Vet Comp Orthop Traumatol 2018; 31(02): 144-152
DOI: 10.3415/VCOT-17-02-0035
Clinical Communication
Schattauer GmbH Stuttgart

Treatment of Osteochondrosis Dissecans of the Canine Stifle Using Synthetic Osteochondral Resurfacing

Pádraig Egan
,
Susan Murphy
,
Jelena Jovanovik
,
Russell Tucker
,
Noel Fitzpatrick
Further Information

Publication History

22 March 2017

24 October 2017

Publication Date:
13 March 2018 (online)

Abstract

Objective This article aimed to describe the use and evolution of a synthetic osteochondral resurfacing (SOR) implant in the treatment of osteochondrosis dissecans (OCD) of the femoral condyle and to report the clinical, radiographic, computed tomography and magnetic resonance imaging outcomes of this technique.

Methods Medical records of dogs that were treated with first-generation (G1) and second-generation (G2) SOR at a single institute were reviewed. Surgical reports and clinical examinations as well as the preoperative, postoperative, and follow-up radiographs, computed tomographic images and magnetic resonance imaging images were reviewed.

Results Fourteen stifles (nine dogs) were included in the study. G1-SOR implants were employed in six stifles of four dogs and G2-SOR implants in eight stifles of five dogs. Osteochondrosis dissecans of the medial femoral condyle was confirmed as the sole pathology in all dogs treated with G1-SOR. Only one of eight OCD lesions was located on the medial condyle in the G2-SOR group with the remaining seven lesions affecting the lateral femoral condyle. At 12 weeks, 13 of 14 stifles displayed implant stability, with no subchondral bone changes or evidence of lucency around any implant. Eight of nine dogs achieved a good-excellent clinical outcome. Complications included one minor surgical site infection and one infective arthritis which required implant removal.

Clinical Significance In this cohort of dogs, both G1-SOR and G2-SOR were successful and repeatable surgical procedures for dogs with OCD of the femoral condyle.

Author Contributions

P. Egan, S. Murphy and N. Fitzpatrick contributed to the study conception and study design. All authors contributed to acquisition of data, data analysis and interpretation, drafting or revising of the manuscript, and approved the submitted manuscript.


Note

This article was presented in part as abstract form at the Annual Conference of Veterinary Orthopaedic Society 2009, Veterinary Arthrology Advancement Association (VA3) Conference 2009, American College of Veterinary Surgeons Symposium 2010, VA3 Conference 2011 and VA3 Conference 2012.


