Comparison of biologic hip preservation versus total hip arthroplasty in a preclinical canine model

Abstract While total hip arthroplasty (THA) is an effective treatment option when indicated, young, active individuals are not ideal candidates. Biologic hip preservation (BHP) using femoral head osteochondral and acetabulum labrum allograft transplantation provides a potential alternative. This study was designed to test the hypothesis that BHP would result in superior hip joint function compared to THA in a ‘young adult’ preclinical canine model. With Institutional Animal Care and Use Committee Approval, canine femoral heads and acetabular labrums were aseptically recovered for subsequent transplantation. Ten purpose-bred hounds were randomly assigned to undergo either BHP or THA (n = 5 each). Postoperatively, dogs were compared for differences in pain, function, and hip range of motion (ROM), and were evaluated for allograft/implant integration, joint architecture and health, and complications using radiographic, gross, and histologic assessments. At 6 months postoperatively, BHP had significantly (P = 0.039) greater hip ROM recovery (97.8% versus 89.9%) and significantly (P = 0.02) less pain (0.3 versus 1.4) compared to THA. Radiographic, gross, and histologic assessments supported the safety of BHP. BHP using femoral head osteochondral and acetabulum labrum allograft transplantation was consistently safe and effective in preserving the architecture of the native hip while restoring hip joint health and function with potential advantages over THA for pain relief and hip ROM. Study results support the use of BHP as an alternative option to THA in patients amenable to this treatment strategy. Future studies are needed to delineate the type and extent of hip joint disorders that are amenable to this treatment strategy.