Multiple Osteochondral Autografts for Treatment of a Medial Trochlear Ridge Subchondral Cystic Lesion in the Equine Tarsus

Case Report: First Evidence of a Benign Bone Cyst in an Adult Teckel Dog Treated With Shark Teeth-Derived Bioapatites

Bone cysts are a very rare orthopedic pathology in veterinary medicine, the general prevalence of which is unknown. A unicameral bone cyst was diagnosed in an adult female Teckel dog with a limp that was treated surgically by filling the defect with marine bioapatites. The treatment was effective and at 8 weeks the defect had remodeled 50.24%. Eighteen months after surgery, the defect had remodeled 94.23%. The limp disappeared after surgery, and functional recovery was good in all stages after surgery. No adverse reactions were observed at the local or systemic level. This is the first report of a benign bone cyst in an lame adult female Teckel successfully treated with a novel marine bioapatite.

Evaluation of a Permanent Synthetic Osteochondral Implant in the Equine Medial Femoral Condyle

OBJECTIVE

To evaluate bone ingrowth, integration, and tolerance of a synthetic osteochondral implant in the medial femoral condyle (MFC) of normal horses.

STUDY DESIGN

Experimental study.

ANIMALS

Adult horses (n = 6).

METHODS

Horses were anesthetized and bilateral femorotibial arthrotomies were performed for placement of 1 implant consisting of polycarbonate urethane with a titanium base in 1 MFC. The contralateral MFC served as a sham-operated control without reaming of cartilage or subchondral bone. Lameness evaluations and radiographs were performed pre-operatively with subsequent monthly lameness exams and radiographs at 6 months. Synovial fluid was collected for analysis from the adjacent femoropatellar joints pre-operatively and at several intervals post-operatively. Horses were euthanatized 6 months post-operatively. Stifles were harvested for gross and histologic evaluations.

RESULTS

Two horses were never lame, 2 were mildly lame, and 1 exhibited moderate lameness. Synovial fluid inflammatory parameters of the adjacent femoropatellar joints were not significantly different. No significant changes occurred radiographically over time in either stifle. Histologic assessment of synovium from the medial femorotibial joint revealed no differences in inflammatory changes between implant and sham stifles. Integration and osteoconductivity of the implant were graded as good in 4 and 3 of 5 specimens, respectively. Complications included joint sepsis resulting in euthanasia (1 horse), persistent lameness (1 horse), incisional seromas (4 horses), and incisional dehiscence (2 horses).

CONCLUSION

Results of this pilot study indicate that the implant was compatible with placement in the MFC of normal horses. Implant design allowed bone ingrowth within the titanium base and provision of a synthetic articular surface.

Cartilage defect repair in horses: Current strategies and recent developments in regenerative medicine of the equine joint with emphasis on the surgical approach

Chondral and osteochondral lesions due to injury or other pathology are highly prevalent conditions in horses (and humans) and commonly result in the development of osteoarthritis and progression of joint deterioration. Regenerative medicine of articular cartilage is an emerging clinical treatment option for patients with articular cartilage injury or disease. Functional articular cartilage restoration, however, remains a major challenge, but the field is progressing rapidly and there is an increasing body of supportive clinical and scientific evidence. This review gives an overview of the established and emerging surgical techniques employed for cartilage repair in horses. Through a growing insight in surgical cartilage repair possibilities, surgeons might be more stimulated to explore novel techniques in a clinical setting.

Mosaic arthroplasty of the medial femoral condyle in horses - An experimental study

One Arabian and 5 Hungarian half-bred horses were used to study the macroscopic and microscopic survival of autologous osteochondral grafts in the weight-bearing surface of the medial femoral condyle (MFC). Grafts were harvested from the cranial surface of the medial femoral trochlea (MFT) under arthroscopic control. Three of them were transplanted into the weight-bearing surface of the contralateral MFC using an arthrotomy approach. Three months later this transplantation procedure was repeated on the opposite stifle joints in the same animals, but at that time transplantation was performed arthroscopically. Follow-up arthroscopy was carried out 12 months after the first operations, and biopsies were taken from both the recipient and the donor sites for histological examination. During follow-up arthroscopy, the transplanted areas looked congruent and smooth. Microscopically, the characteristics of hyaline cartilage were present in 5 out of the 10 biopsies examined; however, in the other half of biopsies glycosaminoglycan (GAG) loss and change in the architecture of the transplanted cartilage was observed. In a 16-year-old horse, all grafts broke during harvesting, and thus transplantation was not performed. No radiological signs of osteoarthritic changes were detected 9 to 12 months after the operations in the donor and recipient joints. Clinically, no lameness or effusion was present three months after the transplantations.

Fragmentation of the proximal tubercle of the talus in horses: 9 cases (2004-2010)

OBJECTIVE

To identify the prevalence of fragmentation of the proximal tubercle of the talus (FPTT) in a hospital population of horses, characterize the anatomic features of the affected area and fragments, and describe clinical findings, diagnosis, treatment, and outcome for horses with FPTT.

DESIGN

Retrospective case series.

ANIMALS

9 horses with FPTT.

PROCEDURES

2,543 radiographic views of the tarsal region of 1,526 horses that were evaluated between June 2004 and December 2010 were reviewed. Medical case records for horses with detectable FPTT were retrieved, and signalment, history, clinical signs, diagnostic methods, treatment, and outcome were recorded for assessment.

RESULTS

9 horses (median age, 5 years; age range, 1 to 12 years) with FPTT were identified. Seven horses were warmbloods. Diagnosis was made on the basis of radiographic findings, occasionally along with results of ultrasonography and CT. The only horse that was lame in the affected limb had a history of a prior traumatic event and resultant lateral tibial malleolus fracture. One horse underwent arthroscopy, but fragments were not found and were presumed to be extra-articular. Outcome was available for 7 horses; mean ± SD duration of stable radiographic and clinical examination findings was 3 ± 1 years (range, 1 to 4 years).

CONCLUSIONS AND CLINICAL RELEVANCE

FPTT appeared to occur more frequently in warmbloods and was not usually associated with lameness. Affected horses remained clinically and radiographically stable over time. These data have provided some information regarding the importance of FPTT for practitioners who perform radiographic screenings during prepurchase examinations.