Hip&femur

Question 1

Mund, VCOT 2023
Management of Feline Femoral, Tibial and Humeral Fractures Using a 3.5 mm Titanium Interlocking Nail

[marmed, non angle stable]
-complication rate?
-major complication rate?
-most common major complication?
-factor correlated with complication?

Answer 1

16%
12% major
screw breakage
fracture type correlated with complication (transverse more prone to complication)

Question 1

Alvarez-Sanchez, vet surg 2021
Zurich cementless total hip arthroplasty as a treatment option for capital physeal fractures in dogs: Outcome in 53 cases

-what % cases had good outcome?
-% intra-op and post-op complications?
- what factor was more common in the chronic fractures?

Answer 1

96% good outcome.
8% intra-op complications and 11% post-op
Acetabular remodelling more common in chronic fractures

Question 2

Vezzoni, VCOT 2022
Hemiepiphysiodesis for the Correction of Distal Femoral Valgus in Growing Dogs

• what was the mean difference between pre-op and post-op?
  -how many were undercorrected?
  -how many over corrected?
  -of cases that had implants removed, what % had rebound growth?

Answer 2

11 degrees difference
undercorrection in 2/17
None over corrected
25% (3/12) had rebound growth when implants removed.

Question 3

Allaith, vet surg 2023
Outcomes and complications reported from a multiuser canine hip replacement registry over a 10-year period

-what factor was associated with increased complications?
-rate of complication reported by vets?
-and complications reported by owners?

Answer 3

-BFX and helica implants in FHNE revision had higher rate of complications
-8.5% complications reported by vets
-23% complications reported by owners

Question 4

Kwok, vet surg 2023
Clinical outcomes of canine total hip replacement utilizing a BFX lateral bolt femoral stem: 195 consecutive cases (2013–2019)

-what was post-op complication rate?
-what were the two most common complications?
-what factor was associated with post-operative femoral fractures?
-what was mean stem subsidence at 1 month?
-what % cases returned to normal?

Answer 4

-14% post-op complication rate
-femoral fracture and coxofemoral luxation (both 3.6%)
-canal flare index associated with post-op femoral fracture
-mean stem subsidence 1mm at 1 month
-98% returned to normal

Question 5

Israel, vet surg 2023
Preclosure povidone-iodine lavage in total hip replacement surgery: Infection outcomes and cost–benefit analysis
- what was the infection rate of the iodine lavage group?

Answer 5

0% (versus 1% for the remainder of the population)
deemed cost effective in lowering infection rates

Question 6

Meltzer Vet surg 2022
Case factors for selection of femoral component type in canine hip arthroplasty using a modular system

-what CFI has been reported to be risk for subsidence with cementless stem?
-in this report what factors were linked to hybrid system?

Answer 6

CFI <1.8
older patients, heavier patients, lower CFI had hybrid fixation.

Question 7

Tilve, vet surg 2022
Long-term follow up of 44 cats undergoing total hip replacement: Cases from a feline hip registry (2010-2020)

-what was the most common indication?
-complication rate?

Answer 7

slipped capital physis
20% complications

Question 8

Brand, vet surg 2021
Evaluation of a novel method to calculate cementless femoral stem level on craniocaudal projection radiographs

-what angle of rotation on a radiograph was the proportion correction able to minimise variation for when assessing femoral stem position?

Answer 8

proportion correction minimized variability in the stem-level measurements due to sagittal angulation (up to 30°) of the femur at 0° or 15° of internal rotation.

[proportion correction may be useful to evaluate stem level on radiographs and may help with diagnosis of subsidence]

Question 9

Sapora, Vet surg 2021
Ventral femoral head and neck ostectomy: Standard versusnovel K-wire guided technique using a premeasuredostectomy angle in canine cadavers

-what was the ideal FHA for ventral FHO?

Answer 9

38.5 degrees (less than previously described 45)

Question 10

Gifford, vet surg 2020
Total hip replacement in dogs with contralateral pelvic limb amputation: A retrospective evaluation of 13 cases

-what was the one major complication encountered?

