Hip dysplasia - clinical studies

Question 1

Monotti VCOT 2020
periprosthetic femoral fractures in cementless press fit

Answer 1

fractures: 3% cemented, 10% cementless

gd-excellent outcome with lateral plate and cerclage wires

Question 2

Israel VS 2022

Retrospective study 184 BFX collared stem with periprosthetic cerclage placed proximal to lesser trochanter

Answer 2

no proximal femoral fractures

no comp with cerclage wires
1 fissure 2 # distal stem postop

Question 3

Meltzer VS 2022

algorithm for femoral stem selection
135 THRs

Answer 3

14% comp rate - 1.5% catastrophic (SSI), 3% femoral #

CFI <1.8 is risk factor for BFX subsidence -> use collar or lateral bolt

<12kg or >50kg -> use CFX stem

> 7yo -> use CFX stem

Question 4

Mitchell VS 2020

Retrospective 101 THRs BFX lateral bolt, collared stem, traditional

Answer 4

BFX lateral bolt less subsidence

Question 5

Liska VS 2019

retrospective 200THRs
polar gap

Answer 5

polar gap seen in at least 1 zone in 70% immediately postop

gaps common in zones 2 and 5 (<1mm) - middle

no gaps seen 5w postop

Question 6

Allaith VS 2023

Prospective study 1852 dogs
kyon, CFX, Biomedtrix hybrid, BFX, helica

Answer 6

8.5% comp
BFX and helica a/w increased comp when used for rv FHNE
excellent outcomes overall

Question 7

Franklin VCOT 2021

retrospective study

zurich THR 21 cases

Answer 7

10% major comp (1 excess internal femoral rotation, 1 luxation)

high success rate in initial cases using zurich for surgeons experienced with other systems

Question 8

Kwok VS 2023

retrospective 195 THRs using BFX lateral bolt

Answer 8

overall 14% comp
9% major comp - 4% femoral #, 4% lux, stem failure, septic loosening, acetabular #

97% successful long term

Question 9

Rodino VS 2022

retrospective

44 CATS -56 THRs
cemented micro and nano hips

Answer 9

20% overall comp
16% major comp - 10% luxation

90% owner satisfied

Question 10

Vezzoni VCOT 2023

retrospective
zurich mini cementless 42 small dogs, 8 cats

Answer 10

17% postop comp
most excellent outcome

Question 11

Zuendt JAVMA 2023

centerline cementless THR (C-THA, biomedtrix)
20 hips in 17 dogs

Answer 11

75% excellent long term outcome

25% postop comp (5% femoral neck #, 10% aseptic loosening, 10% septic loosening)

Question 12

Anaesthesia/analgesia THR

Answer 12

Viilmann VCOT 2022: epidural 0.5% levo/bupivacaine + morphine/buprenorphine 206 dogs
- 90% success
-3 luxated within 3d postop - unlikely related to epidural
-within 24h postop, 20% urinary retention, 10% GI signs, 6% sciatic neuropraxia (40% resolved in 8w postop)

Israel VS 2023: preclosure iodine lavage
-1% that did not have lavage developed infection vs none in lavage group
-no comps

Question 13

Horwood VS 2024

Luxoid hips

Answer 13

Higher risk of major complications including intraop fissures fractures, postop dorsal luxation

rx sx results in acceptable outcome