Shoulder joint hemiarthroplasty for treatment of a severe osteochondritis dissecans lesion in a dog

T. Sparrow; N. Fitzpatrick; J. Meswania; G. Blunn

doi:10.3415/VCOT-13-07-0087

Veterinary and Comparative Orthopaedics and Traumatology, Inhaltsverzeichnis

Vet Comp Orthop Traumatol 2014; 27(03): 243-248
DOI: 10.3415/VCOT-13-07-0087

Case Report

Schattauer GmbH

Shoulder joint hemiarthroplasty for treatment of a severe osteochondritis dissecans lesion in a dog

Authors

T. Sparrow

¹Fitzpatrick Referrals Ltd., Eashing, Godalming, UK
N. Fitzpatrick

¹Fitzpatrick Referrals Ltd., Eashing, Godalming, UK
J. Meswania

²Institute of Orthopaedics and Musculoskeletal Science, UCL, London, UK
G. Blunn

²Institute of Orthopaedics and Musculoskeletal Science, UCL, London, UK

Abstract

Summary

Introduction: Partial resurfacing of the humeral head has been reported in humans to treat humeral osteochondritis dissecans. The aim is to describe a custom-made humeral resurfacing prosthesis for treatment of severe humeral head osteochondritis dissecans in a dog.

Case report: A seven-month-old female entire St. Bernard dog was presented with a 10 week history of severe left thoracic limb lameness. Radiography, arthroscopy and magnetic resonance imaging confirmed an extensive osteochondritis dissecans lesion affecting the caudal, medial and central regions of the humeral head. A prosthesis designed from computed tomography (CT) images was manufactured in polished stainless steel alloy with a hydroxyapatite coated base and central finned humeral stem for cementless insertion. A standard caudal approach to the shoulder was used to place the prosthesis following reaming of the caudal humeral head.

Results: Radiography and CT imaging revealed appropriate topographical placement on the humerus. Force plate analysis demonstrated initial reduction in ground reaction force at six weeks, followed by gradual improvement at three months. There was no radiographic evidence of implant loosening and the range of shoulder joint motion was comparable to the contralateral joint at three months; these findings were maintained to final follow-up at 24 months.

Clinical significance: Placement of a humeral head resurfacing prosthesis was an effective technique for the management of severe osteochondritis dissecans-related shoulder lameness. To the authors’ knowledge, this is the first report of the clinical use of shoulder hemiarthroplasty in a dog.

Keywords

Dog - humerus - shoulder - hemiarthroplasty - osteochondritis dissecans

Volltext

Referenzen

References
1 Cogar SM, Cook CR, Curry SL. et al. Prospective evaluation of techniques for differentiating shoulder pathology as a source of forelimb lameness in medium and large breed dogs. Vet Surg 2008; 37: 132-141.
2 McKee M, Macias C. Orthopaedic conditions of the shoulder in the dog. In Practice 2004; 26: 118-129.
3 Paatsama S, Rokkanen P, Jussila J. et al. A study of osteochondritis dissecans of the canine humeral head using histologic, OTC bone labeling, microradiographic and microangiographic methods. J Small Anim Pract 1971; 12: 603-611.
4 Olivieri M, Ciliberto E, Hulse DA. et al. Arthroscopic treatment of osteochondritis dissecans of the shoulder in 126 dogs. Vet Comp Orthop Traumatol 2007; 20: 65-69.
5 Johnston SA. Osteochondritis dissecans of the humeral head. Vet Clin North Am Small Anim Pract 1998; 28: 33-49.
6 Rudd RG, Whitehair JG, Margolais JH. Results of management of osteochondritis dissecans of the caudal humeral head in dogs: 44 cases (1982-1987). J Am Anim Hosp Assoc 1990; 26: 173-178.
7 van Bree H. Evaluation of subchondral lesion size in osteochondrosis of the scapulohumeral joint in dogs. J Am Vet Med Assoc 1994; 204: 1472-1474.
8 Fitzpatrick N, van Terheijden C, Yeadon R. et al. Osteochondral Autograft Transfer for treatment of osteochondritis dissecans of the caudocentral humeral head in dogs. Vet Surg 2010; 39: 925-935.
9 Cook JL, Hudson CC, Kuroki K. Autogenous osteochondral grafting for treatment of stifle osteochondrosis in dogs. Vet Surg 2008; 37: 311-321.
10 Fitzpatrick N, Yeadon R, Smith TJ. et al. Shoulder arthrodesis in 14 dogs. Vet Surg 2012; 41: 745-754.
11 Pucheu B, Duhautois B. Surgical treatment of shoulder instability. A retrospective study on 76 cases (1993-2007). Vet Comp Orthop Traumatol 2008; 21: 368-374.
12 Kalff S, Gemmill T. Proximal focal humeral deficiency in a large breed dog. Vet Comp Orthop Traumatol 2012; 25: 532-536.
13 Burgess DL, McGrath MS, Bonutti PM. et al. Shoulder resurfacing. J Bone Joint Surg Am 2009; 91: 1228-1238.
14 Dillon MT, Inacio MC, Burke MF. et al. Shoulder arthroplasty in patients 59 years of age and younger. J Shoulder Elbow Surg 2013; 22: 1338-1344.
15 Matsen FA, Clark JM, Titelman RM. et al. Healing of reamed glenoid bone articulating with a metal humeral hemiarthroplasty: a canine model. J Orthop Res 2005; 23: 18-26.
16 Gahring DR. A modified caudal approach to the canine shoulder joint. J Am Anim Hosp Assoc 1985; 21: 613-618.
17 Boyd A, Thomas W, Scott R. et al. Total shoulder arthroplasty versus Hemiarthroplasty. Journal of arthroplasty 1990; 5: 329-336.
18 Cruess RL, Kwok DC, Duc PN. et al. The response of articular cartilage to weight-bearing against metal. A study of Hemiarthroplasty of the hip in the dog. J Bone Joint Surg Br 1984; 66: 592-607.
19 Quinn MM, Keuler NS, Lu Y. et al. Evaluation of agreement between numerical rating scales, visual analogue scoring scales, and force plate gait analysis in dogs. Vet Surg 2007; 36: 360-367.
20 Levy O, Copeland SA. Cementless surface replacement arthroplasty of the shoulder. 5- to 10-year results with the Copeland Mark-2 prosthesis. J Bone Joint Surg Br 2001; 83: 213-222.
21 Fitzpatrick N, Sparrow T, Tuan J. Total shoulder arthroplasty in two dogs for the treatment of severe glenohumeral arthrosis. Proceedings of European College of Veterinary Surgeons 22nd Annual Scientific Meeting. 2013. July 4-6 Rome, Italy: Pg. 253.
22 Levy O, Copeland SA. Cementless surface replacement arthroplasty (Copeland CSRA) for osteoarthritis of the shoulder. J Shoulder Elbow Surg 2004; 13: 266-271.