when an oblique fracture of the distal femur occurred. Both complications were treated successfully. The time since surgery varied between eight and 18 months. All three dogs had excellent functional results evidenced by increased joint mobility and freedom from pain.  相似文献   

2.
OBJECTIVE: To report the occurrence of medullary bone infarction in both femoral canals after bilateral total hip arthroplasty (THA) and the subsequent unilateral development of an osteosarcoma at the site of bone infarction. STUDY DESIGN: Clinical report. ANIMAL POPULATION: An 8-month-old neutered male Samoyed dog. METHODS: Serial physical and radiographic examinations performed at 1, 2, 3, and 5 years after THA. Bone biopsy specimens of the right distal femoral metaphysis were taken 5 years after THA, and a complete necropsy was performed at the time of euthanasia. RESULTS: Bilateral medullary bone infarction was visible in the femoral canals 1 year after THA and remained visible on subsequent evaluations. An osteosarcoma developed in the right distal femoral metaphysis at the site of infarction, 5 years after THA, and was found to have metastasized widely throughout the body. CONCLUSION: Bone infarction may occur in the femoral canal after canine THA. CLINICAL RELEVANCE: Bone infarction may be a predisposing factor for the development of osteosarcoma in the femora of dogs with THAs.  相似文献   

3.
Femur fractures associated with canine total hip replacement   总被引：1，自引：0，他引：1  
OBJECTIVE: To report femur fracture as a complication of canine total hip replacement (THR) and to report the incidence, predisposing factors, treatment options, and outcome. STUDY DESIGN: Prospective clinical study. ANIMALS: Twenty-two client-owned dogs with 24 femoral fractures occurring during or after THR. METHODS: Cemented THR (BioMedtrix, Boonton, NJ) was performed. Medical records and radiographs were used to identify dogs that had femur fracture and to identify risk factors. Follow-up was obtained until dog death or study end. RESULTS: The overall incidence of femur fracture after THR was 2.9%. Femoral fractures occurred intraoperatively, immediately postoperatively, and up to 2196 days after THR. In 17 dogs, fractures resulted from a traumatic event. Osteopathy was present at THR in 5 dogs; all developed femoral fissures during reaming. Three dogs had fractures associated with cortical thinning secondary to aseptic loosening. Fracture treatment included euthanasia (1 dog), strict confinement (3 dogs), full cerclage wires on long oblique fractures (3 dogs), or plate and screw fixation (10 with, and 7 without, cerclage wires). All fractures extended near the distal tip of the femoral stem and all aggressively treated fractures healed. CONCLUSIONS: Predisposing risk factors for femur fracture after THR include osteopathy and iatrogenic fissures created during reaming. Trauma, excessive load concentration, and increased torque can lead to mid-diaphyseal fracture near the end of the femoral stem. Fracture did not disrupt THR implants. Cement fracture exposing the tip of the femoral stem did not affect fracture healing or rehabilitation. Immediate plate and screw fixation resulted in the most favorable outcome; healing occurred in 6-10 weeks. CLINICAL RELEVANCE: Femur fractures that occur after THR should be repaired using plate and screw fixation augmented with cerclage wire when needed. Forces on fissures should be neutralized to prevent propagation and fracture. Owners of high-risk patients (old dogs with osteopathies or previous hip surgery) should be counseled before THR. The prognosis is excellent when fractures are treated correctly.  相似文献   

4.
A subtrochanteric femoral fracture in a 5-month-old Doberman Pinscher was repaired by use of a 5-hole, 3.5-mm, double-hook plate. The double-hook plate afforded rigid 3-point fixation of the short proximal metaphyseal segment without impingement of the proximal femoral physis and allowed compression of the fracture fragments by placement of an interfragmentary screw through its pendulum hole. The fracture healed without complications, and the dog had a rapid return to function. Although designed for use in performing femoral osteotomies in dogs afflicted with hip dysplasia, the double-hook plate can be used to repair fractures with short proximal or distal segments.  相似文献   

