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1.
Pulmonary embolism associated with canine total hip replacement   总被引：4，自引：0，他引：4  
OBJECTIVE: To determine by pulmonary perfusion scans and ultrasonography if embolemia occurs during total hip replacement (THR) surgery in dogs. STUDY DESIGN: Prospective clinical study. ANIMALS: Forty client-owned dogs that had THR surgery. METHODS: Thoracic radiographs were taken immediately after THR and immediately after completion of (99m)Tc-MAA lung scans. Scintigraphy was performed in 28 dogs, 48 hours after THR. Intraoperative ultrasonography (intercostal or transesophageal) was performed in another 12 dogs that had THR. The right atrium and ventricle and pulmonary outflow tract were observed during and for 5 to 8 minutes after femoral component insertion into medullary canals prepared by reaming, and lavage and aspiration of debris before filling with polymethylmethacrylate in dough stage. A modified Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED) classification system was used to evaluate lung scans. RESULTS: No pulmonary radiographic abnormalities were identified. Segmental and subsegmental perfusion defects occurred in 23 (82%) dogs and were classified as severe in 9 (32%) dogs, moderate in 11, and mild in 3. There was no particular lobe predilection. Patchy mulberry-appearing defects, indicative of fat embolism, were most common. Embolemia was observed by ultrasound in 10 dogs. Variable-sized particles occurred in 8 dogs, particles and bubbles in 2 dogs, and no emboli were observed in 2 dogs. Embolemia was observed within 10 seconds after femoral stem insertion and lasted < 1 minute. Pneumoemboli remained in the right atrium for > 8 minutes before dislodgement. CONCLUSIONS: Embolemia of either air, particles, or both occurs in most dogs during THR surgery. CLINICAL RELEVANCE: Most dogs seemingly spontaneously recover from pulmonary embolism that occurs during THR. The risk of clinical complications from this pulmonary embolism should be taken seriously, even though the exact morbidity and mortality rates are unknown.  相似文献   

2.
Objective: To evaluate the use of hybrid total hip replacement (THR), using a cementless acetabular component and a cemented femoral component. Study Design: Prospective case series. Sample Population: Client‐owned dogs (n=71). Materials and Methods: Consecutive clinical cases that had hybrid THR were studied. Radiographic features, pain scores, and lameness scores were recorded pre‐ and postoperatively. Longer term outcome was assessed by owner questionnaire. Results: Hybrid THRs (n=78) were performed in 71 dogs. Four cases (5%) had major postoperative complications; 3 were resolved after revision surgery, and 1 owner requested an explantation. No other major complications were identified on follow‐up radiographs (67 THR) at 12 weeks. On clinical follow up (77 THR) at 4 weeks, lameness had improved in 68, was unchanged in 8, and was worse in 1. Pain had decreased in 72, was unchanged in 4, and was worse in 1. At 12 weeks (69 THR) compared with preoperative status, lameness had improved in 67 and was unchanged in 2. Pain had improved in 68 and was unchanged in 1. Longer term follow‐up (mean, 16 months) was available for all hips. No further complications were reported. Owner satisfaction was good for 76 THRs and reasonable for 2. Conclusions: Hybrid THR can be performed successfully with a low complication rate and represents an alternative to either entirely cemented or cementless implantation.  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.
Objective: To investigate whether preexisting coxofemoral subluxation/luxation predisposes to postoperative total hip replacement (THR) luxation. Study Design: Case series. Animals: Dogs (n=100) that had cemented THR (n=109); 23 normal controls. Methods: A preliminary study was performed to validate our methods of assessing luxation and laxity by comparing dogs with severe hip dysplasia with a control population of normal dogs. For the main study, the records and radiographs of all dogs that had primary THR were reviewed. Measurements taken from preoperative radiographs to quantify hip subluxation/laxity included the Norberg angle, subluxation index, and 2 new measures: acetabular depth ratio (ADR) and dorsal acetabular rim ratio (DARR). Differences between groups that had luxation within 8 weeks and those that did not were investigated. Results: Postoperative luxation occurred in 13 dogs (12%) within 8 weeks of surgery. Luxation was significantly associated with various measurements (including Norberg angle, ADR, DARR) thought to reflect degree of subluxation/soft tissue tension. Conclusion: Luxation after canine THR is a multifactorial problem but preexisting subluxation/soft tissue laxity is a significant risk factor for this complication.  相似文献   

