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DrLucy
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Experience:  Almost 30 yr as a practicing small animal vet.; experience in gen.medicine, surgery, emerg/crit.care
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Can physical therapy be done after aseptic loosening occurs

Resolved Question:

Can physical therapy be done after aseptic loosening occurs in the femoral component of a total hip replacement in order to get the dog to walk?
Submitted: 4 years ago.
Category: Veterinary
Expert:  DrLucy replied 4 years ago.
I don't want to second-guess your doctor, but that sounds odd to me. If it is loose, something needs to be done. Orthopedists usually suggest one of two things--removing the implant and the cement and allowing the leg to heal as if it were a femoral head excision (osteotomy); or replacing the original implant with a cementless one. I can get you references and more information, if you would like. Is the doctor that gave you this advice an orthopedic specialist? If not, I would highly recommend a consultation with a board-certified surgical specialist (or two) before making a decision.

Please let me know if you would like more specific information about your options.
Customer: replied 4 years ago.

Thank you. I would like references that support what you've said about the appropriate course if an implant has loosened.

The doctor is an orthopedic specialist but I'm having doubts about his suggestion.

Expert:  DrLucy replied 4 years ago.
Here is an abstract of an article about replacing a failed implant with a cementless one.
http://www.ncbi.nlm.nih.gov/pubmed/19152620
From hearing some of the orthopedists discuss similar problems on the message boards of the Veterinary Information Network, the best place for advice on this issue is the team at NC State Univ. (the vet school), specifically Dr. Denis Marcellin-Little. (http://www.cvm.ncsu.edu/about/force-innov.html) Are you anywhere near there? If not, if you are at least near one of the major veterinary schools, you can be confident of their being on the cutting edge of what to do about implants loosening. Most of the orthopedists will say that they cannot determine the best plan without exploring the hip surgically. I would certainly want to make sure that your surgeon was right about its being aseptic, too.
Customer: replied 4 years ago.

Thank you again. I have read some papers and articles about implants loosening and none have mentioned doing physical therapy after this has happened. The doctor also said that maybe the implant has reset itself and won't move anymore so PT could possibly help. The dog is holding his leg up and won't put weight on it. What I have read seems to indicate that once the loosening has occurred, there is no remedy. Once loosened, the implant will continue to move and revision surgery will be needed.

I just wanted another expert opinion before I found another doctor.

Expert:  DrLucy replied 4 years ago.
I would agree.
DrLucy, Veterinarian
Category: Veterinary
Satisfied Customers: 618
Experience: Almost 30 yr as a practicing small animal vet.; experience in gen.medicine, surgery, emerg/crit.care
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DrLucy
DrLucy
Small Animal Veterinarian
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Almost 30 yr as a practicing small animal vet.; experience in gen.medicine, surgery, emerg/crit.care