Cylindrical press-fit osteochondral allografts for resurfacing the equine metatarsophalangeal joint (original) (raw)
Related papers
CARTILAGE, 2016
ObjectiveTo evaluate a biphasic cartilage repair device (CRD) for feasibility of arthroscopic implantation, safety, biocompatibility, and efficacy for long-term repair of large osteochondral defects.MethodsThe CRD was press-fit into defects (10 mm diameter, 10 mm deep) created in the femoral trochlea of 12 horses. In the contralateral limb, 10 mm diameter full-thickness chondral defects were treated with microfracture (MFX). Radiographs were obtained pre- and postoperatively, and at 4, 12, and 24 months. Repeat arthroscopy was performed at 4 and 12 months. Gross assessment, histology, mechanical testing, and magnetic resonance imaging (MRI) were performed at 24 months.ResultsThe CRD was easily placed arthroscopically. There was no evidence of joint infection, inflammation, or degeneration. CRD-treated defects had significantly more sclerosis compared to MFX early ( P = 0.0006), but was not different at 24 months. CRD had better arthroscopic scores at 4 months compared to MFX ( P = 0...
Surgical osteochondral defect repair in the horse—a matter of form or function?
Equine Veterinary Journal, 2020
Focal cartilaginous and osteochondral lesions can have traumatic or chondropathic degenerative origin. The fibrocartilaginous repair tissue that forms naturally, eventually undergoes fibrillation and degeneration leading to further disruption of joint homeostasis. Both types of lesion will therefore eventually lead to activity‐related pain, swelling and decreased mobility and will frequently progress to osteoarthritis. Most attempts at realising cartilage regeneration have so far resulted in cartilage repair (and not regeneration). The aim of this article was to review experimental research on surgical cartilage restoration techniques performed so far in equine models. Currently available surgical options for treatment of osteochondral lesions in the horse are summarised. The experimental validity of equine experimental models is addressed and finally possible avenues for further research are discussed.
Arthroscopic mosaic arthroplasty in the equine third carpal bone
Veterinary Surgery, 2001
Objective-To investigate survival and function of autogenous heterotopic osteochondral grafts in a site where injuries are common. Study Design-Three osteochondral grafts were harvested arthroscopically from the femoropatellar joint and transplanted to the third carpal bone (C 3). Nine months later, histologic, histomorphometric, and biochemical comparisons were made between the transplanted grafts in C 3 and tissue adjacent to the recipient site, the opposing radial carpal bone (C r), the donor site in the femoropatellar joint, and the sham-operated contralateral C 3. Animals-One mixed-breed pony and 5 Standardbred horses aged 3 to 8 years old. Methods-Using instruments modified for equine use, four 4.5-mm-diameter osteochondral grafts were harvested arthroscopically from the distal aspect of the lateral trochlea of the right femur and inserted into the radial facet of the right third carpal bone. The fourth graft was kept as a donor-site control sample. Three months later, regular exercise was started and at 6 months, repeat arthroscopy was conducted to evaluate healing. The horses were euthanatized 9 months after transplantation, and comparisons were made between the grafts, opposing radial carpal bone, and contralateral third carpal bone. The assessment criteria included paravital staining, a modified Mankin scoring system, and biochemical analyses for collagen type, total collagen content, and sulfated glycosaminoglycan concentration. Results-All horses were sound 21 days' postoperatively. At 6 months, all 18 grafts were intact but somewhat soft and opaque compared with surrounding carpal cartilage. Nine months' postoperatively, the bony portions of the grafts were well integrated with the recipient sites, but 6 grafts had histologic evidence of cartilage degeneration. From biochemical analysis of grafts, there was little or no new repair tissue invading the experimental sites, but sulfated glycosaminoglycan (proteoglycan) loss from the transplanted cartilage was marked. Conclusions-Heterotopic transfer of osteochondral grafts from the distal aspect of the lateral femoral trochlea to the third carpal bone is feasible with minor modifications of human mosaic arthroplasty instruments. The bony portion of the osteochondral grafts was quickly remodeled to provide subchondral support to the transplanted articular cartilage. The loss of proteoglycan from the transplanted cartilage indicates that the grafts might have been injured during harvesting or insertion, or, more likely, did not remodel to meet the demands of a new biomechanical environment. Clinical Relevance-These findings suggest that arthroscopic resurfacing of focal osteoarticular defects will not be successful in the long term unless donor and recipient sites can be matched with respect to cartilage thickness, biochemical constituents, and physical properties. Mosaic arthroplasty may be indicated in selected cases in which no other options exist to create a confluent cartilage-covered surface.
Veterinary Surgery, 2004
Objective-To describe treatment of equine subchondral bone cysts (SBCs) by reconstruction of the articular surface with osteochondral grafts. Study Design-Case series of horses with SBCs unresponsive to conservative therapy. Animals-Eleven horses (1-12 years). Methods-SBCs were identified in 4 locations: medial femoral condyle (5 horses), lateral femoral condyle (1), distal epiphysis of the metacarpus (4), or metatarsus (1). Osteochondral autograft transplantation (mosaic arthroplasty) was performed, taking grafts from the abaxial border of the medial femoral trochlea of the unaffected limb. Graft implantation was achieved through a small arthrotomy or by arthroscopy depending on SBC location. Results-All horses improved postoperatively; 10 horses had successful outcomes with radiographic evidence of successful graft incorporation and 7 returned to a previous or higher activity level. On follow-up arthroscopy (5 horses) there was successful reconstitution of a functional gliding surface. One horse had delayed incorporation of a graft because of a technical error but became sound. One horse had recurrence after 4 years of work and soundness. One stallion was used for breeding and light riding because of medial meniscal injuries on the same limb. Conclusions-Implantation of osteochondral grafts should be considered for SBC when conservative management has not improved lameness and there is a risk of further joint injury and degeneration.
