INNOVATION • EDUCATION • SUPPORT
The Total Hip Replacement
Canine THR is a surgical procedure in which the arthritic hip joint is replaced with a new prosthetic ball (femoral head) and socket (acetabulum). THR can be performed on dogs ranging from five through 170 pounds, and also on cats. It is the only treatment that fully restores life-long mobility and prevents recurrence of hip dysplasia; the leading cause of hind-leg lameness in dogs.
HIP REPLACEMENT SOLUTIONS FOR EVEN THE LARGEST OR SMALLEST BREEDS
BIOMEDTRIX TOTAL HIP REPLACEMENTS COMPLETED WORLDWIDE SINCE 1990
OF ALL PATIENTS TO RECEIVE A BIOMEDTRIX THR RECOVER FULL MOBILITY
HIP DYSPLASIA
Both hips are usually affected but symptoms may be more severe on one side. Hip dysplasia is manifested by varying degrees of laxity (looseness) of the hip joint with instability and malformation of the joint components. Arthritis is the long-term consequence of hip joint laxity.
SYMPTOMS of hip dysplasia may be subtle. They can include the presence of lameness in one or both hind legs and the reluctance to climb stairs or jump. Dogs that are affected often become less active and less playful. They may be reluctant to go on walks and their gait may be a “bunny hop” at certain speeds.
SYMPTOMS of hip dysplasia may be subtle. They can include the presence of lameness in one or both hind legs and the reluctance to climb stairs or jump. Dogs that are affected often become less active and less playful. They may be reluctant to go on walks and their gait may be a “bunny hop” at certain speeds.
SURGICAL OVERVIEW
During surgery, the arthritic femoral head is removed, the arthritic acetabulum is prepared, and the acetabular component (socket) is implanted.
Next, the femur is prepared, and the femoral component (stem) is implanted. The femoral head (ball) is placed on the femoral stem, and the new joint is articulated by placing the femoral head (ball) within the acetabulum (socket).
The Total Hip Replacement requires special training to be performed reliably. Certification Workshops are held regularly to provide surgeons with the resources to ensure full recovery.
Originally adapted from the analogous procedure in human orthopedics, this procedure has been developed over 45 years, and continually benefits from the expertise and support of pioneers in the veterinary industry.
RECOVERY
Most veterinarians keep dogs for one to three days following surgery.
Dogs often begin using their operated limb on the day of surgery.
Activity should be supervised and limited to leash walks for approximately six weeks after surgery.
The average length of a THR surgical procedure is approximately 75 minutes.
OVER 1,000 IMPLANT COMBINATIONS
BioMedtrix proudly introduced the CFX® (Cemented Fixation) Total Hip System in 1990, and the BFX® (Biologic Fixation) system in 2003. Since then, over 60,000 procedures have been performed.
Available in a broad range of sizes, the implants in each system are interchangeable, allowing for hybrid fixation, and are prepared to a common surgical preparation with a common set of instruments, providing greater versatility in the clinical options for total hip replacement.
Hybrid fixation is achieved when one component is cemented and the other is press-fit. The common femoral head is compatible with both the cemented and cementless acetabular cup and femoral stem implants.
Both applications use the same primary surgical steps, providing the option to press-fit or cement into the same acetabular or femoral preparation. The decision to use cemented or cementless (biologic fixation) implants is preferably made prior to surgery and varies with surgeon experience, preference and the morphology of the patient’s bone.
FEMORAL STEM TECHNOLOGIES
BioMedtrix continues to pioneer cementless, press-fit technologies for the Canine THR with solutions utilizing both bone in-growth and geometric stabilization methods.
EBM (Electron Beam Melting) is an FDA approved manufacturing process capable of creating one-piece implants (no additional coating or ingrowth) with optimum mechanical properties. Titanium alloy provides improved biocompatibility and is the preferred material for human hip stems.
Cranial and caudal flutes provide improved stem insertion.
Porous surface has an increased coefficient of friction for improved resistance to subsidence. Bone attachment is through the proximal fully interconnected 3-D titanium structure.
Built using the same EBM technology as our standard EBM stem, the BFX EBM Collared stem is designed to resist subsidence and assist in stabilizing the stem for bone ingrowth in the early post-op period.
Clinical indications for the collared stem are large breed dogs, German Shepherds and dogs with a low canal flare index (“stove pipe” geometry).
In addition to the clinical indications for the BFX Collared Stems, the Lateral Bolt stem may be used to address cases where calcar bone is absent and use of a collared BFX stem is not possible, cases where there may be an increased concern for stem position changes postoperatively.
The lateral bolt is used to increase the stability of BFX stems against subsidence and rotation while early implant stabilization and bone ingrowth is occurring.
Poly-XVE™: Highly Crosslinked and Vitamin E Stabilized UHMWPE
The polyethylene articular surfaces of all BioMedtrix total joint replacement implants are manufactured from Poly-XVE.
Increased Resistance to Long-term Wear: Up to 95% over standard UHMWPE
Potential Benefits: Prevent wear particle-induced bone resorption and implant loosening
The New Standard: FDA approved with overwhelming laboratory and clinical success in human arthroplasty
Vitamin E Stabilized: Produces a less brittle material with minimal reduction to mechanical resilience
The Small Breeds Hip System has been developed to provide Total Hip Replacement (THR) as the primary recommendation for very small dog breeds and cats.
