Transcutaneous tibial implants: a surgical procedure for restoring ambulation after amputation of the distal aspect of the tibia

OBJECTIVE: To report surgical planning, technique, and long-term outcome of custom transcutaneous tibial implants used to restore ambulation after bilateral pelvic limb amputation in a dog. STUDY DESIGN: Case report. ANIMALS: A 4-year-old, 25.5 kg, female spayed, Siberian Husky. METHODS: Computed tomographic scans of the pelvic limbs were used to build sterolithographic models of the remaining tibia after bilateral amputation of the distal aspect of the tibiae. The sterolithographic models facilitated fabrication of implants that would replace the missing distal segments of the tibiae. Custom implants were surgically placed in both limbs. RESULTS: Assisted ambulation was restored immediately postoperatively and unassisted locomotion occurred at 7 days. At 14 months, aseptic loosening of the right implant occurred, it was removed and a 2nd transcutaneous implant was fabricated and implanted. At 26 months after initial surgery and 17 months after revision of the right implant, function is restored at a walk, trot, and run. CONCLUSION: Based on over a 2-year follow-up, transcutaneous tibial implants allowed for restoration of locomotion. CLINICAL RELEVANCE: Transcutaneous tibial implants offer a potentially viable treatment option for restoring ambulation after amputation of the distal aspect of the tibiae in the dog.