Clinical Performance of the Zurich Canine Total Hip Replacement: complications, outcomes and risk factors

Abstract

Objective: This study aims to assess the outcomes and complications in dogs treated with the Zurich Cementless Total Hip Replacement (ZCTHR) at Utrecht University between 2012 and 2024, and to statistically identify parameters influencing postoperative complications, with a focus on surgical parameters, implant positioning, and patient characteristics. Materials and Methods: Medical records and radiographs of 38 dogs (54 hips) treated with ZCTHR were retrospectively evaluated. Signalment, weight, implant size and positioning, indication for treatment, surgical duration, intraoperative and postoperative complications, and overall outcome were recorded. Manual and automated (backward) logistic regression analysis was performed to determine predictors of postoperative complications. Results: A 6th generation ZCTHR was placed in 50 hips. Intraoperative and postoperative complication rates were 32% and 34%, respectively. Fissures were the main intraoperative complications, while luxations and aseptic cup loosening were the main post-operative complications. Surgical duration increased the risk of postoperative complications by 2% per additional minute (p < 0.05). Medium-sized dogs had a significantly lower risk of complications compared to giant-sized dogs. At the last follow-up, 86% of dogs had near-normal function, 6% showed lameness, and ZCTHR failed in 8% of cases. Conclusion: Complication rates may have been a result of case selection, surgical technique and materials used, with surgical duration and size of the dog significantly affecting the postoperative complication rate. Despite the complication rate, the outcomes were favorable in most cases. Clinical Significance: ZCTHR restores mobility and quality of life in most canine patients. Careful case selection and surgical technique are important to reduce complications.