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Heikkilä H, Reunanen V, Hyytiäinen HK, Junnila JJT, Laitinen-Vapaavuori O, Keränen P. Randomized, Blinded, Controlled Clinical Trial of Polylactide-Collagen Scaffold in Treatment of Shoulder Osteochondritis Dissecans in Dogs. Vet Comp Orthop Traumatol 2024. [PMID: 39048025 DOI: 10.1055/s-0044-1788726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Abstract
OBJECTIVE The aim of our study was to investigate a degradable polylactide-collagen scaffold (COPLA) in the treatment of shoulder osteochondritis dissecans (OCD) in dogs. STUDY DESIGN The study was a controlled, randomized, blinded clinical trial with a parallel group design with a 1.5-year follow-up. Twenty dogs with uni- or bilateral shoulder OCD (29 shoulders) were randomized to receive a COPLA or arthroscopic debridement only (Control). The outcome of treatment was assessed with gait and stance analysis, passive range of motion measurement, pain and lameness evaluation, Helsinki Chronic Pain Index, and computed tomography (CT). RESULTS Eighteen dogs (25 shoulders) completed the study. The clinical outcome variables improved significantly from baseline in COPLA and Control groups after treatment but no significant differences emerged between groups. Significantly fewer COPLA than Control shoulders had osteoarthritis (OA) in CT at 6 months (p = 0.019) but the difference was not significant at 1.5 years. At 1.5 years, all dogs were sound and pain-free in joint palpation, but OA was diagnosed in 13/18 dogs (18/25 shoulders) with CT. CONCLUSION The results suggest that COPLA scaffold slowed down the development of OA at 6 months but it did not improve the clinical recovery or prevent OA in dogs with shoulder OCD in long-term follow-up at 1.5 years compared with arthroscopic debridement only. Regardless of the treatment method, clinical recovery was good, but OA developed in the majority of dogs.
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Affiliation(s)
- Helka Heikkilä
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
- Lahti Veterinary Hospital, IVC Evidensia, Lahti, Finland
| | - Vilma Reunanen
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Heli K Hyytiäinen
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | | | - Outi Laitinen-Vapaavuori
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Pauli Keränen
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
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Franklin SP, Stoker AM, Murphy SM, Kowaleski MP, Gillick M, Kim SE, Karlin M, Cross A, Cook JL. Outcomes Associated With Osteochondral Allograft Transplantation in Dogs. Front Vet Sci 2022; 8:759610. [PMID: 35004920 PMCID: PMC8739896 DOI: 10.3389/fvets.2021.759610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 12/06/2021] [Indexed: 11/25/2022] Open
Abstract
The purpose of this study was to retrospectively characterize outcomes and complications associated with osteochondral allograft transplantation for treating chondral and osteochondral lesions in a group of client-owned dogs with naturally-occurring disease. Records were reviewed for information on signalment, treated joint, underlying pathology (e.g., osteochondritis dissecans; OCD), and type, size, and number of grafts used. Complications were classified as “trivial” if no treatment was provided, “non-surgical” if non-surgical treatment were needed, “minor surgical” if a minor surgical procedure such as pin removal were needed but the graft survived and function was acceptable, or “major” if the graft failed and revision surgery were needed. Outcomes were classified as unacceptable, acceptable, or full function. Thirty-five joints in 33 dogs were treated including nine stifles with lateral femoral condyle (LFC) OCD and 10 stifles with medial femoral condyle (MFC) OCD treated with osteochondral cylinders or “plugs.” There were 16 “complex” procedures of the shoulder, elbow, hip, stifle, and tarsus using custom-cut grafts. In total there were eight trivial complications, one non-surgical complication, two minor surgical complications, and five major complications for a total of 16/35 cases with complications. Accordingly, there were five cases with unacceptable outcomes, all of whom had major complications while the other 30 cases had successful outcomes. Of the 30 cases with successful outcomes, 15 had full function and 15 had acceptable function. Based on these subjective outcome assessments, it appears osteochondral allograft transplantation is a viable treatment option in dogs with focal or complex cartilage defects. However, no conclusions can be made regarding the inferiority or superiority of allograft transplantation in comparison to other treatment options based upon these data.
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Affiliation(s)
- Samuel P Franklin
- Colorado Canine Orthopedics and Rehab, Colorado Springs, CO, United States
| | - Aaron M Stoker
- Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, MO, United States
| | - Sean M Murphy
- WestVet Animal Emergency and Specialty Center, Garden City, ID, United States
| | - Michael P Kowaleski
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA, United States
| | - Mitchell Gillick
- Toronto Veterinary Emergency and Referral Hospital, Toronto, ON, Canada
| | - Stanley E Kim
- Department of Small Animal Clinical Sciences, University of Florida, Gainesville, FL, United States
| | - Michael Karlin
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA, United States
| | - Alan Cross
- BluePearl Pet Hospital, Atlanta, GA, United States
| | - James L Cook
- Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, MO, United States
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