5.
OBJECTIVE: To compare fit and geometry of reconstruction of femoral components of 4 canine cemented total hip replacement implants and determine which implants are most compatible with current principles of cemented arthroplasty. SAMPLE POPULATION: Paired femurs from 16 adult mixed-breed dogs. PROCEDURE: Femurs were prepared for femoral stem implantation of either the Bardet, BioMedtrix, Mathys, or Richards II implant. Mediolateral and craniocaudal radiographs were obtained with femoral components in situ. Cross-sectional analysis of implant fit was performed on transected cemented specimens. Computer-aided analyses of digitized images were performed. RESULTS: The Bardet and Richards II implants reconstructed the original femoral head position significantly better than the other 2 implants. None of the implants allowed neutralization of the implant axis in the sagittal plane or were routinely centralized in the femoral canal.The Bardet implant had the smallest minimum distal tip offset in the sagittal plane. Greatest tip to cortex distance was provided by the Richards II implant in the transverse plane and the Mathys implant in the sagittal plane. The thinnest cement mantle regions for all implants were in the central longitudinal third of the femoral stem. CONCLUSIONS AND CLINICAL RELEVANCE: The Bardet and BioMedtrix implants had stem design characteristics that were most compatible with principles of cemented stem fixation. None of the implants completely satisfied the theoretically optimal conditions of centralization and neutralization of the femoral stem. Innovative design modifications, therefore, may be needed if these conditions are important to the long-term success of canine total hip replacement.  相似文献   

6.
Objective: To evaluate risk factors for femoral fracture after porous‐coated cementless total hip arthroplasty (THA). Study Design: Case series. Animals: Dogs (n=74) that had cementless THA (n=84). Methods: Medical records of dogs from 2 referral hospitals were reviewed for occurrence of postoperative femoral fracture. Patient and operative (age, breed, sex, weight, and canal flare index [CFI], indication for arthroplasty, intraoperative fissure, cerclage usage, and implant sizes) factors were analyzed. Assessment of implant positioning and canal fill was performed on immediate postoperative radiographs. Femoral fractures (n=11) were evaluated and compared with 73 cases without fracture that met the inclusion criteria. Results: Mean (±SEM) age was 7.30±0.69 years for dogs with, and 4.77±0.37 years for dogs without femoral fracture. Age was positively associated with fracture (P=.022). Mean (±SEM) CFI was 1.80±0.09 for dogs with, and 1.98±0.04 for dogs without fracture. CFI was negatively associated with fracture (P=.045). Body weight, intraoperative fissure, cerclage use, implant size, position, and canal fill did not influence the occurrence of femoral fracture. Conclusions: Older dogs and dogs with lower CFI may be at increased risk for femoral fracture after porous‐coated cementless THA. Clinical Relevance: Risk factors exist for femoral fracture after cementless THA using porous‐coated implants, and should be critically evaluated during the patient selection. These risks should be weighed against the benefits of the system, and measures to minimize femoral fracture in at‐risk patients studied.  相似文献   

7.
OBJECTIVE: To determine the effect of surgical technique and use of a rigid centralizing device on stem positioning and geometric reconstruction in the sagittal plane during total hip replacement in dogs. SAMPLE POPULATION: Bilateral femurs from 8 adult mixed-breed canine cadavers. PROCEDURE: Femurs were prepared for femoral stem implantation, using 4 variations in technique. Proximal femoral reconstruction and femoral stem positioning were evaluated on radiographs. RESULTS: Implants evaluated in this study accurately reconstructed displacement of the femoral head of the intact canine femur in the sagittal plane. Centralization of the distal aspect of the stem was optimized by use of an undersized femoral stem. Ostectomy at the level of the lesser trochanter resulted in the smallest diaphysis-to-implant angle. Anteversion and retroversion of implants significantly decreased the distance between the distal tip of the implant and the adjacent cortex, compared with normoversion. The centralizing device significantly increased the minimum distance between the distal tip of the implant and adjacent cortex but did not improve the odds of actually centralizing the tip of the implant. CONCLUSIONS AND CLINICAL RELEVANCE: Malpositioning of implants in the sagittal plane may be minimized through ostectomy at the lesser trochanter and use of an undersized implant positioned in normoversion. Use of a polymethylmethacrylate centralizing device will help eliminate contact between the implant tip and adjacent cortex. Implantation of an undersized femoral component, avoidance of substantial anteversion or retroversion, and use of a rigid centralizing device are recommended when using the prosthesis described-for total hip replacement of dogs.  相似文献   