As a viable option over femoral head ostectomy (FHO), a THR provides wider range of motion, improved function and pain-free joints. It is estimated over 3,000 cases have been performed on dogs and cats from 4 pounds to 20 pounds since 2005.
Purchasing Requirements for new expanded sizes of BFX cups (#10/12/14/16/18): Active accounts that have completed the Universal Hip Mentorship Program with BFX implants and completed a Micro & Nano THR workshop can purchase implants. An Instrument Set Upgrade is available for surgeons who own the Micro & Nano Set. Please contact us for more information.
SYSTEM UPDATE
As an addition to the standard line of Cemented Fixation (CFX) Implants, Biologic Fixation (BFX) press-fit cups are now available for smaller breeds in sizes 10 mm – 18 mm. The Small Breeds Hip Implant System is similar in design and manufactured from the same materials as the Standard Breed System. It consists of Femoral Heads, CFX or BFX Acetabular Cups, and both monoblock and modular Femoral Stems.
The surgical technique is predominantly the same as for larger breed dogs receiving a cemented stem, except the patient and instruments are smaller.
WORKSHOPS
BioMedtrix conducts product workshops throughout the United States and Europe. Each workshop details the application and surgical technique for a specific product such as the Universal Hip (BFX® and CFX® systems), Small Breeds Hip, TATE Elbow®, or I-Loc® Nail. Workshops consist of classroom instruction supported by lab experience, offering participants the opportunity to use the surgical instrumentation in order to familiarize themselves with the procedure.
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FREQUENTLY ASKED QUESTIONS
What is canine total hip replacement (THR)?
Canine THR is a surgical procedure in which the arthritic hip joint surfaces are replaced with a new prosthetic ball and socket. The prosthesis is designed to fit precisely and mimics the anatomy of the original joint. The arthritic joint is pain free after total hip replacement.
BioMedtrix proudly introduced the CFX® (Cement Fixation) Total Hip System in 1990, and the BFX® (Biologic Fixation) system in 2003. Since then, over 54,000 procedures have been performed. The implants in each system are interchangeable and are prepared to a common surgical preparation with a common set of instruments, providing greater versatility in the clinical options for total hip replacement.
What is hip dysplasia?
Hip dysplasia is an abnormal development and growth of the hip joint. Both hips are usually affected but symptoms may be more severe on one side. Hip dysplasia is manifested by varying degrees of laxity (looseness) of the hip joint with instability and malformation of the joint components. Arthritis is the long-term consequence of hip joint laxity.
What are the clinical signs of hip dysplasia?
The signs of hip dysplasia may be subtle. They can include the presence of lameness in one or both hind legs and the reluctance to climb stairs or jump. Dogs that are affected often become less active and less playful. They may be reluctant to go on walks and their gait may be a “bunny hop” at certain speeds.
How common are THRs in dogs?
The first THR in a dog was performed in 1957. Since their introduction in 1990, over 60,000 procedures have been performed using BioMedtrix implants. THR can be performed on dogs ranging from five through 170 pounds, and also on cats.
What is the success rate for canine THR procedures?
The success rate is very high. More than 95% of the patients who receive a THR should be able to use the new hip for the rest of their lives.
How long will my dog be in the hospital following THR surgery?
Most veterinarians keep dogs for one to three days following surgery. In some rare instances, high-risk patients may be hospitalized for longer periods to provide additional assistance or to protect the stability of the new prosthetic joint.
What is the typical recovery time for THR and what is involved?
Dogs often begin using their operated limb on the day of surgery. Most dogs use their operated leg quite well within a couple of weeks but activity should be supervised and limited to leash walks for approximately six weeks after surgery.
What does THR surgery entail?
A THR involves removing both the arthritic ball (femoral head) and socket (acetabulum) and replacing them with an artificial ball and socket joint.
The surgical procedure is precisely planned using several radiographic (X-ray) views and specialized templates that match the available implant sizes.
The average length of a THR surgical procedure is approximately 75 minutes.
During surgery, the arthritic femoral head is removed, the arthritic acetabulum is prepared, and the acetabular component (socket) is implanted. Next, the femur is prepared, and the femoral component (stem) is implanted. The femoral head (ball) is placed on the femoral stem, and the new joint is articulated by placing the femoral head (ball) within the acetabulum (socket).
Implant System
Both applications use the same primary surgical steps, providing the option to press-fit or cement into the same acetabular or femoral preparation. With a common head, implants are interchangeable between the two systems, allowing for hybrid fixation. Cement one component and press-fit the other. Both BFX and CFX implants are available in a broad range of sizes. This combination of interchangeability and multiple implant sizes provides clinical options for the surgeon to resolve hip reconstruction problems in a wide range of dog sizes and breeds.
Instrument System
As with all surgical procedures, patient-owners should consult with their veterinary orthopedic surgeon prior to surgery concerning any potential risks associated with surgery.
BioMedtrix Total Joint Replacement implants are available in a wide range of sizes and configurations to address various anatomic morphologies, and are manufactured to precise tolerances to ensure optimal performance and long-term success. The use of BioMedtrix implants in a hybrid configuration with other implant systems has not been validated by BioMedtrix, and may result in implant failure. For specialty cases, custom implants may be designed and produced upon request.