Use of Synthetic Osteochondral Implants to Treat Bilateral Shoulder Osteochondritis Dissecans in a Dog

Abstract

Case Description An 8-month-old American Bulldog was presented for assessment of bilateral thoracic limb lameness. Computed tomographic imaging revealed large, deep osteochondritis dissecans lesions in both humeral heads.

Treatment and Outcome The osteochondritis dissecans lesions were debrided and the exposed subchondral defects were prepared to receive synthetic grafts. Circular implants consisting of a surface layer of polycarbonate urethane and a deep layer of lattice-type titanium were implanted into the osteochondral defects to reconstruct the articular surface topography. Follow-up clinical examination 1.5, 3 and 9months postoperatively revealed a lack of signs of shoulder pain and resolution of thoracic limb lameness. Nine-month follow-up radiographs showed radiographic evidence of osteointegration of both implants.

Clinical Relevance Synthetic osteochondral implantation in the caudocentral aspect of the humeral head appeared technically feasible and effective in resolving lameness caused by humeral head osteochondritis dissecans.

Keywords

SynACART - dog - joint resurfacing - OCD - osteochondritis dissecans

Author Contributions

Alan Danielski and Michael Farrell contributed to conception of study, study design, acquisition of data and data analysis and interpretation. Both authors also drafted and revised and approved the submitted manuscript.

• References

• 1 Ytrehus B, Carlson CS, Ekman S. Etiology and pathogenesis of osteochondrosis. Vet Pathol 2007; 44 (04) 429-448
• 2 Mahirogullari M, Chloros GD, Wiesler ER, Ferguson C, Poehling GG. Osteochondritis dissecans of the humeral head. Joint Bone Spine 2008; 75 (02) 226-228
• 3 Milton J, Rumph PF, Reed AO. Osteochondritis dissecans of the shoulder in the racing greyhound: a report of two cases and a survey of 109 greyhound anatomy specimens. J Am Hosp Assoc 1981; 17: 617-622
• 4 Orellana-Jaimes N, Ginja MM, Roman-Llorens FS. , et al. Magnetic resonance imaging: findings of osteochondrosis like-lesions in glenoid fossa and proximal humeral metaphyses in a dog: a case report. Vet Med (Praha) 2015; 1: 387-390
• 5 Olivieri M, Ciliberto E, Hulse DA, Vezzoni A, Ingravalle F, Peirone B. Arthroscopic treatment of osteochondritis dissecans of the shoulder in 126 dogs. Vet Comp Orthop Traumatol 2007; 20 (01) 65-69
• 6 Rudd RG, Whitehair JG, Marsolais JH. Results of management of osteochondritis dissecans of the humeral head in dogs: 44 cases (1982 to 1987). J Am Anim Hosp Assoc 1990; 26: 173-178
• 7 Slater MR, Scarlett JM, Kaderly RE. , et al. Breed, gender, and age as risk factors for canine osteochondritis dissecans. Vet Comp Orthop Traumatol 1991; 4: 100-106
• 8 van Bree H. Comparison of the diagnostic accuracy of positive-contrast arthrography and arthrotomy in evaluation of osteochondrosis lesions in the scapulohumeral joint in dogs. J Am Vet Med Assoc 1993; 203 (01) 84-88
• 9 Van Ryssen B, van Bree H, Missinne S. Successful arthroscopic treatment of shoulder osteochondrosis in the dog. J Small Anim Pract 1993; 34 (10) 521-528
• 10 Lenehan TM, van Sickle C. Canine osteochondrosis. In: Newton CD, Nunamaker DM. , eds. Textbook of Small Animal Orthopedics. Philadelphia, PA: J. B. Lippincott; 1895: 981-997
• 11 van Bree H. Evaluation of subchondral lesion size in osteochondrosis of the scapulohumeral joint in dogs. J Am Vet Med Assoc 1994; 204 (09) 1472-1474
• 12 Person MW. Arthroscopic treatment of osteochondritis dissecans in the canine shoulder. Vet Surg 1989; 18 (03) 175-189
• 13 Minas T, Nehrer S. Current concepts in the treatment of articular cartilage defects. Orthopedics 1997; 20 (06) 525-538
• 14 Nehrer S, Spector M, Minas T. Histologic analysis of tissue after failed cartilage repair procedures. Clin Orthop Relat Res 1999; (365) 149-162
• 15 Fitzpatrick N, van Terheijden C, Yeadon R, Smith TJ. Osteochondral autograft transfer for treatment of osteochondritis dissecans of the caudocentral humeral head in dogs. Vet Surg 2010; 39 (08) 925-935
• 16 Cook JL, Hudson CC, Kuroki K. Autogenous osteochondral grafting for treatment of stifle osteochondrosis in dogs. Vet Surg 2008; 37 (04) 311-321
• 17 Böttcher P, Zeissler M, Maierl J, Grevel V, Oechtering G. Mapping of split-line pattern and cartilage thickness of selected donor and recipient sites for autologous osteochondral transplantation in the canine stifle joint. Vet Surg 2009; 38 (06) 696-704
• 18 Husby KA, Reed SK, Wilson DA. , et al. Evaluation of a permanent synthetic osteochondral implant in the equine medial femoral condyle. Vet Surg 2016; 45 (03) 364-373
• 19 Cook JL, Kuroki K, Bozynski CC, Stoker AM, Pfeiffer FM, Cook CR. Evaluation of synthetic osteochondral implants. J Knee Surg 2014; 27 (04) 295-302
• 20 Vezzoni A. An Alternative Surgical Approach for Shoulder OC. Paper presented at Proceedings BVOA Autumn Meeting; October 24-26, 2014; Brighton, United Kingdom; 46–52
• 21 Laursen JO. Treatment of full-thickness cartilage lesions and early OA using large condyle resurfacing prosthesis: UniCAP(®). Knee Surg Sports Traumatol Arthrosc 2016; 24 (05) 1695-1701
• 22 Bedi A, Williams RJ. Cartilage resurfacing using synthetic composite plugs. Tech Knee Surg 2009; 8: 29-36