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马股骨内侧髁永久性合成骨软骨植入物的评估。

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

作者信息

Husby Kirsty A, Reed Shannon K, Wilson David A, Kuroki Keiichi, Middleton John R, Hoepp Natalie C, Charles Elizabeth M, Cook James L

机构信息

Department of Clinical Sciences, Oregon State University, Corvallis, Oregon.

Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri.

出版信息

Vet Surg. 2016 Apr;45(3):364-73. doi: 10.1111/vsu.12453. Epub 2016 Feb 22.

Abstract

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.

摘要

目的

评估一种合成骨软骨植入物在正常马股骨内侧髁(MFC)的骨长入、整合情况及耐受性。

研究设计

实验研究。

动物

成年马(n = 6)。

方法

对马实施麻醉,进行双侧股胫关节切开术,在一侧MFC植入1个由带钛基的聚碳酸酯聚氨酯制成的植入物。对侧MFC作为假手术对照,不进行软骨或软骨下骨的扩孔。术前进行跛行评估和X线片检查,术后每月进行跛行检查并在6个月时拍摄X线片。术前及术后多个时间点从相邻的股髌关节收集滑液进行分析。术后6个月对马实施安乐死。采集膝关节进行大体和组织学评估。

结果

2匹马从未出现跛行,2匹有轻度跛行,1匹表现为中度跛行。相邻股髌关节的滑液炎症参数无显著差异。随时间推移,两个膝关节的X线片均未出现显著变化。内侧股胫关节滑膜的组织学评估显示,植入物侧和假手术侧膝关节的炎症变化无差异。5个标本中有4个和3个的植入物整合及骨传导性分别被评为良好。并发症包括导致安乐死的关节败血症(1匹马)、持续性跛行(1匹马)、切口血清肿(4匹马)和切口裂开(2匹马)。

结论

这项初步研究结果表明,该植入物与在正常马的MFC植入兼容。植入物设计允许骨长入钛基内并提供一个合成关节表面。

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