🔍 Key Findings
- Hybrid implants were used in older, heavier dogs with lower canal flare index (CFI) compared to cementless types.
- CFI <1.8 was associated with higher risk of femoral fracture or stem subsidence with cementless implants.
- Total complication rate was 14%, with catastrophic complications in only 1.5%—lower than reported in other studies.
- No significant difference in complication rates across implant types (BFX, BFX-C, hybrid).
- Femur fractures were rare (2.9%), lower than in prior studies, and successfully managed with cerclage/plate fixation.
- Coxofemoral luxation was the most common complication (8 cases); all occurred within 62 days post-op, mostly resolved with revision.
- Collared BFX stems did not significantly reduce complications, though they may limit stem subsidence.
- An implant selection algorithm was proposed, using age ≥7 years, weight ≥45 kg, and CFI <1.8 to guide cemented vs. cementless stem use.
