Fracka Agnieszka B, Allen Matthew J, Dejardin Loic M
College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA.
Department of Veterinary Medicine, University of Cambridge, Cambridge, UK.
Vet Surg. 2025 Apr;54(3):621-631. doi: 10.1111/vsu.14175. Epub 2024 Oct 14.
The aim of the study was to describe long-term outcomes and report post-retrieval implant analysis following cementless total knee replacement (TKR) in a dog.
A seven-year-old, male neutered, Labrador retriever.
The dog presented for evaluation of chronic left pelvic limb lameness. Orthopedic examination identified bilateral cranial drawer and medial buttress. Radiographs revealed severe bilateral osteoarthritis with moderate joint effusion/synovial hypertrophy. Given the end-stage osteoarthritis, TKR was considered more appropriate than tibial plateau leveling osteotomy (TPLO). The dog underwent a left cementless TKR.
Immediate postoperative radiographs showed appropriate implant positioning. Moderate left pelvic limb lameness with full, pain free and stable stifle range of motion (ROM) was documented at 2 weeks. Increased left hindlimb weight-bearing with a peak vertical force of 70% bodyweight (BW) versus 50% BW on the contralateral leg was reported at 6 weeks. Radiographs showed good implant osseointegration. Left stifle ROM was 50°/170°, a 30° increase compared to preoperative values. Additional rechecks at 14 and 30 weeks showed gradual improvement in stifle ROM and weight-bearing. The dog was euthanized 6 years after surgery for reasons unrelated to TKR. Radiographs demonstrated static implant position without signs of osteolysis and gross examination revealed mild polyethylene wear on the caudal aspects of the tibial insert. Histological evaluation of the implant-bone interface showed extensive and robust osseointegration.
This case demonstrates that cementless TKR can be associated with excellent clinical function over the course of at least 6 years and suggests that early surgical intervention could be considered.
本研究的目的是描述一只犬行非骨水泥全膝关节置换术（TKR）后的长期结果，并报告取出植入物后的分析情况。
一只7岁、已绝育的雄性拉布拉多猎犬。
该犬因慢性左后肢跛行前来评估。骨科检查发现双侧前抽屉试验阳性和内侧支撑。X线片显示双侧严重骨关节炎伴中度关节积液/滑膜增生。鉴于处于终末期骨关节炎，TKR被认为比胫骨平台水平截骨术（TPLO）更合适。该犬接受了左侧非骨水泥TKR。
术后即刻X线片显示植入物位置合适。术后2周记录到左后肢中度跛行，膝关节活动范围（ROM）完全、无痛且稳定。术后6周报告左后肢负重增加，峰值垂直力为体重的70%，而对侧腿为50%。X线片显示植入物骨整合良好。左膝关节ROM为50°/170°，比术前值增加了30°。术后14周和30周的再次检查显示膝关节ROM和负重逐渐改善。该犬在术后6年因与TKR无关的原因实施安乐死。X线片显示植入物位置固定，无骨溶解迹象，大体检查显示胫骨假体尾侧轻度聚乙烯磨损。植入物-骨界面的组织学评估显示广泛且牢固的骨整合。
本病例表明，非骨水泥TKR在至少6年的时间里可具有出色的临床功能，并提示可考虑早期手术干预。
