Total hip arthroplasty outcomes assessment using functional and radiographic scores to compare canine systems

Abstract

A retrospective multi-centre study was carried out in order to compare outcomes between cemented and uncemented total hip arthoplasties (THA). A quantitative orthopaedic outcome assessment scoring system was devised in order to relate functional outcome to a numerical score, to allow comparison between treatments and amongst centres. The system combined a radiographic score and a clinical score. Lower scores reflect better outcomes than higher scores. Consecutive cases of THA were included from two specialist practices between July 2002 and December 2005. The study included 46 THA patients (22 uncemented THA followed for 8.3 +/- 4.7M and 24 cemented THA for 26.0 +/- 15.7M) with a mean age of 4.4 +/- 3.3 years at surgery. Multi-variable linear and logistical regression analyses were performed with adjustments for age at surgery, surgeon, follow-up time, uni- versus bilateral disease, gender and body weight. The differences between treatment groups in terms of functional scores or total scores were not significant (p > 0.05). Radiographic scores were different between treatment groups. However, these scores were usually assessed within two months of surgery and proved unreliable predictors of functional outcome (p > 0.05). The findings reflect relatively short-term follow-up, especially for the uncemented group, and do not include clinician-derived measures, such as goniometry and thigh circumference. Longer-term follow-up for the radiographic assessments is essential. A prospective study including the clinician-derived outcomes needs to be performed in order to validate the outcome instrument in its modified form.

Management of an infected cementless cup with prosthetic retention and antibiotic therapy in a dog

“…The diagnosis was confirmed with a positive culture. The bacteria cultured were consistent with the common implant associated infections reported in human and veterinary orthopaedic surgery (Iwata et al , Zimmerli & Moser ). Treatment consisted of surgical debridement of periprosthetic fibrotic tissue, copious saline lavage, and 8 days of parenteral followed by 60 days of oral antibiotics.…”

“…Implant exchange procedures to address periprosthetic infection have been described in dogs, but are associated with significant morbidity (Massat & Vasseur , Dyce & Olmstead , Torres & Budsberg ). Several treatment options have been described in humans (Spangehl et al , Peel et al ); however, explantation remains the treatment recommendation in small animals (Tigges et al , Massat et al , Iwata et al , Allen ). Spangehl et al () described a classification system for periprosthetic infection in humans which is used to direct management decisions and provide prognostic information (Table ).…”

Management of total hip replacement luxation with triple pelvic osteotomy

“…The success of these procedures in preventing subsequent luxation is rarely reported; most research focuses on risk factors for initial luxation . In two case series of 4 and 19 dogs, TPO resulted in a successful outcome in 80% of dogs with traumatic coxofemoral luxation . The reported advantages of TPO for traumatic coxofemoral luxation include reduced joint capsule stress and increased Norberg angle .…”

Avaliação radiográfica e tomográfica de cães submetidos à artroplastia coxofemoral total híbrida

“…No entanto, o exame radiográfico possui algumas limitações e não pode ser utilizado com acurácia para se determinar o posicionamento e a estabilidade dos implantes (Jehn e Manley, 2002;Bergh et al, 2006;Iwata et al, 2008). Já o exame tomográfico por meio de tomografia computadorizada possibilita a aquisição de imagens sem sobreposições e, dessa forma, permite a mensuração e a determinação do posicionamento dos componentes protéticos com maior precisão em relação ao exame radiográfico (Ginja et al, 2007;Kjellberg et al, 2012;Goldvasser et al, 2012).…”

“…Adicionalmente, segundo Katz (2006) e, mais recentemente, Kjellberg et al (2012), o exame radiográfico pode subestimar as alterações osteoartríticas devido à sobreposição de imagens e, por isso, apresentar menor acurácia quando comparado à tomografia computadorizada (Jehn e Manley, 2002;Bergh et al, 2006;Iwata et al, 2008). Devido a isso, o exame tomográfico possibilitaria determinar de maneira mais fidedigna o resultado funcional em longo prazo (Suh et al, 2013).…”