Download PDF
Vet Comp Orthop Traumatol 2015; 28(01): 48-53
DOI: 10.3415/VCOT-14-02-0027
Clinical Communication
Schattauer GmbH

Risk factors for loosening of cementless threaded femoral implants in canine total hip arthroplasty

K. A. Agnello
1   University of Pennsylvania, Department of Clinical Studies, Philadelphia, PA, USA
,
Cimin D. Brown
1   University of Pennsylvania, Department of Clinical Studies, Philadelphia, PA, USA
,
K. Aoki
2   Uni-Vets, Onojo City, Fukuoka, Japan
,
S. Franklin
3   University of Georgia, Department of Small Animal Medicine and Surgery, Athens, GA, USA
,
K. Hayashi
4   Cornell University, Department of Clinical Sciences, College of Veterinary Medicine, Ithaca, NY, USA
› Author Affiliations
Further Information

Publication History

Received:15 February 2014

Accepted:13 October 2014

Publication Date:
26 December 2017 (online)

Also available at
    Permissions and Reprints

Summary

Objective: To determine the incidence and potential risk factors of femoral implant loosening in the canine Helica® total hip replacement (THR) system.

Method: Sixteen dogs with a Helica THR were included. Medical records were reviewed for signalment and size of implants. Stem angle, stem collar to lateral cortex distance, tip to cortex distance, stem collar to lateral cortex distance at a stem angle of 150°, lever arm distance, and the distance on the diaphysis measurements were calculated from the one year postoperative radiographs. Three ratios were determined from these measurements to take into account the size of the femur in relation to the size of the implant. Femoral implant loosening was identified by radiographic and clinical signs, and confirmed at the time of surgical explantation. Differences in the successful and fe-moral stem failure groups were compared using either a students t-test or a Mann Whitney test. Significance was set at p <0.003.

Results: Six of the 16 dogs had loosening of the femoral prostheses within one year post-implantation. One dog had evidence of a septic cause for loosening. No significant risk factors could be identified in this group of dogs with Helica stem loosening.

Clinical significance: Helica femoral stem loosening was a common complication within one year post-implantation in this group of dogs. No risk factors were identified to potentially decrease the incidence of loosening. Therefore, due to this unacceptably high complication rate, the authors do not recommend this model of the Helica THR.

