Patient specific, synthetic, partial unipolar resurfacing of a large talar osteochondritis dissecans lesion in a dog

Abstract

Objective To describe the application and early outcome of a custom‐made unipolar partial tarsal replacement in a dog with an extensive medial talar ridge OCD. Animal A 7‐month‐old, 25 kg male Rhodesian Ridgeback with progressive left hindlimb lameness (grade III–IV/IV) and diagnosis of talar OCD. Methods The dog presented with progressive lameness attributed to extensive medial talar ridge OCD. Due to the severity of the lesion, a resurfacing procedure was chosen. Based on CT data, a bi‐layered resurfacing implant consisting of a titanium socket and a polycarbonate urethane bearing surface was constructed. For intraoperative guidance, a set of matching drill guides were 3D‐printed, along with some models of the affected talus, to allow for dry‐lab training. Surgical implantation using a medial malleolar osteotomy to approach the lesion was without complications. Orthopedic follow‐up examinations were conducted at 10 days, 4 weeks, 6 weeks, 6 months and 12 months. Radiographic examinations were included at the 6‐week, 6‐month, and 12‐month follow‐ups. Results Function improved considerably during the follow‐up period with a lameness grade of 0‐I/IV at the 12‐month follow‐up. ROM differed by 15° in flexion compared to the contralateral side, while there was no difference in extension. Moderate periarticular fibrosis was present at 12 months. Implant positioning was unchanged at follow‐up‐radiographic examination and there was only mild progression of osteoarthritis (OA). Conclusion Patient specific instrumentation ‐ guided tarsal OCD resurfacing with a synthetic patient‐specific implant may be an effective treatment option.

Use of a Custom-Made Patellar Groove Replacement in an American Staffordshire Terrier Puppy with a Severe Bone Defect in the Femoral Trochlea Caused by Hematogenous Osteomyelitis

“…Total hip replacement (THR), total knee replacement (TKR), patellar groove replacement (PGR) and total elbow replacement (TER), but also compartmental prostheses such as biomechanically anatomic non-constrained compartmental partial elbow replacement (BANC PER), are some of the prostheses available [ 13 , 14 , 15 , 16 ]. Despite the different prosthetic models and sizes, in some cases, the use of customized prosthesis with specific characteristics is necessary for a better anatomical and functional adaptation [ 12 , 17 , 18 ]. In the last few years, in the human and veterinary orthopedics fields, the use of three-dimensional (3D) printing has been found to be a valuable method for fabricating bespoke implants tailored to the precise requirements of recipients [ 12 , 17 ].…”