Pedicle screw pull-out testing in polyurethane foam blocks: Effect of block orientation and density

Synthetic bone models such as polyurethane (PU) foam are a well-established substitute to cadaveric bone for screw pull-out testing; however, little attention has been given to the effect of PU foam anisotropy on orthopaedic implant testing. Compressive and screw pull-out performance in three PU foam densities; 0.16 g/cm3 (PCF 10), 0.32 g/cm3 (PCF 20) and 0.64 g/cm3 (PCF 40) were performed in each of the X, Y or Z orientations. The maximum compressive force, stiffness in the linear region, maximum stress and modulus were determined for all compression tests. Pedicle screws were inserted and pulled out axially to determine maximum pull-out force, energy to failure and stiffness. One-way ANOVA and post hoc tests were used to compare outcome variables between PU foam densities and orientations, respectively. Compression tests demonstrated the maximum force was significantly different between all orientations for PCF 20 (X, Y and Z) while stiffness and maximum stress were different between X versus Y and X versus Z. Maximum pull-out force was significantly different between all orientations for PCF 10 foam. No significant differences were noted for other foam densities. There is potential for screw pull-out testing results to be significantly affected by orientation in lower density PU foams. It is recommended that a single, known orientation of the PU foam block be used for experimental testing.

Seed skin grafts for reconstruction of distal limb defects in 15 dogs

OBJECTIVES

To report the surgical technique of seed skin grafting and clinical application for reconstruction of wounds on the distal limb of client-owned dogs.

MATERIALS AND METHODS

Medical records from The Animal Hospital at Murdoch University were retrospectively reviewed for dogs requiring reconstruction using seed grafting for distal limb skin defects between January 2009 and May 2020.

RESULTS

Fifteen dogs were included. Grafting was performed on distal limb wounds at or below the carpus or tarsus, following trauma (n = 12) or neoplasia excision (n = 3). Complete epithelialisation with minimal contracture was recorded at a median of 4 weeks (range 3 to 8 weeks) after implantation. Median follow-up was 37 months (range 3 to 55 months) after grafting. Postoperative complications included epidermal inclusion cyst in two dogs. Good functional outcome with acceptable cosmesis despite sparse hair growth was achieved in all cases.

CLINICAL SIGNIFICANCE

Seed grafting is a simple technique that can be used reliably to reconstruct wounds on the distal limb in dogs where other reconstructive techniques are not suitable. Complete epithelialisation with sparse hair growth, good long-term functional outcome and minimal complications can be expected.

Computed tomographic findings, surgical management and postoperative outcomes of large intermuscular lipomas in the hindlimb of 11 dogs

OBJECTIVE

Lipomas are benign adipose tissue tumours of mesenchymal origin and can originate in various locations. Intermuscular lipomas in the thigh can cause substantial hindlimb expansion in the dog. We describe the computed tomography findings, surgical management and the outcomes of 11 dogs with large intermuscular lipomas of the hindlimb.

DESIGN

Retrospective case series.

METHODS

Medical records between 2009 and 2019 of dogs presenting to The Animal Hospital at Murdoch University were reviewed. Inclusion criteria included dogs with a histologically confirmed, large hindlimb lipoma that was surgically excised following preoperative computed tomography (CT) imaging.

RESULTS

CT with intravenous contrast revealed a well-defined, smoothly marginated, fat attenuating mass with minimal vascularity, separating the muscle bellies of the caudal hindlimb. The mass was often in close proximity to the femoral artery and vein. All lipomas were marginally excised. At surgery, some lipomas were intimately associated with the sciatic nerve and some showed infiltration of, or attachment to, neighbouring muscle that could be excised en bloc with the lipoma. Postoperative closed-suction wound drainage was used in 6 of 11 dogs. One dog required revision surgery due to partial wound dehiscence. Long-term follow-up with owners reported good postoperative function of the affected hindlimb in all dogs. One dog developed an infiltrative lipoma in the same location 22 months post-excision.

CONCLUSION

Preoperative CT allowed a presumptive diagnosis of intermuscular lipoma and facilitated surgical planning for marginal excision. Large intermuscular lipomas of the hindlimb can be safely excised with minimal short-term complications, good long-term functional outcome and low likelihood of recurrence.

Laparoscopic and computed tomography-guided percutaneous radiofrequency ablation of renal tissue: acute and chronic effects in an animal model

OBJECTIVES

To evaluate the laparoscopic and percutaneous delivery of impedance-based radiofrequency ablation (RFA) of the kidney by studying the acute and chronic clinical, radiographic, and histopathologic effects in the porcine model.

METHODS

Eight kidneys from 4 pigs underwent laparoscopic RFA. Six kidneys from 3 additional pigs received computed tomography (CT)-guided, percutaneous RFA. CT scans were performed immediately after RFA and before harvest at 2 hours, 24 hours, 3 weeks, and 13 weeks. The gross, radiographic, and histopathologic changes were recorded for each period.

RESULTS

Grossly, the RFA lesions were sharply demarcated, measuring 3 to 5 cm. Two major complications (14%) occurred (one urinoma, one psoas muscle injury) in 14 ablations. No deaths or significant blood loss occurred as a result of RFA. Radiographically, the immediate CT scanning demonstrated small perinephric hematomas and wedge-shaped defects. Delayed CT showed nonenhancing defects up to 5 cm. Color-flow and power Doppler were unable to distinguish significant tissue changes during RFA. The histopathologic evaluation revealed marked inflammation surrounding the necrotic regions in the early lesions; chronic lesions were characterized by dense fibrosis. The tissue temperatures ranged from 62 degrees to 118 degrees C in the area of ablation.

CONCLUSIONS

RFA is readily delivered laparoscopically or percutaneously with minimal morbidity. Impedance-based application of radiofrequency energy allows monitoring and control of ablation. Using a multi-antenna probe, areas of tissue up to 5 cm can be completely destroyed. The RFA lesion can be monitored as a nonenhancing cortical defect on CT.