Hemipelvic and proximal femoral limb salvage endoprosthesis with tendon ongrowth in a dog

Publication date 

Research authors Noel Fitzpatrick, James W. Guthrie

 

Objective

To report the clinical application of a hemipelvic and proximal femoral endoprosthesis for limb salvage.

Methods

An invasive soft tissue mass (histiocytic sarcoma) with bone lysis of the femoral head and acetabulum was noted on radiographs, computed tomography (CT), and MRI. Custom‐designed hemipelvic and proximal femoral endoprostheses were produced from CT images and manufactured with hydroxyapatite coated surfaces to allow tissue integration. The proximal femoral implant allowed tendon ongrowth and muscle attachment. The pelvic implant was anchored to the ilium and ischium with screws, and the femoral implant was cemented. Chemotherapy consisted of lomustine (CCNU).

Results

No evidence of implant loosening or local/thoracic metastases was noted on radiographs or CT at 6 weeks and at 3, 6, 9, and 12 months after surgery. A neurapraxia resolved 14 weeks postoperatively. Intensive rehabilitation was performed. At 12 months, activity was unrestricted with minimal residual lameness. The dog was euthanized at 14 months for metastatic disease.

Clinical relevance

Neoplasia involving the bones of the coxofemoral joint traditionally requires hemipelvic resection and pelvic limb amputation. This report provides evidence that limb salvage can result in satisfactory levels of activity.

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