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RELATED PROCEDURES:

  • Early Hip Evaluation for Dysplasia
  • Total Hip Replacement (THR)
  • Total Elbow Replacement
  • Triple Pelvic Osteotomy
  • Femoral Head Ostectomy
  • Tibial Plateau Leveling Osteotomy (TPLO)
  • Other Cruciate Ligament Injuries
  • Patellar Luxation Repair

 




Total Joint Replacement in the Veterinary Patient

Canine Total Joint Replacement, Animal Specialty Group, Emergency Vets

by Kirk Wendelburg, DVM,
Diplomate American College of Veterinary Surgeons


Total Hip Arthroplasty (THA)

THA is the surgical treatment of choice for painful osteoarthritis resulting from hip dysplasia. It has been successfully performed for over 35 years in the canine patient. More recently the patient population has expanded beyond medium and large breed dogs to include cats and small or toy breeds of dogs. The indications for THA not only include hip dysplasia but also problems such as hip fracture, aseptic necrosis of the femoral head and neck, and hip dislocation. THA can be performed on patients slightly less than a year of age to the geriatric patient.

The most common types of joint replacement and hip replacement systems successfully used today include the BioMetrix CFx and BFx systems and Kyon (Swiss hip) system. Other less commonly used systems include the Helica and NGD systems. Both the BFx and Kyon are bone ingrowth/ongrowth systems which rely on the bone growing into the porosity of the prosthesis metal. The Kyon system is complemented by screws (point fixation) that lock the prosthesis to the bone. BFx relies on a press fit into the bony bed. CFx is the cemented system by BioMetrix and has been in use for over 20 years.

Hip replacements are meant to return our veterinary patient back to good, pain free function, and last their entire life. Although complication rates have been reported to range between 4% and 20%, an experienced surgeon and surgical team can have expected success rates of approximately 90% to 95% in the typical dog or cat with hip osteoarthritis. The relatively small percentage of potential complications are similar to what is experienced in the human patients, and include hip luxations, aseptic loosening, implant subsidence, implant associated fracture, sciatic neuropraxia, and infection. Most of the possible complications can be revised or repaired by a surgeon experienced in total hip arthroplasty revision procedures. If revision is not possible, the explantation of the prosthesis with a conversion to an excision arthroplasty (FHO) can be performed.

Total Knee (Stifle) Arthroplasty   

Total knee arthroplasty has been successfully performed in a small number of dogs over the past 10 years. BioMetrix produces the only commonly used knee replacement system. Kyon and Helica systems are in development but have not been used extensively in clinical cases.

Dr. Wendelburg, Animal Specialty Group, Los Angeles, CATotal or Partial Elbow Arthroplasty (TEA and PEA)

Total elbow arthroplasty has been sporadically performed in canine patient over the past 20 years. Thus far it has not enjoyed the same high success rate that has been shown in the total hip arthroplasty. Several designs have been attempted over the years with marginal success.

Currently, a prototype for partial and total elbow arthroplasty is being tested with extremely promising results. Kyon is manufacturing the new elbow arthroplasty system and will likely have it available for clinical patients in the near future.

Joint Replacement at Animal Specialty Group

Joint replacements at ASG are currently performed by Dr. Kirk Wendelburg. He has performed successful hip replacements on hundreds of patients over the past 25 years. He is well versed in both cemented and non-cemented techniques. Dr. Wendelburg has collaborated in the design and development of hip/elbow replacement systems, orthopedic implants, and surgical procedures.

Total Joint Replacement, Animal Specialty Group, Los Angeles, CADr. Wendelburg developed and described the joint replacement technique to determine the precise positioning of the femoral and acetabular components in the replaced hip. These joint replacement techniques are currently being used by the Sound/Eklin Orthoplanner and are accepted for publication in the Veterinary Surgery Journal.

Along with being a past chairperson at the Annual Veterinary Orthopedic Society Conference (Hip Section), he has written book chapters, and lectured nationally and internationally in the area of hip dysplasia and joint replacement.   Dr. Wendelburg was also a member of the CUTTING EDGE PANEL for “Canine Elbow Dysplasia Management – How should we be treating?” and “Unsolved Problems In Canine Total Hip Replacement” at the 2011 and 2012 ACVS Veterinary Symposiums.

Dr. Wendelburg designed and patented a total and partial elbow replacement system and procedure. The elbow replacement system is currently being tested with promising results, and is manufactured by Kyon, a veterinary surgical company known internationally for its total hip system, TTA and ALPS plating systems.

Animal Specialty Group

DVM, Diplomate American College of Veterinary Surgeons

Dr. Wendelburg is internationally recognized in veterinary orthopedics and is particularly well known for his collaboration in developing today’s most-used canine total hip replacement implants and procedures. He has authored several presentations involving hip replacement and limb biomechanics.


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