Use of a custom-made acetabular cage to treat aseptic loosening following cemented total hip replacement in a giant breed dog

A 7-year-old, female, spayed Dogo Argentino was presented with right hindlimb lameness 9 months following right total hip replacement. Investigations identified loosening of the acetabular cup and significant loss of bone stock, including defects of the dorsal acetabular rim and caudal pillar. A custom-made acetabular cage inspired from the human acetabular reinforcement ring was implanted and fixed into the ilium and the acetabular rim with screws. Improvement in right hindlimb function was delayed by the occurrence of a right cranial cruciate ligament rupture; however, radiography 6 months following the surgery demonstrated osseointegration despite loosening of a single screw. Three years postoperatively, the dog showed no resentment on manipulation of the right hip and the owners reported a return to normal activity including off-lead running. Aseptic cup loosening associated with acetabular medial wall and caudal pillar defect were ameliorated using a custom-made acetabular cage in a giant breed dog.