44

Total Knee Replacement

in the Dog

Matthew J. Allen, William D. Liska, and Valentina Brioschi

History of total knee replacement in
the dog

In humans, total knee replacement (TKR) has
become a routine and highly successful proce-
dure for patients with pain or disability associ-
ated with arthritic disorders of the knee joint.
The long-term survival of TKR prostheses is
comparable to that of total hip replacement
prostheses, with approximately 10% of patients
requiring revision surgery within the first 10
postoperative years (Robertssonet al. 2001). The
most common cause of implant failure is aseptic
loosening of the implant.
During the late 1980s, Dr Tom Turner
described the development of a condylar-style
TKR prosthesis for the dog (Turneret al. 1989).
Although initially used as a preclinical model
for studying the effects of different fixation
methods on bone apposition and bone ingrowth
in cementless tibial components (Berzinset al.
1994; Sumneret al. 1994), the research implants
were subsequently used in selected clinical
cases with subjectively acceptable initial results
(Dr T. Turner, personal communication).
Allenet al. (2009) reported 1-year follow-up
data on a series of 24 skeletally mature purpose-
bred dogs that underwent cemented TKR with
a second-generation research implant sys-

tem, consisting of a cobalt-chromium (Co-Cr)

alloy femoral component and an ultra-high-

molecular-weight polyethylene (UHMWPE)

tibial insert enclosed in a Co-Cr tibial tray

(Allen et al. 2009). Follow-up examinations

were performed at 6, 12, 26, and 52 weeks

postoperatively. The results were encouraging

in all animals. However, the design of the

femorotibial articulation was deemed to be less

than optimal and a commercial implant was

not subsequently developed.

Liska et al. (2007) described the use of

a custom-designed cemented canine TKR

implant to reconstruct a stifle joint with femoral

bone loss secondary to traumatic injury. This

TKR was followed and remained functional for

9 years when the dog died of unrelated causes

(Liska 2015). Subsequent to this initial report, a

modular implant system and associated instru-

mentation were developed and released for

clinical use. This implant system (Canine Total

Knee System; BioMedtrix LLC, Whippany,

NJ, USA) is currently used worldwide. The

standard implant system is intended for hybrid

fixation, with a cementless femoral component

and cemented tibial component. A cementless

option is also available for the tibia, using a

metal tray with a porous fixation surface. This

has been used successfully in a preclinical

Advances in the Canine Cranial Cruciate Ligament, Second Edition. Edited by Peter Muir. © 2018 ACVS Foundation.
This Work is a co-publication between the American College of Veterinary Surgeons Foundation and Wiley-Blackwell.

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