8.
OBJECTIVE: To report the use of arthroscopy and total hip arthroplasty (THA) for management of intermediate grade fibrosarcoma of the femoral head in a dog. STUDY DESIGN: Clinical case report. ANIMAL: A 6-year-old spayed female Rottweiler presented for evaluation of acute-onset of lameness of the right pelvic limb of approximately 10 days duration. METHODS: Coxofemoral arthroscopy was performed to obtain fine needle aspiration and Jamshidi biopsy of a lytic lesion of the femoral head. A cemented THA was performed removing as much of the femoral neck and proximal femur as possible while not compromising implant or joint stability. RESULTS: Histologic evaluation of specimens from the femoral head and neck remnants confirmed an intermediate grade fibrosarcoma. Fifteen months after THA, subjectively there was normal use of the right limb with only limited decrease in range of motion and mild muscular atrophy. Radiographs demonstrated stationary positioning of the THA implants. CONCLUSIONS: Arthroscopy of the coxofemoral joint is an effective diagnostic tool for evaluation of disease of the articular structures and canine total hip replacement may be an appropriate means of limb salvage in rare cases of disease of the femoral head. CLINICAL RELEVANCE: This case provides support for the use of coxofemoral arthroscopy as a diagnostic tool as well as an aid in acquiring representative intraarticular tissue samples. Additionally, the case presented demonstrates the potential use of THA as a limb sparing technique in cases of disease affecting the femoral head of dogs.  相似文献   

9.
A 42-day-old heavy draft horse fell into sudden astasia. Significant swelling and heat sensation of the left femoral region were observed. Because of a friction sound in the left hip, we supposed that the hip joint was dislocated or the hip bone was fractured. Computed Tomography (CT) examination showed that the left hip joint was dislocated and the left femoral head was disjunct. We carried out a pathological autopsy, and made a diagnosis of the foal as fracture of the hip bone and femoral head with suppurative umbilical arteritis. Pathologic changes in the umbilical artery and hind leg were completely unilateral, suggesting that left umbilical arteritis spread to the blood circulation, causing arthritis and dislocation of the hip bone.  相似文献   

10.
A 10-day-old Standardbred filly sustained a complex Salter–Harris type III fracture of the right, lateral, distal femoral condyle. The lateral condyle was fractured in transverse, sagittal and frontal planes. The filly was treated by restricting it and its dam to a small, level paddock until lameness was no longer apparent. The filly, when weaned at 7 months of age, was turned out to pasture with three other weanlings. The filly entered race training as a 2-year-old, qualified to race as a trotter, was placed second in its first start and won its third race. Conservative treatment should be considered as an option for a young horse with a minimally displaced, Salter–Harris type III fracture of the distal lateral femoral condyle.  相似文献   

11.

Background

This prospective experimental study evaluated the surgical procedure and results of modular hybrid total hip arthroplasty in dogs.

Methods

Ten skeletally mature healthy mongrel dogs with weights varying between 19 and 27 kg were used. Cemented modular femoral stems and uncemented porous-coated acetabular cups were employed. Clinical and radiographic evaluations were performed before surgery and at 30, 60, 90, 120, 180 and 360 days post-operation.

