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33rd Annual Scientific Meeting proceedings


Stream: SA   |   Session: Total Hip Arthroplasty 2
Date/Time: 05-07-2024 (11:15 - 11:45)   |   Location: Auditorium 1
What is the evidence for THR in cats?
Schnabl-Feichter EVA*
Veterinärmedizinische Universität Wien, Kleintierchirurgie, Vienna, Austria.

Feline total hip replacement (THR) is a surgical procedure that has become increasingly recognized and utilized for the treatment of various debilitating hip conditions in cats including fractures, luxations and hip dysplasia with consecutive osteoarthritis (1-3). Nevertheless, unlike in dogs, femoral head and neck ostectomy (FHO) is still commonly performed in cats as an alternative option to THR. This is despite evidence showing that long-term results, based on objective outcome measures (e.g., gait analysis) are also not satisfactory and result in lameness and pain on examination (4,5).

 When examining the evidence for THR in cats, one can find case reports (6-8) and case series (9-12) detailing the outcome after the procedure. Most of them being short term results and some with medium-long term results. One recently published paper uses results from the feline hip registry; a validated owner questionnaires long-term follow up report (median 752 days) of 44 cats after cemented THR (13). The conclusions drawn from this study indicate that the complication rate (19%) is similar to those reported in canine THR and that cats show clinical improvement after THR. The results of the owner questionnaires were in 90% very good with a median duration of follow up being 752 days.

Nevertheless, if these results are better than the ones described for FHO in cats are unclear. Especially since a study using a comparable study design with fewer patients showed nearly identical results after FHO (14). Therefore, our intention was, to conduct a multicentric study and compare the long-term outcome in cats after unilateral THR with a group of cats after FHO. We invited cat owners for a re-visit more than one year after the procedure. Cats underwent a radiographic and orthopedic examination and were asked to cross a pressure sensitive plate to measure temporospatial parameters and ground reaction forces. Measurement of ground reaction forces (peak vertical force, PFz and vertical impulse, IFz) using a pressure-sensitive walkway represents a suitable method for the objective determination of lameness and therapy success. The preliminary results of that study are promising that it is favorable to perform THR also in cats compared to FHO.

In conclusion it can be said that there is evidence in veterinary literature to support the use of THR in cats. Additionally, we were able to show, that there is some benefit in direct comparison between the procedures. conduction of more prospective case-controlled studies with larger case numbers as already performed in dogs and the use of objective outcome measures would be desirable.

References

  1. 1. Liska WD. Micro total hip replacement for dogs and cats: surgical technique and outcomes. Vet Surg. 2010;39(7):797-810. doi:10.1111/j.1532-950X.2010.00725
  2. Kalis RH, Liska WD, Jankovits DA. Total hip replacement as a treatment option for capital physeal fractures in dogs  and cats. Vet Surg. 2012;41(1):148-155. doi:10.1111/j.1532-950X.2011.00919
  3. Marino DJ, Ireifej SJ, Loughin CA. Micro total hip replacement in dogs and cats. Vet  Surg. 2012;41(1):121-129. doi:10.1111/j.1532-950X.2011.00933
  4. Off W, Matis U. Excision arthroplasty of the hip joint in dogs and cats. Clinical, radiographic, and  gait analysis findings from the Department of Surgery, Veterinary Faculty of the Ludwig-Maximilians-University of Munich, Germany. 1997. Vet Comp Orthop Traumatol. 2010;23(5):297-305.
  5. Schnabl-Feichter E, Schnabl S, Tichy A, Gumpenberger M, Bockstahler B. Measurement of ground reaction forces in cats 1 year after femoral head and neck  ostectomy. J Feline Med Surg. 2021;23(4):302-309. doi:10.1177/1098612X20948143
  6. Liska WD, Doyle ND, Schwartz Z. Successful revision of a femoral head ostectomy (complicated by postoperative  sciatic neurapraxia) to a total hip replacement in a cat. Vet Comp Orthop Traumatol. 2010;23(2):119-123. doi:10.3415/VCOT-09-07-0075
  7. Roh Y, Jeong J, Jeon Y, Kim D, Jeong S, Lee H. Pelvic Endoprosthesis after Hemipelvectomy Using a 3D-Printed Osteotomy Guide for Infiltrative Osteoma in a Cat. Vet Sci. 2022 May 16;9(5):237. doi: 10.3390/vetsci9050237
  8. Bourbos A, Piana F, Langley-Hobbs SJ. Total hip replacement in a cat with contralateral pelvic limb amputation. JFMS Open Rep. 2024 Apr 24;10(1):20551169241232297. doi: 10.1177/20551169241232297
  9. Liska WD, Doyle N, Marcellin-Little DJ, Osborne JA. Total hip replacement in three cats: surgical technique, short-term outcome and  comparison to femoral head ostectomy. Vet Comp Orthop Traumatol. 2009;22(6):505-510. doi:10.3415/VCOT-08 09-0087
  10. Witte PG, Scott HW, Tonzing MA. Preliminary results of five feline total hip replacements. J Small Anim Pract. 2010;51(7):397-402. doi:10.1111/j.1748 5827.2010.00953
  11. Fitzpatrick N, Pratola L, Yeadon R, Nikolaou C, Hamilton M, Farrell M. Total hip replacement after failed femoral head and neck excision in two dogs and  two cats.Vet Surg. 2012;41(1):136-142. doi:10.1111/j.1532-950X.2011.00940
  12. Vezzoni A, Boano S, Sacristani A, Bresina S, Lanz O. Zurich Mini Cementless Total Hip Arthroplasty in 42 Small Breed Dogs and 8 Cats: Surgical Technique and Outcomes. VCOT Open. 2023;06:e22-e36. doi:10.1055/s-0043-1761600
  13. Rodiño Tilve V, Allaith S, Girling S, Moores AP, Mulholland L, Morrison S, Onyett J, Maddox TW, Lascelles BDX, Langley-Hobbs S, Comerford E. Long-term follow up of 44 cats undergoing total hip replacement: Cases from a feline hip registry (2010 2020). Vet Surg. 2022 Jul;51(5):763-771. doi: 10.1111/vsu.13822
  14. Yap FW, Dunn AL, Garcia-Fernandez PM, Brown G, Allan RM, Calvo I. Femoral head and neck excision in cats: medium- to long-term functional outcome in  18 cats. J Feline Med Surg. 2015;17(8):704-710.doi:10.1177/1098612X1455684

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