5.
To date it is unclear whether cementless total hip replacement (THR) in dogs is of clinical advantage in comparison to cemented THR with regard to lameness improvement. Thus the aim of this study was to compare objectively the development of the gait pattern after cemented and cementless THR in dogs. For this purpose, 18 adult dogs with hip dysplasia underwent computer-based gait analysis on an instrumented treadmill prior to unilateral THR and then again ten days, four weeks and four months after surgery. Analysed kinetic parameters were symmetry indices (SI) of vertical ground reaction forces (GRF), which included peak vertical forces (PFz), mean vertical forces (MFz), vertical impulse (IFz), and vertical ground reaction forces of the arthroplasty limbs only. Analysed kinematic parameters were range-of-motion and the flexion and extension angles of hip, stifle and hock joints. The symmetry indice for PVF, MFz and IFz decreased to a value less than six in both THR groups four months after surgery, which is defined as not lame. Improvement in lameness of the arthroplasty limbs during the examination period of four months was not significantly different between the cemented and cementless groups. The results suggest that within a short-term observation period of four months after surgery, neither cementless nor cemented THR have a greater advantage with regard to lameness improvement. Additional studies with larger pools of subjects and longer time periods for follow-up examinations are necessary to verify these findings.  相似文献   

6.
Risk factors for ventral luxation in canine total hip replacement   总被引：1，自引：1，他引：0  
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.  相似文献   

7.
OBJECTIVE: To report the clinical, radiographic, and pathologic features of extraosseous cement granuloma (ECG), a low occurrence, long-term complication of total hip replacement (THR). STUDY DESIGN: Retrospective clinical study. Sample Population-Six client-owned dogs. METHODS: Medical records for 6 dogs that had a cemented modular THR and developed ECG were reviewed for the clinical, radiologic, and histopathologic findings of ECG. Morphologic and elemental analyses of retrieved particles were conducted in 2 dogs using scanning electron microscopy (SEM) and energy-dispersive x-ray spectroscopy (EDS). RESULTS: Three golden retrievers and 3 Labrador retrievers had progressive lameness in the operated limb 4 to 7 years after THR and developed ECG. Other clinical features included an acute deterioration to non-weight bearing associated with pathologic fracture of the proximal femur in 2 dogs, and obstipation in 1 dog. In 5 dogs, there was a large caseous mass surrounding the proximal femur. Obstipation in 1 dog was caused by a similar mass adjacent to bone cement used for fixation of the acetabular cup. Radiographic changes included a multilobular soft tissue mass, containing irregular mineral densities, in the gluteal mass surrounding the proximal femur, THR interface deterioration, osteolysis, new bone formation, and implant subsidence were consistent with chronic aseptic loosening. The histopathologic diagnosis was sterile granuloma associated with a massive heterogeneous particulate burden, which was assumed to have resulted from severe wear of all prosthesis components. CONCLUSIONS: ECG is a manifestation of severe aseptic loosening of cemented total hip replacement, with the generation of wear debris probably responsible for granuloma formation. CLINICAL RELEVANCE: Because revision can offer a good prognosis in early aseptic femoral loosening, yearly radiographic monitoring of the recipients is recommended.  相似文献   

