Hind Limb Amputation Prosthesis (PerFiTS)

What is a Hind Limb Amputation Prosthesis (PerFiTS)?

A PerFiTS is a uniquely designed prosthesis incorporating the joining of an endoprosthesis and exoprosthesis avoiding limb amputation to provide your dog or cat with a fully functional limb as a result of limb malformation or trauma. We are the only centre in the world offering this unique custom made amputation prosthesis and feel very honoured to have given the gift of mobility to many cats and dogs across the country allowing you and your animal friend to pursue a normal lifestyle filled with exercise and adventure.

What is limb salvage surgery?

Limb salvage surgery is an innovative surgical technique used to treat animals where the lower part of the hind limb is obliterated either by cancer (bone cancer or soft-tissue cancer), or by severe trauma to bones, muscles, nerves and/or blood vessels. We have treated both dogs and cats with this technology in circumstances where amputation or euthanasia was the only possible alternative. The surgery uses an amputation endoprosthesis that allows the lower portion of the limb to be replaced with an exoprosthesis, or foot, via a metal peg that protrudes from the skin.

Avascular necrosis of the paw requiring amputation and replacement with PerFiTS

Avascular necrosis of the paw requiring amputation and replacement with PerFiTS

 

What is an amputation endoprosthesis?

Fitzpatrick Referrals has spent years pioneering the technology used in the design and manufacture of the PerFiTS (Percutaneous Fixation to Skeleton) amputation endoprosthesis.  The implant, although small, is packed full of ground breaking technology. Special coatings on the implant allow the patients bone to incorporate into the metal of the implant meaning the implant because a physical part of the patients skeleton. Further specialist coatings at the interface where the implant passes through the skin allow the skin cells to incorporate into the metal ensuring a robust, bacteria proof, seal forms between the skin and the implant. The portion of the implant that passes through the skin allows an exoprosthesis, or foot, to be attached to the endoprosthesis.

PerFiTS (Percutaneous Fixation To Skeleton) amputation endoprosthesis

PerFiTS (Percutaneous Fixation To Skeleton) amputation endoprosthesis

 

What is an amputation exoprosthesis?

The exoprosthesis is the portion of the implant that the patient walks on after surgery. The exoprosthesis, or foot, is designed to allow the patient to walk as if their original foot was still present. Each exoprosthesis is custom-made to accommodate the patient’s height, weight and natural gait. Each exoprosthesis is custom-made for each patient using a combination of blades and clamps. We use carbon fibre for the blade construction so we can tune its flex to the weight of the patient. Over time the base of the exoprosthesis will wear out just like the sole of a shoe. When this happens we simply unbolt the exoprosthesis from the endoprosthesis (PerFiTS) and refurbish the base of the foot.

 

Endoprosthesis connected to exoprosthesis resulting in PerFiTS of the hindlimb

Endoprosthesis connected to exoprosthesis resulting in PerFiTS on the hind limb

 

What does limb salvage surgery involve?

Surgery involves the removal of the damaged section of limb in either a single or two-stage process. In cases where the lower limb is affected by cancer we can amputate the affected portion of the limb and place the PerFiTS implant in the same surgery. In cases of major trauma to the lower limb we tend to amputate the damaged portion of the limb and allow the surgical site to heal fully before placing the PerFiTS implant at a second surgery.

What are the risks of limb salvage surgery?

Infection remains the biggest risk during limb salvage surgery; this is why patients who have suffered trauma to their lower limb have PerFiTS surgery over two surgical procedures. Every precaution is taken to prevent infection of the device both during surgery and in the post-operative period.

Are there reasons why my pet shouldn’t have limb salvage surgery?

Not every patient is a suitable candidate for limb salvage surgery using the PerFiTS device. In patients that have cancer of the lower limb we will only consider the patient as a surgical candidate after rigorous staging to assess if the cancer has spread from the limb to other areas of the body.

What is the typical recovery time after limb salvage surgery?

Careful rehabilitation after limb salvage surgery is the key to success and it is vital that patients whom undergo this surgery are managed diligently for the first 5-6 weeks after surgery to prevent damage to the implant. After the initial 10 days patients are placed on a carefully managed exercise program that gradually brings them back to normal off-lead exercise by 12 weeks after surgery. During the 6 weeks after surgery a custom made exoprosthesis, or foot, is designed and manufactured to allow the patient to learn to walk on the PerFiTS implant. Once the design of the foot has been finalised and the patient has moved through the recovery and rehabilitation period we can expect a return to near normal exercise.

During your dog or cats hospitalisation period they will be cared for by a dedicated team of ward nurses and patient care auxiliaries who work alongside the clinician, a team of veterinary surgeons and chartered physiotherapists ensuring all your animal friends clinical and emotional needs are met. Due to the prolonged hospitalised period following surgery the patient care team make sure your pet feels at home and treat them just as if they were their own with the love and affection they desire and deserve.

Can my dog or cat have a normal lifestyle following PerFits surgery?

Most dogs and cats return to a normal lifestyle following PerFiTS surgery. Your animal friend will have to have regular checks to make sure the PerFiTS is functioning well and to allow resurfacing of the exoprosthesis as necessary.

As shown in this short video patients can run, jump and play just like a normal dog and they use the operated limb just like their normal leg. This applies to cats also.

 

What alternatives to limb salvage surgery are available?

In patients with cancer of the lower limb, amputation may be the only treatment available to prevent spread of the cancer to other parts of the body. In the case of major trauma where reconstructive surgery is not appropriate amputation may once again be the only option available to the patient.

What should I do if I think my pet has a condition that would benefit from a limb-salvage procedure?

If you think your pet needs a limb salvage procedure we recommend asking your primary care vet to contact us for further advice. We are more than happy to talk to your vet about what is involved with the surgery and ascertain if limb salvage surgery could help your pet.

Fitzpatrick Referrals