A retrospective multicenter study of outcomes and complications in dogs undergoing total hip replacement with a BFX collared stem

Abstract Objective To evaluate outcomes and complications of the cementless BFX collared (BFX‐C) stem in canine total hip replacement (THR) and identify risk factors for complications and subsidence. Study design Retrospective multicenter study. Animals A total of 104 dogs undergoing 134 THR at four referral institutions (2019–2024). Methods Medical records and radiographs of dogs receiving a BFX‐C stem were reviewed. Radiographic measurements included canal fill, canal flare index, stem alignment and subsidence. Clinical outcomes were assessed by orthopedic examination and owner questionnaire. Associations between putative risk factors and stem‐specific complications and subsidence were assessed using univariable and multivariable analysis. Results Major stem‐specific complications occurred in 15 (11.2%) procedures: intraoperative femoral fissures (7; 5.2%), intraoperative greater trochanter fractures (4; 3.0%), postoperative femoral fractures (3; 2.2%), subsidence requiring revision surgery (1; 0.8%). Median subsidence was 1.0 mm (range: −1.8–10.8). Subsidence of >3 mm in five (3.7%) cases, with one associated major complication. Increasing age was associated with greater subsidence ( p = .04), but not with the likelihood of subsidence >3 mm ( p = .08). At clinical follow‐up (>3 months), 88/100 (88.0%) cases showed no lameness. Owners reported full limb function in 122 (91.0%) and acceptable function in 12 (9.0%) cases. Conclusion The use of the BFX‐C stem resulted in low rates of stem‐specific complications and clinically relevant subsidence in this cohort. Subsidence ≤3 mm was common but not associated with stem‐specific complications. Clinical significance The BFX‐C stem is an acceptable option for cementless THR in dogs, providing high rates of full function and owner satisfaction.