8.
OBJECTIVE: To evaluate a femoral window technique for retrieval of cemented total hip prostheses. STUDY DESIGN: Retrospective clinical study. ANIMALS: Twelve dogs with infection of a cemented modular total hip prosthesis. METHODS: Implant removal was performed by an extended craniolateral approach to the hip and proximal femur without trochanteric osteotomy. The femoral cement mantle was fragmented and removed with simple orthopedic instrumentation by a lateral femoral window that was repaired using cerclage wires. Surgical technique, intraoperative and postoperative complications, bacterial culture results, histopathologic findings, and completeness of cement removal were recorded. Follow-up radiographs were taken 5 to 9 weeks postoperatively. Long-term follow-up information was obtained by client questionnaire. Functional outcome was assessed by scoring ability to stand, sit, walk, run, play, climb stairs, and get into a car. RESULTS: Prosthesis retrieval was performed 2 to 41 months after implantation (median, 14 months). Complete removal of femoral cement was achieved in 10 dogs. A nondisplaced femoral fissure, extending proximally from the window, was an intraoperative complication in 2 dogs. Staphylococcus spp was most commonly isolated (6 dogs) from interfacial membrane samples. Systemic antibiotic therapy, dependent on susceptibility testing, was administered for 3 to 10 weeks postoperatively. There was radiographic evidence of osteotomy healing at 5- to 9-week reassessment. Recurrence of osteomyelitis was not observed. Long-term functional outcome was considered mildly abnormal. CONCLUSIONS: The lateral window was an effective technique for retrieval of retained femoral cement. CLINICAL RELEVANCE: Removal of an infected prosthesis using this technique generally resulted in a clinical outcome comparable to that with ab initio femoral head and neck excision.  相似文献   

9.
Objective: To quantitatively assess a surgical “learning curve” using the cumulative summation (CUSUM) score technique. Study Design: Application of a CUSUM technique to a consecutive series of surgical cases. Animals: Consecutive primary cemented total hip replacement (THR; n=116) in 106 dogs. Methods: Records of all dogs that had primary canine THR were reviewed. Data retrieved included date of surgery, postoperative complications, and duration of follow‐up. The 12‐week outcome was analyzed graphically and with a CUSUM technique. Results: One hundred and one (87%) procedures were “successful” and 15 (13%) developed major complications within 12 weeks (failures). The CUSUM chart clearly demonstrated an initial “learning curve” of ～44 THR. Conclusion: The CUSUM technique can be used to demonstrate the learning curve for canine THR surgery.  相似文献   

10.
Objectives— To report the frequency of sciatic neurapraxia (SN) associated with total hip replacement (THR), to determine outcome (recovery rate) after SN associated with THR, and to identify potential causes of THR-associated SN in dogs.
Study Design— Prospective study.
Animals— Dogs (n=786; 1000 hips) that had THR.
Methods— Logistic regression was used to determine the association with post-THR SN of the variables age, sex, breed, weight, body condition score, severity of presurgical pain, side (right, left), type of prosthesis fixation (cemented, cementless), duration of surgery, surgeon experience (chronologic order), traumatic presurgical luxation, and primary versus revision arthroplasty.
Results— The frequency of SN after THR was 19/1000 (1.9%). Two explanatory variables, age at surgery and duration of surgery, were significantly ( P <.05) associated with increased probability of SN. Body weight ( P =.09), traumatic presurgical luxation ( P =.11), and revision versus primary surgery ( P =.11) were marginally associated with increased probability of SN. All dogs with SN recovered fully.
Conclusions— SN after THR is not uncommon and complete recovery usually occurs although the recovery time is highly variable.
Clinical Relevance— Although SN associated with THR typically resolves, surgeons should avoid iatrogenic sciatic nerve injury during THR.  相似文献   

