# Opinion on THR -cement vs cementless



## Kayos and Havoc

Most clinics are still doing the procedure with cement to hold the prosthesis in place. The Kyon method is cementless. There are 4 doctors in the PNW doing this, 1 is in Sun VAlley ID, Dr Randy Ackerman. Another memher her recommended him. The other 3 are in OR, and 2 of them are in the Portland area which is an easy 3 hour drive for me. Same distance as WSU (they do cement).

http://www.kyon.ch/

Opinions on this anyone???


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## M&J

Rudy has a cementless. The surgeon decided on the operating table which to do.
Cemented is a very good alternative. The pro is that the first few weeks of recovery has more 'give'. Not as fragile. The cons are that some dogs have allergic reactions to the cement, and years down the road the cement can come loose and they have to remove the implant and do a modified FHO.
Cementless: Pros--no allergic reaction. Also, bone fills in the implant so there is no chance it will come loose years down the road. Con: The hip is more fragile the first few weeks. After 6 weeks the bone fills in there, and after 8 it is pretty solid.

I cheated on recovery after about week 4. I gave Rudy a lot more freedom than was recommended.


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## LandosMom

my Lando had cemented steel THR (one side). she got it at 7 yo and all was still well at almost 14 when she went to the bridge.


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## Kayos and Havoc

Mary I thought I remember someone mentioning the cementless that last year when I was kind of exploring surgery for Kayos. It was you!!! Thanks for the input.


Last year kayos went subclinical after taking some weight off her, about 7 pounds. Now she is back in the same boat and on Rimadyl at 5 years of age. 

She is actually doing okay today, actually wanted to chase her ball for the first time last night.


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## M&J

Really, if you can afford it, it is worth not having to worry whether Kayos is in pain or not, whether the supplements are working etc.
I was worried about the recovery period, but it was very easy. 
I also did not want Rudy on pain management drugs for the rest of his life. In addition to the health concerns with those, the cost of a THR over time is less than all those drugs and supplements---that may or not be healthy or even working.

I'm sure you will do the right thing and what is best for both of you. But I can attest that THR was the way to go with Rudy. He will be even better once I get these extra thirteen pounds off him.
My other dog has mild to moderate HD and if she ever needs surgery, I will rob a bank and have it done for her.

I had Rudy's surgery done in early spring so he wouldn't be recovering with snow ont he ground, and would be all healed for the summer.


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## Sean Rescue Mom

Kathy, no experience or words of advice in this area. Have been following your thread and just wanted to say I wish Kayos and you the best.


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## BowWowMeow

What's the price difference on the two options?


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## M&J

I paid $3800. It would have been the same with the cemented version.
My surgeon charges $1800 for an FHO but I know others who do it for well below that price.


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## BowWowMeow

Wow! The price has really gone up. I paid $2000 for Massie's THR 15 years ago. But back then they were said to last only 4-5 years. I think the material has improved.


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## Kayos and Havoc

I do not know if there is a difference and it would not matter to me anyway. I plan on calling a couple clinics that do the cementless at lunch time today. I want to get and idea of cost and recovery and infection chance and stuff like that.


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## BowWowMeow

I was just curious about the prices and whether there was a difference. I am always willing to pay more if it is safer, etc.


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## agilegsds

Shelby had the cementless done. It can extend the recovery process a bit because it is more fragile at first. But we chose to go with it over the cement because in the event that there's complications and it has to be removed, it is much easier to remove than the cement version. I can't recall exactly how long the surgery to remove the cement version is, but as I recall, the docs said it was a long and complicated surgery.

I don't remember there being any price difference between the two.


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## Kayos and Havoc

I just spoke to a vet at the Sun Valley Animal Hospital in Ketchum ID. He actually got on the phone and spent about 20 minutes with me. He ws very nice!!! THANK YOU Shyne (GuardyanKennels) for the info on him.

In a nut shell there are 2 kinds of "cementless" THR. One uses the Kyon system that I posted the link for. This is the system this vet uses. He likes it because it has less chance of infection than cement and fewer complications. He alse feels for GSD with thinner femurs than other dogs (Kayos does have thin femurs) there is less risk of secondary femur cracks from the implants. Also less slippage of the implant with the screw system the Kyon uses.

The vets at WSU also do cementless. The ID vet told me that and he knows the vet that does the procedures. He is very good and it would be a good choice for Kayos. 

He also said that of 100 dogs in a University of Colorado study examined at time of death, every one of them, 100% had loosening of the cement. He said some never had clinical sypmptoms and some did. What that means to me is that generally, cement is going to loosen over time. In a dog Kayos's age that is not acceptable. If she were a 10 year old dog the amount of loosening over the rest of her lifetime would be acceptable most likely. I do not want to back in there in 4 years to do it again on a 9 year old or have to do an FHO. 

