Complications of cementless total hip replacement. A retrospective study of 163 cases

Cementless total hip implants are relatively new to the veterinary market and therefore complication rates and prognostic indicators associated with the procedure have not been thoroughly documented. The objective of this study was to determine the prevalence of complications and identify prognostic indicators of success or failure for the Zurich cementless total hip replacement (THR). Medical records of 163 dogs that underwent Zurich cementless-THR were reviewed; continuous and categorical variables, clinical outcomes and complications were recorded. Complications were separated into intra-operative (IOC), short-term (STC), and long-term (LTC). Bivariate and multivariate statistical analysis was used to compare complications. The clinical significance of this study was to provide surgeons with prognostic indicators of success or failure when evaluating prospective Zurich cementless-THR patients, and to report the complication rate of Zurich cementless-THR. The complication rates of Zurich cementless-THR were then compared to previously-reported complication rates of cemented-THR and other cementless-THR systems. Short-term complications, LTC, and IOC rates of Zurich cementless-THR were found to be 6.75%, 10.4%, and 11.0% respectively. The most common complications were intra-operative femoral fracture, luxation of the implant, and septic loosening of the implant. Increased body weight and prior cemented-THR or femoral head and neck ostectomy of the contra-lateral hip were identified as negative prognostic indicators. The overall complication rate identified was greater than those previously reported for other cementless- and cemented-THR systems.