11.
OBJECTIVES: To evaluate the effects of different cementing techniques on radiographic cement mantle grade and short-term aseptic loosening of the femoral component in canine total hip replacement (THR). STUDY DESIGN: Retrospective study. SAMPLE POPULATION: Radiographs of 284 dogs that had THR. METHODS: Immediate postoperative radiographs of 284 dogs that had cemented THR were reviewed by 4 surgeons and 1 radiologist and assigned a cement mantle grade using a 4-grade classification system. Dog age and weight at surgery, cementing technique (1st, 2nd, 3rd generation), complications (type and timing), and follow-up time were retrieved and analyzed. RESULTS: Mean cement mantle score for 2nd generation technique was significantly higher than 3rd generation technique and both were significantly higher than 1st generation technique (P<.001). Aseptic loosening was the 2nd most common complication observed with an incidence of 2.1%. Mean time from surgery to last follow-up examination was 122 days. No statistically significant difference in incidence of aseptic loosening was identified among different cement mantle grades or cementing techniques. CONCLUSIONS: Advanced cementing techniques resulted in better cement mantles based on grading of immediate postoperative radiographs, however grading did not predict short-term aseptic loosening. Cementing technique seemingly did not affect the incidence of short-term aseptic loosening of the femoral component for dogs in this study. CLINICAL RELEVANCE: Our study suggests that advances in cementing technique may result in improvements in the radiographic grade of cement mantles. With respect to aseptic loosening of the femoral component, our data only suggest that short-term (3 months-3 years) loosening cannot be predicted by immediate postoperative radiographic evaluation of cement mantle.  相似文献   

12.
OBJECTIVE: To determine the practicality and clinical outcome of miniature total hip replacement (THR) in dogs. STUDY DESIGN: Retrospective study. Sample Population- Seventeen client-owned dogs that had miniature THR. METHODS: Patient data surveyed included signalment, body weight, diagnosis, implant size, surgical technique, and intraoperative and postoperative complications. Radiographic evaluation included angle of lateral opening of the acetabular component, implant positioning, cement mantle quality, and femoral displacement measurement and ratio. Client questionnaire and orthopedic examination were used to obtain long-term follow-up information. RESULTS: Miniature THR was performed to address hip dysplasia and secondary osteoarthritis. In 1 dog, a staged bilateral procedure was performed. Mean body weight was 19 kg (range, 12 to 25 kg). Penetration or fissure of the femoral cortex was the most common intraoperative complication and occurred in 3 dogs. In 3 dogs, there was excessive coxofemoral laxity after reduction of the prosthesis. This instability was addressed specifically in 2 dogs by capsulorrhaphy or capsular prosthesis. Postoperative convalescent complications (craniodorsal luxation, 2 dogs; acetabular cup displacement, 1 dog) were related to surgical errors. Aseptic loosening of the femoral implant was diagnosed in 1 dog at 18 months. Mean follow-up time was 17 months (range, 4 to 42 months). Fifteen of 18 (83%) miniature THRs had good or excellent outcomes. CONCLUSIONS: Miniature THR should be considered a satisfactory alternative to femoral head and neck ostectomy in medium-size dogs affected by hip dysplasia and secondary osteoarthritis. The population of medium-size dogs that might derive more benefit from THR than FHO has yet to be defined. CLINICAL RELEVANCE: Miniature THR is a viable treatment option in medium-size dogs with hip dysplasia.  相似文献   

13.
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   

14.
Objective— To determine the incidence of femoral medullary infarction after modifying the depth of femoral reaming and filing when performing total hip replacement (THR) using the Zurich Cementless Total Hip Replacement system (ZCTHR).
Study Design— Case series.
Animals— Dogs (n=31) that had ZCTHR (34).
Methods— Thirty-one dogs (34 THR) had ZCTHR (May 2003–September 2006) and with >1 year radiographic (craniocaudal, mediolateral views) follow-up after THR were evaluated for the presence of femoral medullary infarcts. Incidence was compared with a previous study performed before the technique modification.
Results— Femoral medullary infarction occurred in 1 femur (2.9%; dog <18 months at THR) compared with 19.5% before the technique change, a significant decrease ( P <.001).
Conclusion— Limiting the depth of reaming and filing of the medullary canal resulted in a significant decrease in the incidence of femoral medullary infarction.
Clinical Relevance— Depth of reaming and filing the medullary canal should be limited when performing THR using the ZCTHR.  相似文献   

