title: Custom total knee replacement in a dog with femoral condylar bone loss.
abstract: OBJECTIVE
  To report surgical planning, technique, and outcome of custom total knee replacement (TKR) performed to manage a medial femoral condylar nonunion in a dog.
  
  
  METHODS
  Clinical case report.
  
  
  METHODS
  A 3-year-old, 20 kg Karelian Bear Hound.
  
  
  METHODS
  Computed tomographic scan of the left pelvic limb was used to build a stereolithography model of the distal portion of the femur. The model was used to create a custom augment to replace the missing medial femoral condyle and a custom stem for intramedullary condylar cemented fixation. The augment and stem were adapted to femoral and tibial components already available. The model was used to rehearse the surgery and then the custom prosthesis was implanted.
  
  
  RESULTS
  Weight bearing returned 8 hours after surgery and improved thereafter. Joint alignment was normal and prosthetic joint motion was 60-165 degrees postoperatively. The dog resumed moose hunting 3 months after surgery. Peak vertical force and impulse of the operated limb measured 17 months after surgery were 65% and 47% of the normal, contralateral limb.
  
  
  CONCLUSIONS
  Based on short-term follow-up, cemented canine TKR was successfully achieved for management of a severely abnormal stifle joint.
  
  
  CONCLUSIONS
  With further refinement and development of commercially available prostheses, TKR should be possible for canine patients.
authors.affiliation: Gulf Coast Veterinary Specialists, Houston, TX 77027, USA. DrLiska@GCVS.com
authors.forename: William D
authors.initials: WD
authors.lastname: Liska
authors.forename: Denis J
authors.initials: DJ
authors.lastname: Marcellin-Little
authors.forename: Esa V
authors.initials: EV
authors.lastname: Eskelinen
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Sidebotham
authors.forename: Ola L A
authors.initials: OL
authors.lastname: Harrysson
authors.forename: Anna K
authors.initials: AK
authors.lastname: Hielm-Björkman
mesh_terms: D000818:Animals; D019645:Arthroplasty, Replacement, Knee / Q000379:methods / Q000662:veterinary*; D001843:Bone Cements / Q000627:therapeutic use; D004285:Dogs / Q000293:injuries* / Q000601:surgery*; D005269:Femur / Q000601:surgery*; D007720:Knee Prosthesis / Q000662:veterinary*; D016059:Range of Motion, Articular; D016896:Treatment Outcome; D016474:Weight-Bearing; D014948:Wounds, Gunshot / Q000601:surgery / Q000662:veterinary
chemical_list: D001843:Bone Cements