Answer 10

failure of osteointegration of a cementless cup

Question 11

Janssens, vet surg 2020
Triple pelvic osteotomy with a 12.5° and a 20° Slocum-type plate: A short-term prospective clinical pilot study in 38 dogs

-what was mean femoral head coverage in the 12.5 group, and the 20 group?

Answer 11

67% covreage in the 12.5 degrees
79% coverage in the 20 degrees
fewer hips deemed excessive coverage in 12.5 degrees (>80%)

Question 12

Mitchell, vet surg 2020
Comparison of femoral stem subsidence between three types of press-fit cementless total hip replacement in dogs.

-which stem had the lowest rate of subsidence?

Answer 12

lateral bolt lowest (0.24mm), collared and regular BFX stem no difference between (1.2-1.3mm)

Question 13

Huggard, VCOT 2022
Short-Term Clinical Assessment of Hip Hemi- Arthroplasty in 11 Dogs

-what radiographic findings on 1 year radiographs?

Answer 13

lucency of acetabular bed and mild peri-acetabular sclerosis

Question 14

Tavola, VCOT 2022
Postoperative Complications of Double Pelvic Osteotomy Using Specific Plates in 305 Dogs

-what was the mean age of dogs?
-what was the complicatino rate?
-major complication rate?
-minor complication rate?
-what was the most common complication?
-what two factors were significantly associated with complications after DPO?

Answer 14

-6 months mean age
-8% complications
0.6% major complications (SSI and
persistent pain)
7.6% minor complications
-greenstick fracture of the ischium (3%)
-laterality and increased bodyweight

Question 15

Worden, VCOT 2022
Effect of Stem Positioning on Biomechanical Performance of a Novel Cementless Short-Stem Canine Total Hip Implant

-what factor influenced compressive stiffness?
-what factors influenced torque to failure?

Answer 15

absolute cut height influenced compressive stiffness (higher with more neck retained)

CFI and craniocaudal implant size influenced torque to failure (Higher CFI and having a smaller implant relative to femoral neck isthmus increased torque to failure)

Question 16

Howser, VCOT 2020
Effects of Femur Position on Radiographic Assessment of Femoral Head and Neck Excision Completeness in Cats

-what radiographic position had highest sensitivity, specificity and accuracy fo evaluation of FHNE in cats?

Answer 16

external torsion to 30 or 45 degrees

(45 degrees slightly higher spec (95 vs 92) and accuracy (96 vs 95) )

Question 17

Monotti, VCOT 2020
Treatment outcomes for periprosthetic femoral fractures in cementless press-fit total hip replacement

-According to vancouver classification, what was the most common fracture?
-major complication rate?
-most common complication?

Answer 17

B1
25% major complicatinos
infection

Question 18

Worden VCOT 2020Radiographic and Biomechanical Assessment of Three Implant Designs for Canine Cementless Total Hip Replacement

-what factor influenced compressive stiffness?

Answer 18

stem level influenced compressive stiffness

Question 19

Chantziarras, JSAP 2022
Ventral acetabular augmentation for management of caudoventral luxation following total hip replacement in dogs

-what was the most common implant
-what complication was encountered, and with which implant?

Answer 19

SOP plate most common
recurrent luxation and femoral stem loosening in two dogs with polyethylene implant

Question 20

Ruperez, Vet surg 2021
Complications and outcomes of cats with coxofemoral luxation treated with hip toggle stabilization using ultrahigh–molecular-weight-polyethylene or nylon (2009-2018): 48 cats

-what % had post-op complications
-what % had reluxation
-what factors were associated with reluxation?
-what factor was associated with non-excellent outcome

Answer 20

-24% complications
-11% reluxation

-not performing capsulorrhaphy, performing other orthopaedic procedures and intra-operative complications were associated with reluxation

-other orthopaedic procedures (non-hip) associated with non-excellent outcome.