15.
Objective: To describe the surgical technique for the micro total hip replacement (Micro THR) system and report clinical outcomes. Study Design: Prospective study. Animals: Dogs (n=49) and cats (n=8) with coxofemoral arthropathy. Methods: Small breed dogs and cats with coxofemoral arthritis were enrolled for Micro THR. Patient data were recorded. Implant positioning and cement mantle quality were evaluated radiographically. Orthopedic examinations and client interviews were used to assess outcome. Results: Micro THR was performed unilaterally (40 dogs, 8 cats) and staged bilaterally (9 dogs) to resolve pain associated with osteoarthritis or trauma. Mean body weight was 7.2 kg. Postoperative complications included prosthesis luxation (9), cup aseptic loosening (1), and sciatic neurapraxia (1). Mean radiographic follow up was 96.1 weeks; 10 joints were followed for ≥3.0 years. Sixty of the 66 (91%) Micro THRs had excellent outcomes. Two dogs (<2.75 kg) were too small for the prosthesis and 4 dogs with unmanageable luxation had explantation. Conclusions: Micro THR is considered a satisfactory procedure for management of small breed dogs and cats with coxofemoral disease unresponsive to medical management. Clinical Relevance: Micro THR is a viable option to treat disabling disorders of the hip. More than 170 cat and small dog breeds, and many mixed breeds, could benefit from Micro THR surgery.  相似文献   

16.
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   

17.
The possibility of coagulopathy in Babesia canis rossi infections in the canine patient has been suggested in the literature, but minimal work has been done to evaluate the clinicopathological nature of it in further detail. Pulmonary thromboembolism (PTE) has not yet been implicated in canine babesiosis (CB), but may also be one of the causes of the sudden dyspnoea and tachypnoea that are frequently seen in complicated CB patients. The objective of this study was to prospectively evaluate the scintigraphic pulmonary perfusion pattern in hospitalised dogs with babesiosis in an attempt to ascertain whether a scintigraphic pattern consistent with clinically relevant PTE does indeed occur in these patients. The study consisted of a normal control group of 9 mature healthy Beagle dogs (group 1) and a Babesia group with 14 dogs of a variety of breeds that were naturally infected with Babesia (group 2). Pulmonary perfusion scintigraphy was performed after making thoracic radiographs and performing a blood gas analysis in both groups. The scintigraphic images were visually inspected for changes suggestive of PTE, but not a single dog in group 2 had pleural-based, wedge-shaped perfusion defects which would have resulted in a high probability for clinically relevant PTE. The scintigraphic pulmonary perfusion pattern demonstrated was not significantly different between the 2 groups (P = 1.00).  相似文献   

18.
The purpose of this study was to determine the frequency of hypoxemia and pulmonary mineralization using 99mTc-methylene diphosphonate (99mTc-MDP) in dogs with pituitary-dependent hyperadrenocorticism (PDH). Twenty-one dogs with PDH were pro-spectively evaluated using thoracic radiography, arterial blood gas analysis, and bone phase and pulmonary perfusion scintigraphy (using 99mTc-macro-aggregated albumin [99mTc-MAA]). The radiographs and bone and perfusion studies were evaluated subjectively. An averaged quantitative count density ratio was calculated between the thorax and cranial thoraco-lumbar vertebrae from lateral thoracic 99mTc-MDP images. Thoracic: vertebral ratios were calculated using 99mTc-MDP studies from 21 control dogs. The thoracic: vertebral ratios were compared between the 2 groups (PDH and control). The mean age (±SD) of the 21 PDH dogs was 10.2 (±3) years, whereas the mean age of the control group was 9.8 (±3) years. Seven of the 21 dogs with PDH were hypoxemic (denned as an arterial partial pressure of oxygen [PaO2] <80 mm Hg) with an average PaO2 (±SD) of 62 (±15) mm Hg. Of the 7 hypoxemic dogs, 2 were found to have pulmonary mineralization based on bone scintigraphic images. Pulmonary perfusion abnormalities were not identified using 99mTc-MAA in any of the 21 PDH dogs. Six PDH dogs had an abnormal interstitial pulmonary pattern and 5 of these dogs were hypoxemic. The average quantitative thoracic: vertebral ratio was not significantly different between the PDH and control dogs (0.5 ± 0.4 versus 0.4 ± 0.1, P = .16). Causes of hypoxemia other than pulmonary thromboembolism should be considered in dogs with PDH. Pulmonary mineralization may contribute to hypoxemia in dogs with PDH.  相似文献   