Supplementary Material

 
  • References

  • 1 Fitzpatrick N, Yeadon R, van Terheijden C, Smith TJ. Osteochondral autograft transfer for the treatment of osteochondritis dissecans of the medial femoral condyle in dogs. Vet Comp Orthop Traumatol 2012; 25 (02) 135-143
  • 2 Cook JL, Hudson CC, Kuroki K. Autogenous osteochondral grafting for treatment of stifle osteochondrosis in dogs. Vet Surg 2008; 37 (04) 311-321
  • 3 Palierne S, Bilmont A, Raymond-Letron I, Autefage A. A case of stifle osteochondrosis treated by osteochondral autogenous grafting. One month morphological follow-up. Vet Comp Orthop Traumatol 2010; 23 (03) 190-195
  • 4 McCoy AM, Toth F, Dolvik NI. , et al. Articular osteochondrosis: a comparison of naturally-occurring human and animal disease. Osteoarthritis Cartilage 2013; 21 (11) 1638-1647
  • 5 Edmonds EW, Polousky J. A review of knowledge in osteochondritis dissecans: 123 years of minimal evolution from König to the ROCK study group. Clin Orthop Relat Res 2013; 471 (04) 1118-1126
  • 6 Chambers HG, Shea KG, Carey JL. AAOS Clinical Practice Guideline: diagnosis and treatment of osteochondritis dissecans. J Am Acad Orthop Surg 2011; 19 (05) 307-309
  • 7 Fitzpatrick N. Complications associated with autogenous osteochondral repair. In: Griffon DJ, Hamaide A. , eds. Complications in Small Animal Surgery. Hoboken, New Jersey: Wiley-Blackwell; 2016: 897-901
  • 8 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
  • 9 Innes JF, Costello M, Barr FJ, Rudorf H, Barr AR. Radiographic progression of osteoarthritis of the canine stifle joint: a prospective study. Vet Radiol Ultrasound 2004; 45 (02) 143-148
  • 10 Pappas AM. Osteochondrosis dissecans. Clin Orthop Relat Res 1981; (158) 59-69
  • 11 Nelson BH, Anderson DD, Brand RA, Brown TD. Effect of osteochondral defects on articular cartilage. Contact pressures studied in dog knees. Acta Orthop Scand 1988; 59 (05) 574-579
  • 12 Breinan HA, Martin SD, Hsu HP, Spector M. Healing of canine articular cartilage defects treated with microfracture, a type-II collagen matrix, or cultured autologous chondrocytes. J Orthop Res 2000; 18 (05) 781-789
  • 13 Kocher MS, Czarnecki JJ, Andersen JS, Micheli LJ. Internal fixation of juvenile osteochondritis dissecans lesions of the knee. Am J Sports Med 2007; 35 (05) 712-718
  • 14 Jones MH, Williams AM. Osteochondritis dissecans of the knee: a practical guide for surgeons. Bone Joint J 2016; 98-B (06) 723-729
  • 15 Fitzpatrick N, Yeadon R, Smith TJ. Early clinical experience with osteochondral autograft transfer for treatment of osteochondritis dissecans of the medial humeral condyle in dogs. Vet Surg 2009; 38 (02) 246-260
  • 16 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
  • 17 Kulendra E, Lee K, Schoeniger S, Moores AP. Osteochondritis dissecans-like lesion of the intercondylar fossa of the femur in a dog. Vet Comp Orthop Traumatol 2008; 21 (02) 152-155
  • 18 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
  • 19 Böttcher P, Zeissler M, Grevel V, Oechtering G. Computer simulation of the distal aspect of the femur for assessment of donor core size and surface curvature for autologous osteochondral transplantation in the canine stifle joint. Vet Surg 2010; 39 (03) 371-379
  • 20 Khan I, Smith N, Jones E, Finch DS, Cameron RE. Analysis and evaluation of a biomedical polycarbonate urethane tested in an in vitro study and an ovine arthroplasty model. Part II: in vivo investigation. Biomaterials 2005; 26 (06) 633-643
  • 21 Khan I, Smith N, Jones E, Finch DS, Cameron RE. Analysis and evaluation of a biomedical polycarbonate urethane tested in an in vitro study and an ovine arthroplasty model. Part I: materials selection and evaluation. Biomaterials 2005; 26 (06) 621-631
  • 22 Schwartz CJ, Bahadur S. Development and testing of a novel joint wear simulator and investigation of the viability of an elastomeric polyurethane for total-joint arthroplasty devices. Wear 2007; 262 (3–4): 331-339
  • 23 Kock NB, Van Susante JL, Buma P, Van Kampen A, Verdonschot N. Press-fit stability of an osteochondral autograft: influence of different plug length and perfect depth alignment. Acta Orthop 2006; 77 (03) 422-428
  • 24 Cheng SL, Davey JR, Inman RD, Binnington AG, Smith TJ. The effect of the medial collar in total hip arthroplasty with porous-coated components inserted without cement. An in vivo canine study. J Bone Joint Surg Am 1995; 77 (01) 118-123
  • 25 Flannery M, Flanagan S, Jones E. , et al. Compliant layer knee bearings: part I: friction and lubrication. Wear 2010; 269: 325-350
  • 26 Wu JZ, Herzog W, Hasler EM. Inadequate placement of osteochondral plugs may induce abnormal stress-strain distributions in articular cartilage --finite element simulations. Med Eng Phys 2002; 24 (02) 85-97
  • 27 Choate CJ, Kim SE, Hudson CC, Spreng D, Pozzi A. Effect of lateral meniscectomy and osteochondral grafting of a lateral femoral condylar defect on contact mechanics: a cadaveric study in dogs. BMC Vet Res 2013; 9: 53
  • 28 Nakagawa Y, Suzuki T, Kuroki H, Kobayashi M, Okamoto Y, Nakamura T. The effect of surface incongruity of grafted plugs in osteochondral grafting: a report of five cases. Knee Surg Sports Traumatol Arthrosc 2007; 15 (05) 591-596
  • 29 Cook JL, Hung CT, Kuroki K. , et al. Animal models of cartilage repair. Bone Joint Res 2014; 3 (04) 89-94