Question 21

Mathews, vet surg 2021
Risk factors for reluxation after toggle rod stabilisation for treatment of coxofemoral luxation in 128 dogs

-what was the complication rate?
-what was the reluxation rate?
-which dogs were at higher risk of luxation?

Answer 21

24% complication rate
15% reluxation rate
those that presented with non traumatic, low impact injury

Question 22

Darrow, VCOT 2021
Accuracy of Patient-Specific 3D Printed Drill Guides in the Placement of a Canine Coxofemoral Toggle Pin through a Minimally Invasive Approach

-what was the mean exit hole translation from planned orientation?

Answer 22

2.5mm

Question 23

LeFloch, JFMS 2022
Outcome of coxofemoral luxation treated with closed reduction in 51 cats
-what was the reluxation rate?
-what factor increased the success of closed reduction?

Answer 23

51% reluxation rate
A bandage increased the success of closed reduction

Question 24

Horwood, vet surg 2024 Complications and outcomes of total hip arthroplasty in dogs with luxoid hip dysplasia: 18 cases (2010–2022) - Which complications were luxoid hips at higher risk for?

Answer 24

Luxoid hips at higher risk of complications, specifically: - intra-operative fracture -post-operative dorsal luxation

Question 25

Loh, vet surg 2024 Caudoventral hip luxation in 160 dogs (2003–2023): A multicenter retrospective case series - what was the success rate of closed reduction and hobbles alone? -what was teh complication rate of hobbles? -what was success rate for toggle? - what factors were associated with successful non surgical treatment?

Answer 25

-49%, 62% when accounting for repeated attempts at hobbles -32% complication rate with hobbles -toggle had 88% success rate -use of hobbles, treatment by specialist surgeon and increasing age.

Question 26

De Moya, vet surg 2023 Closed reduction and fluoroscopic-guided percutaneous pinning of femoral capital physeal or neck fractures: Thirteen fractures in 11 dogs -complication rate %?

Answer 26

45% (5/11) complications

Question 27

Ruperez, vet surg 2023 Arthroscopic-assisted hip toggle stabilization (AAHTS) in cats: An ex vivo feasibility study -describe the ports -what aspect of the surgery were most complications related to -to what extent was there articular cartilage damage?

Answer 27

camera port just dorsal to the greater trochanter, instrument port off cranial aspect of trochanter. bone tunnel creation <10% articular cartilage damage in 77% joints

Question 28

Bounds, vet surg 2023 Feasibility of feline coxofemoral arthroscopy using a supratrochanteric lateral portal: A cadaveric study -what structures were visible within the hip joint? -what complicaitons?

Answer 28

Articular cartilage of the femoral head and acetabulum, round ligament, joint capsule, transverse acetabular ligament, and dorsal acetabular rim minor cartilage damage

Question 29

Bondonny, VCOT 2024 Use of a Modified Intramedullary Pinning Technique for Distal Femoral Physeal Salter-Harris Type I and II Fracture Management: A Retrospective Study of 31 Cats -mid term complication rate?

Answer 29

3% mid term complications

Question 30

Butts, JFMS 2023 Comparison of three radiographic assessment methods for detecting slipped capital femoral epiphyses in cats: Klein’s line, modified Klein’s line and the S-sign -which method had highest accuracy -which method had highest specificity

Answer 30

S-sign on the frog leg radiograph was most accurate S-sign on hip extended view had highest specificity

Question 31

De Vreught, JFMS 2023 Stabilisation of femoral capital physeal fractures using transcervical pinning in cats: 19 cases (2014-2022) -what was the major complication rate? -what was the catastrophic complication rate? -what factor was linked to catastrophic complication?

Answer 31

10% major 24% catastrophic high pre-op osteolysis score linked to catastrophic complication

Question 32

Zuendt, JAVMA 2023 Centerline canine cementless total hip arthroplasty as an alternative implant system; results in 17 dogs (2015-2020) -what % dogs had excellent outcome? -what % complications?

Answer 32

75% excellent 25% complications [10% aseptic loosening, 10% septic loosening, 5% neck fracture]