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This is the first dog to receive a total knee replacement combined with a corrective osteotomy of the femur to address a limb deformity on the West Coast. Dr. Laurent Guiot was contacted by Seb's owners during the fall of 2017. The dog, Seb, already had several procedures done to correct a problem with his knee and was not able to use the leg at all. After discussion options with several local veterinarians in China, Seb's owners were told that the best option, if they wanted him to recover some function, was to bring him to the US at a total joint replacement center for evaluation. Seb also had extreme muscle atrophy from not using his leg for several months. The CT image was converted into a 3D model using a 3D printer. The orthopedic team then used the 3D model to design and optimize a surgical technique that would allow them to correct the deformity and replace the damaged joint with total knee replacement implants. The surgery was rehearsed on the bone models several time to ensure that we could execute it perfectly on Seb, and the actual procedure took place on December 18, 2018. The surgery went very well despite the challenges associated with it. At two weeks post-surgery, he was bearing weight at each steps and by 8 weeks postoperatively, he only had a mild residual lameness. At that time, he started developing pain on his other knee. Since the clinical signs were getting worse, we had to perform a corrective surgery on that side using more traditional techniques. That surgery went very well and Seb recovered uneventfully within a few weeks. Today, Seb is back to full activity. He has no pain or problems with his total knee replacement and has regained adequate muscular strength on this leg. We expect he will continue to progress and that he will enjoy a pain-free life now that his knees function are restored.