Keywords

Helica - total hip replacement - canine - hip - osteoarthritis
 

  • References

  • 1 Olmstead ML. The canine cemented modular total hip prosthesis. J Am Anim Hosp Assoc 1995; 31: 109-124.
    CrossrefPubMedSearch in Google Scholar
  • 2 Liska WD, Doyle N, Marcellin-Little DJ. et al. Total hip replacement in three cats: surgical technique, short-term outcome and comparison to femoral head and neck ostectomy. Vet Comp Orthop Tramatol 2009; 22: 505-510.
    PubMedSearch in Google Scholar
  • 3 Marcellin-Little DJ, DeYoung BA, Doyens HH. et al. Canine uncemented porous-coated anatomic total hip arthroplasty: results of a long-term prospective evaluation of 50 consecutive cases. Vet Surg 1999; 28: 10-20.
    CrossrefPubMedSearch in Google Scholar
  • 4 Guerrero T, Montavon P. Zurich cementless total hip replacement: retrospective evaluation of 2nd generation implants in 60 dogs. Vet Surg 2009; 38: 70-80.
    CrossrefPubMedSearch in Google Scholar
  • 5 Bergh MS, Gilley RS, Shofer FS. et al. Complications and radiographic findings following cemented total hip replacement: a retrospective evaluation of 97 dogs. Vet Comp Orthop Traumatol 2006; 19: 172-179.
    Thieme ConnectPubMedSearch in Google Scholar
  • 6 Edwards MR, Egger EL, Schwarz PD. Aseptic loosening of the femoral implant after cemented total hip arthroplasty in dogs: 11 cases in 10 dogs (1991-1995). J Am Vet Med Assoc 1997; 211: 580-586.
    PubMedSearch in Google Scholar
  • 7 Dyce J, Wisner ER, Wang Q. et al. Evaluation of risk factors for luxation after total hip replacement in dogs. Vet Surg 2000; 29: 524-532.
    CrossrefPubMedSearch in Google Scholar
  • 8 Liska WD. Femur fractures associated with canine total hip replacement. Vet Surg 2004; 33: 164-172.
    CrossrefPubMedSearch in Google Scholar
  • 9 Ganz SM, Jackson J, Van Enkevort B. Risk factors for femoral fracture after canine press-fit cementless total hip arthroplasty. Vet Surg 2010; 39: 688-695.
    PubMedSearch in Google Scholar
  • 10 Marsolais GS, Peck JN, Berry C. et al. Femoral medullary infarction prevalence with the Zurich cementless canine total hip arthroplasty. Vet Surg 2009; 38: 677-680.
    CrossrefPubMedSearch in Google Scholar
  • 11 Liska WD, Poteet BA. Pulmonary embolism associated with canine total hip replacement. Vet Surg 2003; 32: 178-186.
    CrossrefPubMedSearch in Google Scholar
  • 12 Andrews CM, Liska WD, Roberts DJ. Sciatic neurapraxia as a complication in 1000 consecutive canine total hip replacements. Vet Surg 2008; 37: 254-262.
    CrossrefPubMedSearch in Google Scholar
  • 13 Hach V, Delfs G. Initial experience with a newly developed cementless hip endoprosthesis. Vet Comp Orthop Tramatol 2009; 22: 153-158.
    PubMedSearch in Google Scholar
  • 14 Kim JY, Hayashi K, Garcia TC. et al. Biomechanical evaluation of screw-in femoral implant in cementless total hip system. Vet Surg 2012; 41: 94-102.
    CrossrefPubMedSearch in Google Scholar
  • 15 Behrens BA, Wirth CJ, Windhagen H. et al. Numerical investigations of stress shielding in total hip prostheses. Proc Inst Mech Eng H 2008; 222: 593-600.
    PubMedSearch in Google Scholar
  • 16 Glassman AH, Bobyl JD, Tanzer M. New femoral designs: do they influence stress shielding?. Clin Orthop Relat Res 2006; 453: 64-74.
    CrossrefPubMedSearch in Google Scholar
  • 17 Hukkanen M, Corbett SA, Batten J. et al. Aseptic loosening of total hip replacement. J Bone Joint Surg [Br] 1997; 79 B 467-474.
    CrossrefPubMedSearch in Google Scholar
  • 18 Decking R, Puhl W, Simon U. et al. Changes in strain distribution of loaded proximal femora caused by different types of cementless femoral stems. Clin Biomech 2006; 21: 495-501.
    CrossrefPubMedSearch in Google Scholar
  • 19 Andreoni AA, Guerrero TG, Hunter K. et al. Revision of an unstable HELICA endoprosthesis with a Zurich cementless total hip replacement. Vet Comp Orthop Tramatol 2010; 23: 177-181.
    PubMedSearch in Google Scholar
  • 20 Tai CL, Shih CH, Chen WP. et al. Finite element analysis of the cervico-trochanteric stemless femoral prosthesis. Clin Biomech 2003; 18: S53-S58.
    CrossrefPubMedSearch in Google Scholar
  • 21 Dosch M, Hayashi K. Garcia. et al. Biomechanical evaluation of the Helica femoral implant system using traditional and modified techniques. Vet Surg 2013; 42: 867-876.
    PubMedSearch in Google Scholar
  • 22 Tomlinson J, Fox D, Cook JL. et al. Measurement of femoral angles in four dog breeds. Vet Surg 2007; 36: 593-598.
    CrossrefPubMedSearch in Google Scholar
  • 23 Gemmill TJ, Pink J, Renwick A. et al. Hybrid cemented/cementless total hip replacement in dogs: seventy-eight consecutive joint replacements. Vet Surg 2011; 40: 621-630.
    CrossrefPubMedSearch in Google Scholar
  • 24 Hayes GM, Ramirez J. Langley-Hobbs. Use of the cumulative summation technique to quantitatively assess a surgical learning curve: canine total hip replacement. Vet Surg 2011; 40: 1-5.
    CrossrefPubMedSearch in Google Scholar
  • 25 Pernell RT, Gross RS, Milton JL. et al. Femoral strain distribution and subsidence after physiological loading of cementless canine femoral prosthesis: the effects of implant orientation, canal fill, and implant fit. Vet Surg 1994; 23: 503-518.
    CrossrefPubMedSearch in Google Scholar
  • 26 Manley PA, Vanderby R, Kohles S. et al. Alterations in femoral strain, micromotion, cortical geometry, cortical porosity, and bony ingrowth in uncemented collared and collarless prostheses in the dog. J Arthroplasty 1995; 10: 63-73.
    CrossrefPubMedSearch in Google Scholar
  • 27 Page A, Jasty M, Bragdon C. et al. Alterations in femoral and acetabular bone strains immediately following cementless total hip arthroplasty: an in vitro canine study. J Orthop Res 1991; 9: 738-748.
    CrossrefPubMedSearch in Google Scholar
  • 28 Innoplant Veterinary. Helica Hip Prosthesis Surgery Manual. Hannover, Germany: Innoplant Veterinary Implants; 2008
    Search in Google Scholar
  • 29 Hauptman J, Prieur WD, Butler HC. et al. The angle of inclination of the canine femoral head and neck. Vet Surg 1979; 8: 74-77.
    CrossrefPubMedSearch in Google Scholar
  • 30 Maloney WJ, Jasty M, Rosenberg A. et al. Bone lysis in well-fixed cemented femoral components. J Bone Joint Surg Br 1990; 72: 966-970.
    PubMedSearch in Google Scholar
  • 31 Maguire P, Siclari M, Lesser A. Femoral imaging artifacts associated with dorsal recumbency craniocaudal radiographic positioning. Description of a modified bisecting angle technique. Vet Comp Orthop Traumatol 2014; 27: 288-296.
    Thieme ConnectPubMedSearch in Google Scholar