Mosaic arthroplasty of the medial femoral condyle in horses — an experimental study
Acta Veterinaria Hungarica, 2014
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...
Acta veterinaria Hungarica, 2016
The purpose of this study was to evaluate changes in biomarker and synovial parameters following autologous osteochondral transplantation (AOT) in the equine stifle joint, to test the hypothesis whether synovial parameters would show significant differences at selected time points following the surgery (at days 3, 14, 60 and 180) compared to baseline level (at day 0). Surgical intervention was performed in both stifles of nine horses (n = 18). The joints were randomly assigned to operated and sham-operated groups. Grafts 8.5 mm in diameter were harvested from the femoropatellar (FP) joint under arthroscopic control and the medial femorotibial (MFT) joints had AOT using mosaicplasty (MP) instrumentation, while the sham FP and sham MFT joints underwent arthroscopy and miniarthrotomy without transplantation, respectively. Synovial fluid (SF) parameters were evaluated at days 4, 14, 60 and 180. Data were analysed by two-way repeated- measures analysis of variance (ANOVA), and P < 0.0...
A novel system improves preservation of osteochondral allografts
Clinical orthopaedics and related research, 2014
Osteochondral allografting is an option for successful treatment of large articular cartilage defects. Use of osteochondral allografting is limited by graft availability, often because of loss of chondrocyte viability during storage. The purpose of this study was to compare osteochondral allografts implanted in canine knees after 28 days or 60 days of storage for (1) initial (1 week) safety and feasibility; (2) integrity and positioning with time (12 weeks and 6 months); and (3) gross, cell viability, histologic, biochemical, and biomechanical characteristics at an endpoint of 6 months. With Institutional Animal Care and Use Committee approval, adult dogs (n=16) were implanted with 8-mm cylindrical osteochondral allografts in the lateral and medial femoral condyles of one knee. Osteochondral allografts preserved for 28 or 60 days using either the current tissue bank standard-of-care (SOC) or a novel system (The Missouri Osteochondral Allograft Preservation System, or MOPS) were used...
Equine Models of Articular Cartilage Repair
CARTILAGE, 2011
Articular cartilage injuries of the knee and ankle are common, and a number of different methods have been developed in an attempt to improve their repair. Clinically, there are 2 distinct aims of cartilage repair: 1) restoration of joint function and 2) prevention or at least delay of the onset of osteoarthritis. These goals can potentially be achieved through replacement of damaged or lost articular cartilage with tissue capable of functioning under normal physiological environments for an extended period, but limitations of the final repair product have long been recognized and still exist today. Screening of potential procedures for human clinical use is done by preclinical studies using animal models. This article reviews equine chondral defect models that have been recently recognized to have specific advantages for translation into human articular cartilage regeneration. Defect models in the femoropatellar, femorotibial, and tibiotalar joints have been developed. The horse pr...
Singapore medical journal, 2001
The aim of this study is to firstly ascertain the survival of autogenously grafted morselised cartilage for full thickness osteochondral defects in knee joints of pigs. Secondly, it is to determine the quality of the grafted cartilage that survives and to score to it based on a recognised and tested system of indices and thirdly, to recognise, if any, the potential for reconstitution of the osteochondral junction. Two groups of five pigs were followed up for six and 12 weeks. Similar osteochondral defects were created in the medial condyles of both knees with the right medial femoral condyle defect filled with graft and the left used as control and filled with gel foam. At the end of the study period, an independent pathologist assessed the defects macroscopically and microscopically with an accepted and comparable histological scoring system. Macroscopically, there was better filling of the defect and restoration of bony contour in the grafted group compared to the control. Microsc...
Optimising femoral-head osteochondral allograft transplantation in a preclinical model
Journal of Orthopaedic Translation, 2016
Background/Objective: Osteochondral autografting and allografting of the femoral head have been described as treatments for avascular necrosis without segmental collapse, fracture, osteochondritis dissecans, and tumours. One long-term study reported that 80% of nonsteroid-treated patients had successful outcomes. Most data are compiled from small case reports or series. Although these results are encouraging, to the authors' knowledge, there is no basic scientific evidence regarding optimal graft source or technique reported in the peer-reviewed literature. The objective of this study was to create a translational canine model to compare femoral-head osteochondral autografts and allografts with respect to safety and efficacy. Methods: With Institutional Animal Care and Use Committee approval, skeletally mature hound-mix dogs (n Z 6) weighing >20 kg underwent aseptic surgical implantation of osteochondral grafts using a craniolateral approach to the hip, without dislocation. Three graft options were evaluated: small auto (n Z 3), 6-mm-diameter autograft from the trochlear ridge of the ipsilateral knee; small allo (n Z 3), 6-mm-diameter fresh (21-day storage) allograft from a size-matched canine femoral head; or large allo (n Z 3), 14-mm-diameter fresh (21-day storage) allograft from a size-matched canine femoral head. Small grafts were implanted into the same femoral head of three dogs, and large grafts were implanted alone in the other three dogs. The dogs were allowed unrestricted activity in their runs, and were walked on a leash for 15 minutes 5 times/wk. The outcome measures included functional, radiographic, and arthroscopic assessments at 8 weeks, and functional, chondrocyte viability, and histologic assessments at 6 months after surgery. The pre-and postoperative data were compared for