THR cemented vs. cementless vs. hybrid

December 16, 2010

I have a 6-year-old neutered male Australian Shepherd patient that is in need of

unilateral THR. Charlie is about 50 pounds, a very athletic agility dog who was

sound and competing successfully at 26 " in USDAA agility in October.

Just a bit of background:

He had several episodes of mild lameness this year, which resolved within 3-5

days with laser, chiropractic +/- Assisi. More recently he was castrated and

subsequently became much more lame. I found trigger points in several muscles

which resolved with acupuncture, and though we resumed previously successful

therapies I have been unable to get him sound. Radiographs confirm a very

shallow acetabulum with subluxation 9which is clinically apparent) with some

osteophytosis but only moderate OA. Since we had discussed THR as a likely

necessity in the future, his owner was ready to pursue surgery.

Due to Charlie's femoral structure the surgeon is recommending a hybrid THR with

cementless socket and cemented femoral implant. His owner would ideally like

him to be able to return to agility but most of all wants him sound so that he

can once again be active. Unfortunately, that surgeon has only done the

procedure on two dogs, so he is a bit wary and is searching for another surgeon,

but in the meantime would like more information about the procedures.

Can anyone give me feedback on their experience with THR, especially if you have

experience with cemented and cementless? Also, if you are doing THR, how many

do you do annually? How many does it take to develop reasonable comfort and

expertise with the procedure? Right now my client is weighing his options and I

would like to give him as much information as I can to help him make an informed

decision.

Personally, I have seen several (though not many) THRs, and my experience has

mainly been with cementless THR's that have loosened (revisions have often

resulted in femoral fractures and FHO). I have seen a couple of cementless

THR's and have been impressed with the results (to date thankfully neither have

had complications), but I realize that sturctural issues may dictate what is

best.

I truly appreciate your feedback!

Jurek, DVM, CCRT, CVA, CAC

TOPS Veterinary Rehabilitation

Grayslake, IL

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