Cementless Total Hip Replacement in 20 Juveniles Using BFX™ Arthroplasty

Fitzpatrick, Noel; Law, Andy Y.; Bielecki, Malgorzata; Girling, Sarah

doi:10.1111/j.1532-950x.2014.12214.x

Cited by 25 publications

(33 citation statements)

References 53 publications

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“…Subsidence, defined as a distal migration of the stem within the medullary canal, may be more prevalent with undersized stems . Mild subsidence of 1‐3 mm is expected in the early postoperative period, but a subsidence greater than 3 mm could reflect a lack of stability, which may predispose to major complications such as femoral fracture and coxofemoral luxation . Numerous clinical studies have attempted to identify risk factors for subsidence; however, associations between early subsidence, stem sizing, and the development of complications remain unclear.…”

Section: Introductionmentioning

confidence: 99%

Effect of stem sizing and position on short‐term complications with canine press fit cementless total hip arthroplasty

2017

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OBJECTIVE: To determine the influence of stem sizing and positioning with early subsidence and stem complications with cementless (BFX) total hip arthroplasty (THA). STUDY DESIGN: Retrospective case series. ANIMALS: Fifty-five dogs; 58 THAs. METHODS: Eighty cobalt-chromium BFX THAs were reviewed, 58 met inclusion criteria. Implant size, positioning, and major complications within 12 months of surgery were recorded. Femoral canal flare (FCF), canal fill, stem angle, and subsidence at 3 months were measured from postoperative radiographs. Appropriateness of final stem size was assessed with digital templates. Odds ratios for associations were calculated. RESULTS: Mean ± SD coronal canal fill (Fillcor ) was 75% ± 6, FCF was 2.0 ± 0.3, and subsidence was 1.7 mm ± 2.6. Stem angulation ranged from 7°varus to 6°valgus, and 7°cranial to 3°caudal. Appropriately sized stems (n = 45) had a mean Fillcor of 78%. Major stem complications occurred in 12% of THAs. Femora with subsidence > 3 mm were 45.3 times more likely to develop postoperative stem complications (P = .02). Stems with varus angulation 5°were 12.5 times more likely to sustain intraoperative fissures (P = .03). Stems considered undersized based on postoperative digital templating were 5.6 times more likely to develop stem complications (P = .04) and 5.7 times more likely to subside > 3 mm (P = .03). CONCLUSION: Varus stem angulation should be avoided to prevent fissures. Canal fill is a poor indicator of optimal stem size and the current recommendation of >85% is unnecessarily high. Postoperative templating may be useful for assessing appropriateness of stem size.

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Section: Introductionmentioning

confidence: 99%

Effect of stem sizing and position on short‐term complications with canine press fit cementless total hip arthroplasty

2017

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“…It is widely accepted that a majority of these young patients have excellent long-term outcomes. 5,6 Recent reports, however, have described cases of significant wear of the acetabular components as a long-term complication that was not previously recognized. 6,15 The cup wear and failure were 4 years to 5 years after THR implantation and may occur more frequently in large breed, younger, more active dogs or dogs with significant morbidity associated with the other limbs.…”

Section: Current Controversies/future Considerationsmentioning

confidence: 96%

“…achieve short-term stability by various methods depending on the implant system used (press-fit, locking screw fixation, or screw-in implants) and long-term stability via bone in-growth (on-growth) into implants. [5][6][7] The Zurich Cementless THR (Kyon, Zurich, Switzerland) was developed at the University of Zurich in the late 1990s 6 (Fig. 1).…”

Section: Key Pointsmentioning

confidence: 99%

“…Canine hip dysplasia, traumatic coxofemoral luxation, femoral head and neck fractures, and failed femoral head and neck ostectomy (FHO) are among the most common indications for canine THR. [2][3][4][5][6] Current THR systems can be broadly categorized as cemented, cementless, or hybrid (combination of cemented and cementless implants). Cemented THR systems achieve both short-term and long-term stability with the use of polymethyl methacrylate as the interface between the implant and bone.…”

Section: Introductionmentioning

confidence: 99%

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Zurich Cementless Total Hip Replacement

Hummel¹

2017

Veterinary Clinics of North America: Small Animal Practice

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“…Conventional radiography is usually applied in veterinary medicine to predict the clinical outcome. Usually, X-ray images are used to evaluate parameters such as femoral cortical thickening/atrophy, signs of fissure/fracture, radiolucent lines, thickness of the cement mantle, position of the implant parts and subluxation [4, 7, 10, 18]. To the authors’ knowledge, the question if bone remodelling processes around femoral implants are reliably detected with digital radiography in dogs has not been answered yet.…”

Section: Introductionmentioning

confidence: 99%

Comparative measurements of bone mineral density and bone contrast values in canine femora using dual-energy X-ray absorptiometry and conventional digital radiography

et al. 2017

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BackgroundAseptic loosening due to bone remodelling processes after total hip replacement is one common cause for revision surgery. In human medicine, dual-energy X-ray absorptiometry (DEXA) is the gold standard for quantitative evaluation of bone mineral density, whereas in veterinary medicine conventional radiography is used for follow-up studies. Recently, a method has been described using digital X-ray images for quantitative assessment of grey scale values of bone contrast. Therefore, the aim of the present study was to evaluate the correlation of bone mineral density (BMD) measured by DEXA with grey scale values (GV) measured in digital X-ray images (RX50, RX66) ex vivo.ResultsThe measured GV in the chosen X-ray settings showed on average a good correlation (r = 0.61) to the measured BMD with DEXA. Correlation between the two X-ray settings was very good (r = 0.81). For comparisons among regions of interests (ROIs) a difference of 8.2% was found to be statistically significant, whereas in the case of RX50 and RX66 differences of 5.3% and 4.1% were found to be statistically significant.ConclusionsResults indicate that measuring absolute changes in bone mineral density might be possible using digital radiography. Not all significant differences between ROIs detectable with DEXA can be displayed in the X-ray images because of the lower sensitivity of the radiographs. However, direct comparison of grey scale values of the periprosthetic femur in one individual patient during the follow-up period, in order to predict bone remodelling processes, should be possible, but with a lesser sensitivity than with DEXA. It is important that the same X-ray settings are chosen for each patient for follow-up studies.Electronic supplementary materialThe online version of this article (doi:10.1186/s12917-017-1047-y) contains supplementary material, which is available to authorized users.

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Cementless Total Hip Replacement in 20 Juveniles Using BFX™ Arthroplasty

Abstract: Cementless THR can safely be performed in skeletally immature dogs, providing satisfactory return to normal joint function and implant survivability for at least a mean of 29.8 months.

Cited by 25 publications

References 53 publications

Effect of stem sizing and position on short‐term complications with canine press fit cementless total hip arthroplasty

Effect of stem sizing and position on short‐term complications with canine press fit cementless total hip arthroplasty

Zurich Cementless Total Hip Replacement

Comparative measurements of bone mineral density and bone contrast values in canine femora using dual-energy X-ray absorptiometry and conventional digital radiography

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