Synthetic osteochondral resurfacing for treatment of large caudocentral osteochondritis dissecans lesions of the humeral head in 24 dogs

Abstract

Objective To report the outcome of dogs with large, caudocentral, osteochondritis dissecans (OCD) lesions of the humeral head treated with synthetic osteochondral resurfacing (SOR) implants. Study design Retrospective case series. Animals Twenty‐four client‐owned large breed or giant dogs. Methods The medical records of all dogs treated with first generation (G1) and second generation (G2) SOR implants were reviewed. All dogs were assessed with clinical examination and imaging 12 weeks after surgery. Assessment of outcome was based on subjective assessment of lameness, scoring of postoperative radiographs, and the Liverpool Osteoarthritis in Dogs (LOAD) questionnaire. Results Osteochondral resurfacing was performed with a G1 implant in 13 dogs (15 shoulders) and a G2 implant in 11 dogs (13 shoulders). Lameness resolved in all dogs treated with G1 implants and in 10 dogs treated with G2 implants by 12 weeks after surgery. One dog treated with a G2 implant was found to have an implant‐associated infection, requiring implant removal. No recurrence of lameness was reported in 9 limbs treated with G1 implants and 10 limbs treated with G2 implants that were available for clinical review at a median time of 387 and 365 days, respectively, after surgery. Mean postoperative LOAD scores were 4.2 of 52 and 5.2 of 52 in dogs treated with a G1 or a G2 implant, respectively. Conclusion Synthetic resurfacing was technically feasible in all joints of this study and resulted in good clinical results. Clinical significance The use of SOR implants seems viable to treat large caudocentral OCD lesions of the humeral head in dogs and warrants prospective comparison with conventional arthroscopic treatment.

Outcomes Associated With Osteochondral Allograft Transplantation in Dogs

“…Cartilage damage that causes pain or lameness is common in people and dogs, either secondary to osteoarthritis in which case cartilage loss is typically diffuse, or as focal cartilage defects secondary to osteochondrosis, trauma, or athletic injury (1)(2)(3)(4)(5)(6)(7). Many treatment options for cartilage damage are used in both human and canine medicine, including non-surgical management, osteochondral autografting, or synthetic resurfacing with focal, unicompartmental, or total joint replacement systems (8)(9)(10)(11)(12)(13)(14). However, osteochondral allograft (OCA) transplantation is a treatment option used in people, which has not been described for use in clinical canine patients (15)(16)(17)(18).…”

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

“…PCU appears to be a good compromise between low coefficient of friction, similar modulus of elasticity to cartilage, and high wear resistance. In dogs, a titanium socket bond to a PCU bearing surface usually leads to satisfactory results 12,13 . However, with the commercially available resurfacing implants it would have been impossible to anatomically resurface the lesion in the case presented here.…”

“…In dogs, a titanium socket bond to a PCU bearing surface usually leads to satisfactory results. 12,13 However, with the commercially available resurfacing implants it would have been impossible to anatomically resurface the lesion in the case presented here. Considering this and the unavailability of a matching donor, the option of PSRI was pursued.…”

“…prognosis, different options were discussed with the owner, including fragment removal and debridement, pantarsal arthrodesis, osteochondral allograft, and partial unipolar synthetic resurfacing based on existing implants. 12,13 Given the unavailability of a matching donor in a 4-week lag period, the owners opted for synthetic resurfacing. Owners were educated about the experimental nature of the patient specific implant and written consent was obtained.…”

“…11 Synthetic resurfacing with an implant consisting of a polycarbonate urethane (PCU) articular component and a trabecular titanium base for bone ingrowth and on-growth shows promising results in dogs affected by an OCD lesion in the shoulder and stifle joint. 12,13 The standardized circular shape with a slightly convex articular surface of such "off-the-shelf" implants, however, limits their use in joints with more complex surface topography, such as the talus. The objective of this case report is to describe the surgical technique and the clinical outcome of a patient-specific unipolar resurfacing implant (PSRI) for the treatment of a large talar OCD in a dog.…”