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Pfund et al: Femoral cortical thickness index in a population of dogs undergoing total hip replacement
Veterinary Surgery 6, 2025

🔍 Key Findings

  • Lower CTI values were significantly associated with higher risk of both intraoperative and postoperative femoral fractures or fissures (p <.0001).
  • The mean CTI for all dogs was 0.285, whereas dogs with fissures/fractures had a mean CTI of 0.246.
  • For each 0.001 increase in CTI, odds of fissure/fracture decreased by 2–3% depending on perioperative timing.
  • High interobserver reliability (ICC = 0.984) and consistency between pre- and postoperative CTI measurements (ICC = 0.96).
  • CTI was the only significant risk factor identified; age, breed, bodyweight, BCS, CFI, or luxoid hips were not significant.
  • Prophylactic lateral plating in dogs with low CTI (mean 0.230) resulted in no postoperative fractures.
  • Postoperative fractures occurred in 8% of cases, and 93% of dogs returned to full function within one year.
  • CTI may be a useful radiographic screening tool, especially when advanced imaging (e.g., DEXA) is unavailable.

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← Articles

Pfund et al: Femoral cortical thickness index in a population of dogs undergoing total hip replacement
Veterinary Surgery 6, 2025

🔍 Key Findings

  • Lower CTI values were significantly associated with higher risk of both intraoperative and postoperative femoral fractures or fissures (p <.0001).
  • The mean CTI for all dogs was 0.285, whereas dogs with fissures/fractures had a mean CTI of 0.246.
  • For each 0.001 increase in CTI, odds of fissure/fracture decreased by 2–3% depending on perioperative timing.
  • High interobserver reliability (ICC = 0.984) and consistency between pre- and postoperative CTI measurements (ICC = 0.96).
  • CTI was the only significant risk factor identified; age, breed, bodyweight, BCS, CFI, or luxoid hips were not significant.
  • Prophylactic lateral plating in dogs with low CTI (mean 0.230) resulted in no postoperative fractures.
  • Postoperative fractures occurred in 8% of cases, and 93% of dogs returned to full function within one year.
  • CTI may be a useful radiographic screening tool, especially when advanced imaging (e.g., DEXA) is unavailable.

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Multiple Choice Questions on this study

In Pfund 2025 et al., on femoral cortical thickness, what was the mean CTI for dogs that developed perioperative fractures?

A. 0.285
B. 0.230
C. 0.246
D. 0.301
E. 0.260

Answer: 0.246

Explanation: The mean CTI in dogs with fissures/fractures was 0.246 vs 0.285 in all dogs.
In Pfund 2025 et al., on femoral cortical thickness, what best describes the reliability of CTI measurements across observers?

A. Low variability, ICC = 0.7
B. High variability, ICC = 0.6
C. Moderate agreement, ICC = 0.82
D. Near-perfect agreement, ICC = 0.984
E. Not assessed in the study

Answer: Near-perfect agreement, ICC = 0.984

Explanation: The CTI showed excellent interobserver reliability with minimal variability.
In Pfund 2025 et al., on femoral cortical thickness, what was the observed effect of a 0.001 increase in CTI on fracture risk?

A. No change in risk
B. Increased risk by 1%
C. Decreased risk by 1%
D. Decreased risk by 2–3%
E. Increased risk by 5%

Answer: Decreased risk by 2–3%

Explanation: Each 0.001 increase in CTI reduced fissure/fracture odds by 2–3% depending on timing.
In Pfund 2025 et al., on femoral cortical thickness, what was the key preoperative radiographic predictor of femoral fissure or fracture in dogs undergoing THR?

A. Body condition score
B. Femoral canal flare index
C. Proximal femoral sclerosis
D. Femoral cortical thickness index
E. Implant position

Answer: Femoral cortical thickness index

Explanation: CTI was the only statistically significant risk factor associated with perioperative fractures.
In Pfund 2025 et al., on femoral cortical thickness, what percentage of dogs sustained intraoperative fissures or fractures during THR?

A. 2%
B. 4%
C. 9.8%
D. 15%
E. 21%

Answer: 9.8%

Explanation: 22 out of 224 dogs sustained intraoperative fissures or fractures (mostly fissures).

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