Surgical Considerations for Extracortical Canine Total Hip Replacement: A Conceptual Framework

Abstract

The currently employed technique for the advanced stages of coxofemoral disease is total hip replacement (THR). Traditionally used methods (cemented or cementless) involve the implantation of components in femoral medullary canal. However, these techniques led to fractures and stress shielding in case of revision surgery. Thus, it becomes extremely necessary to look out for other techniques. In this respect, the use of extracortical fixation could be useful. Extracortical fixation involves fixing of femoral component to the outer surface instead of directly implanting them in the medullary canal. Till now, there are no peer-reviewed studies with keywords like “extracortical,” “canine,” and “total hip replacement” in indexed veterinary literature. The present review discusses the surgical protocol of extracortical THR and special attention was paid to the design which does not requires native femoral medullary canal with intramedullary stem, but also screw tips penetrate the canal without contacting the medial cortex. We hypothesize that this distinctive property prevents intraoperative fractures as well as improves revision surgery when compared to intramedullary approach.