Extended Trochanteric Osteotomy for Cementless Total Hip Replacement Stem Explantation: Technique Description and Clinical Outcome in Nine Cases

C. J. Silveira; J. D. Crowley; M. C. Wawarofsky; B. R. Taylor; J. M. Bevan; M. P. Kowaleski; W. B. Saunders

doi:10.1055/s-0045-1810317

Veterinary and Comparative Orthopaedics and Traumatology, Table of Contents

Vet Comp Orthop Traumatol 2025; 38(04): A1-A35
DOI: 10.1055/s-0045-1810317

PODIUM ABSTRACTS

Extended Trochanteric Osteotomy for Cementless Total Hip Replacement Stem Explantation: Technique Description and Clinical Outcome in Nine Cases

Authors

C. J. Silveira

¹Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, United States
J. D. Crowley

²Small Animal Specialist Hospital, Alexandria, NSW, Sydney, Australia
M. C. Wawarofsky

¹Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, United States
B. R. Taylor

¹Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, United States
J. M. Bevan

³Central Texas Veterinary Specialty and Emergency Hospital, 301 Chisholm Trail, Round Rock, Texas, United States
M. P. Kowaleski

⁴Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts, United States
W. B. Saunders

¹Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, United States

Abstract

Full Text

Introduction: Extended trochanteric osteotomy (ETO) is used for the extraction of cementless stems in humans but has not been described in canine hip replacement. The objective of this study was to describe a surgical technique for the extraction of canine cementless stems using ETO and to report the clinical outcome in a cohort of dogs.

Materials and Methods: Medical records were reviewed to identify dogs that underwent cementless stem extraction following ETO. Inclusion criteria were signalment, indication for explant, pre-, post-, radiographs, operative report, total anaesthetic and surgical time, reported complications, and clinical and radiographic follow-up a minimum of 8 weeks postexplantation. Descriptive statistics were reported as median and range.

Results: Nine dogs met the inclusion criteria. Indications for THR revision included implant failure (n = 1), periprosthetic fracture (n = 2), implant-associated infection; “IAI” (n = 4), IAI with implant luxation (n = 1), and IAI with periprosthetic fracture (n = 1). Anaesthetic and surgical times were 420 minutes (360–487) and 258 minutes (208–396). ETO and stem extraction were successfully performed in all dogs. ETO fixation was achieved with cerclage wires and neutralization plates in all cases. A single case experienced an intraoperative fissure that was addressed during ETO fixation. Six out of nine dogs returned to full function at 8 weeks postoperatively. Complications occurred in 3/9 dogs (one minor and two major). Complications were successfully addressed and resulted in good clinical outcomes.

Discussion/Conclusion: ETO facilitated the extraction of cementless stems and had good clinical outcomes despite major complications in 2/9 cases. ETO should be considered as a central technique for cementless stem extraction.

Acknowledgment

W.B.S. is a member of the Movora SAB and receives honoraria for THR instruction and product development.