Treatment Outcomes for Periprosthetic Femoral Fractures in Cementless Press-Fit Total Hip Replacement
Objective: To report postoperative complications using a commercially available porous-coated press-fit cementless total hip replacement (THR) system in dogs.
Methods: Medical records were reviewed for client-owned dogs with hip pathologies requiring THR. A minimum of six-week postoperative orthopaedic examination and orthogonal pelvic radiographs were used to assess outcome and complications in the perioperative period. Referring veterinarian medical records, phone interviews with clients, or both were used to assess long-term functional outcome and complications.
Results: Bilateral THR was performed in 36 dogs, and unilateral in 147 dogs, making a total of 219 THR procedures in 183 dogs. A total complication rate of 31.1% (68/219) was observed. A catastrophic complication was observed in 8.2% (n = 18), a major complication in 9.6% (n = 21), and a minor complication in 13.2% (n = 29) of procedures. The most common complications were intra-operative femoral fissure (n = 46), diaphyseal femoral fracture (n = 15), and coxofemoral luxation (n = 9). Full return to function was achieved in 88.1% of procedures with a median follow-up period of 42 months.
Clinical significance: Porous-coated press-fit cementless collarless total hip replacements have a high complication rate. The majority of complications occur intra-operatively or perioperatively, with few complications occurring beyond 12 weeks postoperatively. Both fissure fractures and diaphyseal femoral fractures carry a favourable prognosis with immediate cerclage wiring and plate fixation, respectively.