Risk Factors for Femoral Fracture after Canine Press-Fit Cementless Total Hip Arthroplasty

Abstract

To evaluate risk factors for femoral fracture after porous-coated cementless total hip arthroplasty (THA). Case series. Dogs (n=74) that had cementless THA (n=84). Medical records of dogs from 2 referral hospitals were reviewed for occurrence of postoperative femoral fracture. Patient and operative (age, breed, sex, weight, and canal flare index [CFI], indication for arthroplasty, intraoperative fissure, cerclage usage, and implant sizes) factors were analyzed. Assessment of implant positioning and canal fill was performed on immediate postoperative radiographs. Femoral fractures (n=11) were evaluated and compared with 73 cases without fracture that met the inclusion criteria. Mean (+/-SEM) age was 7.30+/-0.69 years for dogs with, and 4.77+/-0.37 years for dogs without femoral fracture. Age was positively associated with fracture (P=.022). Mean (+/-SEM) CFI was 1.80+/-0.09 for dogs with, and 1.98+/-0.04 for dogs without fracture. CFI was negatively associated with fracture (P=.045). Body weight, intraoperative fissure, cerclage use, implant size, position, and canal fill did not influence the occurrence of femoral fracture. Older dogs and dogs with lower CFI may be at increased risk for femoral fracture after porous-coated cementless THA. Risk factors exist for femoral fracture after cementless THA using porous-coated implants, and should be critically evaluated during the patient selection. These risks should be weighed against the benefits of the system, and measures to minimize femoral fracture in at-risk patients studied.