Abstract
Objective The aim of this study was to report outcomes in dogs with periprosthetic femoral
fractures associated with a press-fit cementless femoral total hip replacement implant.
Materials and Methods Electronic medical records and digital radiographs were used to identify dogs with
periprosthetic femoral fractures associated with press-fit cementless total hip replacement.
Data collected included signalment, weight, time of fracture, cause of fracture, presence
of intra-operative fissure, fracture type, repair technique, and clinical and radiographic
outcomes. Long-term patient outcome was assessed by communication with owners or referring
veterinarians.
Results Twenty-eight dogs with femoral fracture repair associated with cementless press-fit
total hip replacement were identified. Eight of the fractures occurred intraoperatively
and 20 occurred at a median of 2 days postoperatively. An oblique or spiral configuration
was noted in 19 cases and 15 occurred at the distal end of the femoral stem (type
B), with thirteen type B1, one type B2 and one type B3 fractures. Fractures were repaired
with non-locking (18/28) or locking-plate fixation (10/28). Cerclage wire was applied
around the plate and proximal bone segment in 17/28 dogs. Major complications occurred
in 7/28 cases (five deep infection, two mechanical failures). Bone healing was noted
in 21/23 cases, for which follow-up radiographic interpretation was available. Return
to function was complete in 17 cases, acceptable in 8 cases and unacceptable in 3
cases.
Conclusions While cementless total hip replacement periprosthetic femoral fractures can be successfully
repaired with lateral plate fixation, the risk of infection appears to be high.
Keywords
cerclage wire - fracture healing - implant infection - arthroplasty - periprosthetic
femoral fracture
