Use of a tibial osseointegrated prosthesis as a limb salvage method in two dogs

To report on the management and outcomes of two dogs treated with osseointegrated prosthesis for pelvic-limb salvage.

Short case series.

Two client-owned large breed dogs with distal tibial amputation due to neonatal and iatrogenic trauma.

Preoperative computed tomography (CT) was performed to assess tibial medullary length and width. A custom-made intramedullary prosthesis was implanted and attached to a 3D-printed external prosthesis simulating a foot. Postoperative care included bandaging and regular chlorhexidine washes. Postoperative monitoring included clinical evaluation, owners' assessment of function and radiographs.

Both dogs regained good use of the operated limb within 3 weeks of surgery. Osseointegration and bone remodelling around the implants were noted on radiographs, with no evidence of loosening or implant migration observed. Mild serosanguinous discharge at the cutaneous-implant interface was observed in the early postoperative period, resolving without intervention. Progressive osteolysis around the implants was detected on radiographs in both dogs by 22 months. Though osteomyelitis is suspected, both dogs were using the limb adequately and had satisfactory quality of life at more than 36 months after surgery. A consistent hygiene routine is suspected to delay this process and should theoretically prolong the lifespan of these implants.

This osseointegrated implant system allowed dogs with traumatic loss of the hindpaw to regain normal clinical function of their pelvic limb for 3 years. Occasional soft tissue infections of the stoma sites were observed, but were easily managed, and long-term (36 month) follow-up suggests durability of the prosthesis.

These results justify further studies in a larger cohort to assess the long-term durability of osseointegrated prostheses as a single-stage strategy to treat partial limb amputation.