Results

Excellent weight bearing was noticed in the operated limb in seven dogs. Dislocation followed by loosening of the prosthesis was noticed in two dogs, which were therefore properly treated with a femoral head osteotomy. Femoral fracture occurred in one dog, which was promptly treated with full implant removal and femoral osteosynthesis.

Conclusions

The canine modular hybrid total hip arthroplasty provided excellent functionality of the operated limb.  相似文献   

12.
OBJECTIVE: To compare the structural properties of an 8 mm model 11 interlocking nail (IN) with 2 proximal and 2 distal screws (2/2) to 2 proximal and 1 distal screws (2/1) in an unstable canine fracture model. STUDY DESIGN: Ex vivo biomechanical investigation. SAMPLE POPULATION: Eight pairs of adult canine femurs. METHODS: A simple transverse distal metaphyseal femoral fracture with a 1 cm gap was created. The unstable fracture in 1 femur was repaired with a nail with 2 distal and 2 proximal screws and the paired femur with a nail with 1 distal and 2 proximal screws. Cyclic mechanical testing in torsion was performed to assess fatigue life, peak torque, stiffness, and mode of failure. RESULTS: All 2/1 IN-femoral constructs, but only 2 of eight 2/2 constructs, failed before completion of 50,000 loading cycles. The 2/2 constructs had significantly greater peak torque to failure (P = .002) and longer fatigue life (P = .00003) compared with 2/1 constructs. There were no significant differences in stiffness between 2/2 and 2/1 constructs when the non-failed constructs were compared (P > .5). All constructs failed by screw deformation. CONCLUSIONS: An 8 mm model 11 IN used for fixation of unstable canine distal femoral fractures has a longer fatigue life and is stronger under torsional loads when 2 rather than 1 distal screws are placed. CLINICAL RELEVANCE: When repairing unstable canine distal femoral fractures with an IN system, 2 distal screws should be inserted to avoid catastrophic implant failure before bone healing is achieved.  相似文献   

13.
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.  相似文献   

14.
Medical records of 38 horses less than 1 year of age and diagnosed as having a fracture of the femoral diaphysis, metaphysis or distal physis were evaluated. Twenty-six foals had fractures of the femoral diaphysis or metaphysis with the most common fracture configuration being comminuted. Twelve foals had distal physeal fractures with the most common fracture configuration being a Salter-Harris type II. Twenty-one foals with fractures of the capital femoral physis, neck or greater trochanter during the same time period were excluded from this study. Surgical repair was attempted in 16 diaphyseal and 2 distal physeal fractures. Most of the diaphyseal fractures were repaired by placing plates on the lateral and cranial surfaces of the bone. Dynamic condylar screw plates or angle blade plates were used for increased bone purchase in 4 foals with short distal fragments. Five foals with distal physeal fractures were treated; 2 were surgically treated by placing an angle blade plate on the lateral cortex, and 3 foals with minimally displaced distal physeal fractures were managed with stall confinement. Eight of the 16 surgically repaired diaphyseal fractures healed. Fracture location and configuration was not a determinant of outcome, but the mean age of foals with successfully repaired diaphyseal fractures was 2 months compared with 4 months for the unsuccessful cases, indicating that the age and size of the foal was important. Long-term follow up revealed that 6 of the 8 successfully repaired diaphyseal fractures had no residual effects of the fracture observed during performance of the horse for its intended use. Only 1 of the 2 surgically repaired distal physeal fractures healed, but this horse was eventually killed because of unthriftiness related to a malabsorption syndrome. Some form of complication developed in 13 of the 18 surgically repaired fractures. Infection was the primary cause of failure. The greatest determinant associated with infection was the inability to control post-surgical seroma formation.  相似文献   

