Canine total joint replacement - Where are we now, and where are we heading?

Total joint replacement has become an accepted treatment option for dogs with advanced degenerative joint disease. The early work on canine total joint replacement focused on total hip replacement, with veterinarians being able to learn a great deal from the positive (and sometimes negative) experiences of their counterparts in human medicine. The evolution of canine THR has mirrored that of human THR so that cemented, cementless and hybrid fixation can now be used for complete joint replacement or hemiarthroplasty with stemmed or surface replacement prostheses. Clinical results with contemporary cemented and cementless THR implants are generally excellent, and this success has provided a solid foundation for expanding total joint replacement to include other joints, most notably the knee and elbow. Early experiences with both total knee replacement (TKR) and total elbow replacement (TER) have been encouraging, but care needs to be exercised in moving forward, particularly with regard to expanding the indications for these procedures. In THR, there has been a gradual move towards early surgical intervention, and a similar approach will likely be seen in TKR and TER, but earlier intervention increases the demand on the implant in terms of both activity level and total time in service.  [...]