Fitzpatrick Referrals has carried out a world-first procedure in which an American Bulldog was fitted with a prosthetic hip and femur with a special in-growth attachment which effectively re-attaches the tendons and muscles to the artificial limb.

The procedure took place after 8 year old Roly was diagnosed with cancer in his rear hind leg earlier this year. It involved a highly complex two-hour operation, during which Dr Noel Fitzpatrick, a neuro-orthopaedic veterinary surgeon, replaced the cancerous femur bone and hip joint with a specially constructed artificial prosthesis, while re-attaching the musculature and realigning the relative position of the joint to restore perfect movement to the dog. 

The prosthesis was designed through a collaboration between Professor Gordon Blunn, Head of the Centre for Bio-Medical Engineering at UCL's Institute of Orthopaedics and Musculoskeletal Science; veterinary surgeon Noel Fitzpatrick and Jay Meswania from specialist implant manufacturer OrthoFitz.

Roly, nine weeks after the ground-breaking opProfessor Blunn said: "What is significant about the design is the way in which it sandwiches tissue and metal together overlaying the gluteal muscles onto the top of the endoprosthetic femur - alternating tendon, synthetic Dacron mesh, tendon, synthetic Dacron mesh, tendon and finally trabecular metal - which has a honeycomb surface resembling a series of small chambers.  In this way, the hope is that the Sharpeys fibres which attach tendons of muscles to the bone will grow into the trabecular metal surface and permanently adhere to it."

"This truly remarkable achievement was made possible through the convergence of biomechanics, biology and surgical innovation," said Noel Fitzpatrick.  "We tapped into the evidence provided by the CT and MRI scanners we have in place at the practice, so that the data collected about Roly during clinical diagnosis was used to design and construct an artificial femur which exactly mirrored his original limb. It has been constructed rather like a telescope - one section fitting inside the adjoining section, so that we get maximum flexibility and traction during motion."

Dr Noel FitzpatrickNoel added: "Hip replacement is common here. We do more than 50 a year, on animals as small as a cat or a Chihuahua. But this hip replacement was special, and to my knowledge, the first of its kind in the world. It's important though to emphasise that this technology must only be employed when it is in the best interests of the individual patient. It's not enough to be able to do something; it must be done for the right reason in every case without exception. It must be ethically right. It's also important to emphasise that Roly will probably not live for a normal lifetime because bone cancer generally spreads to the lungs over time in spite of chemotherapy. However, this technology is equally applicable for dogs and cats affected by trauma who will likely live longer. My job is to look after my patients as best I can and to be honest with their guardians and give them options. What I do is provide pain free functional quality of life for as long as my patient is alive. That's important and that's special, but the decision must remain with each and every individual animal owner".

According to the team, this development also has potentialy life-changing implications for human patients such as motorcycle accident victims, where a key challenge to recovery may be successfully re-attaching the kneecap tendon onto the top of the tibia in the lower leg, and injured sports players with ruptured  repairing ruptured tendons.

Click here to view the x-rays of this case in the VetSurgeon Gallery.

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