Case report: Limb-sparing surgery of tibial chondrosarcoma with frozen autologous bone graft using liquid nitrogen in a dog

Abstract

Chondrosarcoma is the second most common primary bone tumor after osteosarcoma in dogs. Chondrosarcoma has a good prognosis owing to its low metastatic rate and long survival time, even with amputation alone. However, amputation risks reducing the quality of life in patients with other orthopedic diseases of the non-affected limb, neurological diseases, or large body size. Limb-sparing surgery with frozen autologous bone grafting using liquid nitrogen allows bone quality to be maintained in the normal bone area while killing tumor cells, thereby preserving the affected limb. Thus, it is expected to maintain the quality of life. We describe herein limb-sparing surgery for tibial chondrosarcoma with frozen autologous bone graft using liquid nitrogen in an 8-year and 8-month-old castrated male bulldog weighing 29.2 kg. The patient had chondrosarcoma of the left tibia, suspected cranial cruciate ligament rupture of the right stifle, and degenerative lumbosacral stenosis. In such a case, amputation would increase the burden on the non-affected limb or spine, which could cause difficulty in walking; therefore, we performed limb-sparing surgery. Postoperatively, although a circumduction gait associated with stifle arthrodesis remained, the patient maintained the quality of life for 20 months, and the owner was satisfied with the results.

Three cases of dogs with osteosarcoma of the forelimb treated with liquid nitrogen for limb-sparing surgery using autologous bone

“…The long-term prognosis is also good, with reported postoperative complications such as fractures (19.4%), deep infection (11.1%), and local soft tissue recurrence (11.1%), with no recurrence detected within the liquid nitrogen-treated autogenous bone [ 4 ]. Limited reports in the veterinary field also indicated good postoperative mandibular and gait function improvements in cases where reconstruction methods utilizing liquid nitrogen-treated autologous bone were applied [ 1 , 3 , 12 , 16 ]. Although none of the aforementioned complications were observed, exudate was observed postoperatively in Case 1 and screw breakage in Case 2.…”

“…In Tsuchiya et al .’s protocol, the extracted affected bone is treated with liquid nitrogen at −196°C for 20 min, left at a room temperature of 20°C for 15 min, and incubated in a saline solution at 30°C for 10 min, for a total duration of 45 min [ 21 ]. In veterinary medicine, tumor bone has been reconstructed using liquid nitrogen cryoprocessed bone tissue in the scapula in cats [ 1 ] and the mandible [ 12 ], femur [ 3 ], and tibia [ 16 ] in dogs. However, there are few reports of reconstructive surgery using liquid nitrogen-treated autologous bone in the veterinary field.…”