Fitzpatrick Noel, van Terheijden Christiaan, Yeadon Russell, Smith Thomas J
Fitzpatrick Referrals, Eashing, UK.
Vet Surg. 2010 Dec;39(8):925-35. doi: 10.1111/j.1532-950X.2010.00758.x.
To establish whether osteochondral autograft transfer (OAT) procedures for osteochondritis dissecans (OCD) of the canine caudocentral humeral head would restore articular contour, resurface osteochondral defects, and resolve lameness in dogs with OCD.
Case series.
Dogs (n=14) with caudocentral humeral head OCD (16 shoulders).
After arthroscopic assessment, the humeral head was exposed by arthrotomy. The OCD lesion was debrided and OATS(™) instrumentation used for resurfacing the defect with osteochondral core grafts collected from the stifle. Recipient sockets were created to maximally resurface articular lesions. Outcomes measures included clinical, radiographic, and arthroscopic examination at 12-18 weeks and clinical examination at 12-46 months (mean, 30.8 months) postoperatively.
Resurfacing of the humeral head was achieved in all dogs. Subjectively, lameness resolved in 9 of 16 limbs by 5-6 weeks postoperatively, and in 13 limbs by 12-18 weeks. Radiographically, all autografts were maintained. On second-look arthroscopy, the grafted section was intact, resilient on probing, satisfactorily conformed to the adjacent articular contour, and grossly appeared consistent with hyaline or fibrocartilage depending on the graft source. Of 12 limbs available for 12-46 months reevaluation, none were considered lame and mild discomfort on shoulder manipulation was recorded for only 1 joint.
OAT procedures are technically feasible in the caudocentral aspect of the canine humeral head. Articular contour reconstruction, resurfacing of osteochondral defects, and amelioration or resolution of short-term lameness may be achieved.
确定用于犬肱骨头中央尾部剥脱性骨软骨炎(OCD)的自体骨软骨移植(OAT)手术是否能恢复关节轮廓、修复骨软骨缺损并解决患有OCD的犬的跛行问题。
病例系列。
患有肱骨头中央尾部OCD的犬(n = 14)(16个肩部)。
在关节镜评估后,通过关节切开术暴露肱骨头。对OCD病变进行清创,并使用OATS(™)器械,用从 stifle采集的骨软骨核心移植物修复缺损。创建受体窝以最大程度地修复关节病变。结果测量包括术后12 - 18周的临床、放射学和关节镜检查,以及术后12 - 46个月(平均30.8个月)的临床检查。
所有犬均实现了肱骨头的修复。主观上,16只肢体中的9只在术后5 - 6周跛行消失,13只肢体在12 - 18周时跛行消失。放射学检查显示,所有自体移植物均得以保留。在二次关节镜检查中,移植部分完整,探查时有弹性,与相邻关节轮廓贴合良好,根据移植物来源,大体上看起来与透明软骨或纤维软骨一致。在可进行12 - 46个月重新评估的12只肢体中,没有一只被认为跛行,只有1个关节在肩部触诊时有轻微不适。
OAT手术在犬肱骨头中央尾部在技术上是可行的。可以实现关节轮廓重建、骨软骨缺损修复以及短期跛行的改善或消除。