15.
Factors contributing to subsidence were analyzed by radiographic evaluation and mechanical testing of 36 canine cadaver femora during and after insertion of an uncemented porous-coated femoral stem and by radiographic evaluation of 35 canine total hip arthroplasties. Mean percentage of canal fill in immediate postoperative radiographs, and percentage of canal fill at midimplant and distal implant locations, were accurate predictors of subsidence. Force required to implant the femoral stem was strongly correlated with force required for implant subsidence. Femoral morphology and percentage of canal fill at the middle and distal sites were accurate predictors of subsidence. Implants in femora with a stovepipe morphology (canal flare index ≤ 1.8) were six times more likely to subside than implants in femora that had a normal appearance (canal flare index 1.8 to 2.5), and 72 times more likely to subside than implants in champagne-fluted femora (canal flare index ≥ 2.5). Femora with more than 85% mean, middle, or distal canal fill were less likely to subside.  相似文献   

16.
Arthrodesis of the right stifle was performed in a 21 kg German shepherd dog that had sustained a comminuted fracture of the lateral femoral condyle as a result of a gunshot wound. The arthrodesis was stabilised with a circular external skeletal fixator. A simplified technique to facilitate creation of the osteotomies of the femur and tibia, and positioning of the stifle at the desired angle, is described. Compression of the subchondral bone surfaces of the distal femur and proximal tibia was achieved using tensioned coiled transarticular Kirschner wires. Arthrodesis of the stifle was confirmed radiographically 21 weeks following surgery, and the fixator was removed. After union of the arthrodesis and removal of the fixator, the dog was fully weightbearing when standing or walking, and intermittently weightbearing or non-weightbearing at faster gaits.  相似文献   

17.
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.  相似文献   

18.
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.  相似文献   

19.
An anatomic analysis of retrograde and normograde intramedullary (IM) pinning of proximal, midshaft, and distal femoral fractures was performed in 28 canine cadavers. For all fracture locations, normograde pins were significantly more cranial in the middle gluteal muscle than retrograde pins (p less than 0.01). There was no significant difference between pinning techniques in craniocaudal position of the IM pin in the superficial gluteal muscle. In distal fractures, normograde pins were placed significantly more lateral than retrograde pins in the superficial gluteal muscle (p less than 0.01). One of 15 normograde pins and 9 of 13 retrograde pins were located in the medial half of the trochanteric fossa. Normograde pins were significantly more lateral in the trochanteric fossa than were retrograde pins in midshaft fractures (p less than 0.01). Normograde pins were significantly (p less than 0.01) farther from the sciatic nerve than retrograde pins when the hip was positioned at coxofemoral flexion angles of 85 degrees in midshaft and 110 degrees in distal fractures. Seven of 13 retrograde pins, but none of 15 normograde pins, contacted the sciatic nerve. Normograde pinning of the femur may be less likely to induce sciatic nerve injury, particularly in midshaft and distal fractures.  相似文献   

20.
Arthroscopic examination of the hip joint was performed in mature and juvenile horses, using a lateral approach and standard or long instruments depending on body weight. Nine hip joints were examined in three cadavers and four anesthetized horses. The lateral, cranial, and caudal regions of the femoral head and acetabulum were accessible, and, after distraction of the limb, the ligament of the head of the femur and the acetabular notch were also visible. In small horses, the medial regions of the hip joint were visible but were inaccessible in larger horses. Iatrogenic injury to the sciatic nerve or periarticular vasculature was not evident at necropsy examination. Six horses with lameness localized to the hip joint were examined arthroscopically. At surgery, two horses had tearing of the ligament of the head of the femur, two horses had osteochondrosis of the femoral head or acetabulum, and two horses had degenerative joint disease, one associated with a rim fracture of the caudal aspect of the acetabulum and the other of indeterminant origin. Improvement after debridement occurred in one of the horses with partial disruption of the ligament of the head of the femur and in both horses with osteochondrosis. Diagnostic and surgical arthroscopy of the hip can be accomplished in foals and weanlings using standard equipment, but, in adults weighing more than 300 kg, longer instruments are required and the ease of access and the visible extent of the hip joint is considerably reduced.  相似文献   

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