19.
OBJECTIVE: To identify risk factors for luxation after canine total hip replacement (THR). STUDY DESIGN: Retrospective study. SAMPLE POPULATION: 256 client-owned dogs that underwent THR. METHODS: Patient data surveyed included signalment, body weight, diagnosis, prior hip surgery, implant size, intraoperative complications, and angle of lateral opening of the acetabular component. RESULTS: Postoperative complications were recorded in 20 cases (7.8%). The most common complication was dorsal luxation which occurred in 12 dogs (4.7%). The interval between joint replacement and luxation ranged from 1 to 116 days (mean, 44 days). In 1 case, luxation was attributable to failure of the repair of an intraoperative fracture of the greater trochanter. Excluding this case, the mean angle of lateral opening in those dogs that sustained luxation was 62 degrees (range, 46 degrees - 75 degrees). The mean angle of lateral opening overall was 48 degrees (range, 18 degrees - 76 degrees). The angle of lateral opening was the only factor that had a statistically significant effect on whether luxation occurred (P = .035). Acetabular revision, performed primarily to reduce the angle of lateral opening, was performed in 8 dogs and successfully prevented subsequent luxation. CONCLUSION: Luxation of the prosthesis is substantially under the control of the surgeon. It is recommended that the acetabular cup be inserted at an angle of lateral opening of 35 degrees to 45 degrees. In those cases of THR luxation in which an inappropriate angle of lateral opening is identified, acetabular revision arthroplasty generally results in a good clinical outcome.  相似文献   

20.
OBJECTIVE: To determine whether use of hemoglobin glutamer-200 (bovine) as a partial blood volume replacement in dogs undergoing cemented total hip replacement caused any deleterious effects on the bone-cement or cement-prosthesis interface, exerted any deleterious effects on body organs, or caused any complications during the anesthetic, immediate recovery, or long-term recovery period. ANIMALS: 9 adult dogs. METHODS: Dogs were anesthetized, and 15% of the blood volume was removed. Simultaneously, lactated Ringer's solution was infused, and 6 dogs were given hemoglobin glutamer (1 g/kg of body weight, IV). Unilateral total hip replacement was performed. Limb use was assessed visually, and force-plate and radiographic evaluations were performed before, and 8 weeks after, surgery. Eight weeks after surgery, dogs were euthanatized, necropsies were performed, and prosthetic component pullout forces were determined. RESULTS: There were no significant differences between treated and control dogs in regard to biomechanical (visual assessment of gait, force-plate analysis, femoral and acetabular component pullout forces) and pathologic evaluations (physical examination, CBC, serum biochemical analyses, necropsy, and histologic evaluations). Radiographic signs of loosening of the femoral component were seen in 4 dogs treated with hemoglobin glutamer. CONCLUSIONS AND CLINICAL RELEVANCE: Administration of hemoglobin glutamer as a blood substitute did not appear to have any deleterious effects in dogs undergoing total hip arthroplasty. The radiographic findings, which were discordant with the biomechanical results, merit further investigation.  相似文献   

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