So cementless is the choice - but now who? 

Ketchum ID is 7.5 hours for the Kyon, WSU is 3 hours for the Biometrics cementless.

There are a few vets (3) in Portland that do the Kyon also but none of the offices wanted to talk to me unless my vet called. Referral only. 

Go study Biometrics. Back in awhile.


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## Kayos and Havoc

Oh forgot.... cost is $3900 for the Kyon. About same as every where else.


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## Kayos and Havoc

Article on cement vs cementless which mentions the Kyon implant.

http://www.sandyrobinsonline.com/viewarticle.php?id=19


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## Kayos and Havoc

The Biomedtrix FAQ page.

This is a univrsal system that can use cement or no cement and is the more common system which WSU uses. 

http://www.biomedtrix.com/index.php?option=com_content&task=view&id=15&Itemid=86

Probably more than anyone ever wanted to know!
Thanks for humoring me.


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## BowWowMeow

Hmmm, perhaps you should write up a summary of your findings and then we can put it into a sticky for the next person whose dog needs this surgery!


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## Kayos and Havoc

> Originally Posted By: BowWowMeowHmmm, perhaps you should write up a summary of your findings and then we can put it into a sticky for the next person whose dog needs this surgery!


Oh too much work!!!!









But not a bad idea........


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## Barb E

I had forgotten about the referal thing with Dr Munjar, but I'm sorry they wouldn't at least talk to you!


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## Spiritsmam

Several years ago my Shep had both his hips replaced, and Sam had his right replaced this past January. They both had the BFX cementless (Biomedtrix), which, as was mentioned above, can be converted to a CFX (cemented) during surgery if needed. Both Shep and Sam had their surgery at NC State, who helped develop the implant with Biomedtrix.


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## M&J

I think Rudy has the BFX, as well.


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## agilegsds

> Originally Posted By: KathyW
> In a nut shell there are 2 kinds of "cementless" THR. One uses the Kyon system that I posted the link for. This is the system this vet uses. He likes it because it has less chance of infection than cement and fewer complications. He alse feels for GSD with thinner femurs than other dogs (Kayos does have thin femurs) there is less risk of secondary femur cracks from the implants.


That's a plus if it reduces the chance of a femur crack. I don't know which cementless Shelby had, but she did break her femur while still at the hospital and had another long surgery to repair that. She had every complication imaginable and then we lost her to cancer 1.5 years later.


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## Kayos and Havoc

Oh that is horrible!!!! I am so sorry. The complications like with anything can be devastating. They rate of complications is about 5% from my studies.


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## M&J

There is an old post, maybe 2-2 1/2 years old, started by GSDLoverII that covers Casey and Rudy's recovery period. I don't know how to pull up old posts, though. If someone can find it I think it would be helpful to anyone going through recovery with their dog to read it.


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## Kayos and Havoc

Maybe our mods can help????


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## M&J

I hope so. I tried googling it but it didn't come up. Maybe Jean, or other powers that be.........or maybe even GSDLover has it saved somewhere.


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## GSDLoverII

> Originally Posted By: M&JI hope so. I tried googling it but it didn't come up. Maybe Jean, or other powers that be.........or maybe even GSDLover has it saved somewhere.



I tried google and this is all I get.
"There was a problem looking up this post in our database"


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## Kayos and Havoc

Wahhhhhhh!!!!! Oh well, I will have to do a recovery log for kayos so we have another one!!

Today she is doing pretty good, is starting to want to run a bit but I am trying to prevent that.


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## LisaT

I haven't read any of the posts, just the first one in the thread. Since I'm not up on all the THR stuff, I only have one thing to add. 

The less amount of foreign stuff that you put in a body, that will remain in the body, is a good thing. The body doesn't like foreign materials, although it will tolerate some.


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## LisaT

> Originally Posted By: KathyWWahhhhhhh!!!!! Oh well, I will have to do a recovery log for kayos so we have another one!!


I can never find anything with the search on this board, and I think they go back and prune also?

If we have such a log, we can make sure that it gets archived and we can find a place to index it in our sticky above.


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## M&J

That would be great! I PM'd another mod a little while ago to see if it could be found.
Forgot to add.......Rudy's surgeon does cemented and cementless. He tries to do cementles ,but it depends on what he finds when he gets in to operate. If the bones aren't in good enough condition his backup is the cemented. He decided on the table. 
He called as soon as it was over (maybe an hour and a half) and said Rudy's was a routine cementless. 
Wishing the both of you the best and look forward to your recovery log!


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