Results of treatment of subchondral bone cysts in the medial condyle of the equine femur with an autogenous cancellous bone graft

The results of surgical treatment of 10 subchondral bone cysts, all located in the medial femoral condyle, are presented. A cancellous bone graft was used in nine cases and a two component acrylic bone cement was used in the case of an extremely large cyst. Eight out of the 10 cases made a satisfactory clinical recovery.     

Use of an autogenous cancellous bone graft in the treatment of subchondral bone cysts in the medial femoral condyle of the horse

The clinical features, diagnosis and radiological findings of eight cases of a subchondral bone cyst involving the medial condyle of the femur are described. Surgical treatment, which comprised performing an arthrotomy of the femorotibial joint, curetting and packing the cystic cavity with an autogenous cancellous bone graft, is described.     

Open drainage and delayed autogenous cancellous bone grafting for treatment of chronic osteomyelitis in dogs and cats

Ten dogs and 1 cat with 12 chronically infected bones were treated surgically by means of saucerization, primary internal or external rigid fixation, and open irrigation drainage. After formation of a healthy granulation bed, autogenous cancellous bone grafting and skin closure were performed. Eleven of 12 bones healed 4 to 7 weeks (mean, 4.8 weeks) after treatment, without recurrence of infection. Eight of 12 chronically infected bones had a polymicrobial infection, with 2 to 6 bacterial species isolated. Gram-negative bacteria were isolated from 7 of the 12 bones, and anaerobic bacteria were isolated twice.     

Use of autogenous cancellous bone graft for treatment of osteolytic defects in the phalanges of three cattle.

Osteolytic defects were detected radiographically in the distal sesamoid bone of a 16-month-old Bralers heifer, in the middle phalanx of a 14-month-old American Gray Brahman bull, and in the distal phalanx of a 3-year-old American Gray Brahman bull. The articular cartilage was damaged in each animal because of osteolysis or pathologic fracture. After each animal was anesthetized and positioned in lateral recumbency, the lesions were curetted and packed with cancellous bone harvested from the same animal's tuber coxae. Basic postoperative management involved stall rest and immobilization of the graft site with a fiberglass cast (42 to 79 days), after which a support bandage was used for approximately 2 weeks. Recurrence of lameness has not been observed in these animals for 60 months, 58 months, and 21 months, respectively. These cases exemplify the benefit of using an autogenous cancellous bone graft for treatment of severe osteolysis of a digit in cattle.     

Use of cancellous bone graft in treatment of navicular bone osteomyelitis in a foal

A 3-month-old Quarter Horse filly stepped on a fence staple and developed navicular bone osteomyelitis of the right hindfoot. A 1.5-cm spherical portion of medullary cavity containing purulent material was debrided and flushed with 0.9% NaCl solution. Cancellous bone was collected from a caudal sternebra and placed into the defect. The solar defect had filled with granulation tissue and was epithelialized 6 weeks after surgery. At 6-month follow-up evaluation, the navicular bone defect had healed and the foal was sound on the limb. Cancellous bone grafting may have merit for the treatment of navicular bone osteomyelitis in the horse.     

Repair of a scleral defect with an autogenous fascia lata graft in a dog

A case of a traumatic scleral rupture with uveal herniation in a dog was treated with an autogenous fascia lata graft. Placement of the graft resolved the uveal prolapse and resulted in return of strength and a more normal structure. Fascia lata appears to be an effective scaffolding graft for the repair of scleral defects. It is cheap, easily harvested and large grafts may be obtained. Healing was rapid and the end result was a cosmetic, comfortable, fully functional eye.     

Effects of autogenous cancellous bone on healing of homogenous cortical bone grafts

A comparative clinical and histological study was made of the effects of autogenous cancellous grafts on the rate of healing of homogenous cortical bone grafts in dogs: their right foreleg received homogenous bone grafts and their left foreleg received pre-drilled homogenous bone grafts filled with autogenous cancellous bone. Histologically, the use of homogenous cortical grafts with pre-drilled holes and autogenous cancellous bone appeared to accelerate reorganization and development of these grafts. This was seen particularly 1–2 months post-operatively and at nine months when the graft in the left leg was made up of spongy bone marrow; whereas the right leg graft still contained compact dead bone and the marrow was filled with fibrous tissue.     

Treatment of severely comminuted diaphyseal fractures in the dog, using standard bone plates and autogenous cancellous bone graft to span fracture gaps: 11 cases (1979-1983)

Severely comminuted diaphyseal fractures in 11 dogs were repaired with standard bone plates that spanned a fracture gap filled with autogenous cancellous bone graft. Five dogs had closed injuries, 4 dogs had open fractures, and 2 dogs had infected nonunion fractures for which previous attempts at internal pin fixation had failed. A second autogenous cancellous bone graft was performed in 3 of the dogs during the healing period. The technique was successful in all dogs. The technique was considered a versatile and relatively simple alternative, compared with meticulous small fragment reconstruction and cortical bone allografts.     

Comparison of healing of the osteotomy gap after tibial tuberosity advancement with and without use of an autogenous cancellous bone graft

Objective: To evaluate and compare healing, with and without the use of bone graft, of the gap created during tibial tuberosity advancement (TTA). Study Design: Prospective study and case series. Animals: Dogs treated with TTA (n=67). Methods: Prospective study: Mediolateral radiographic projections (6 weeks and 4 months) after TTA without use of bone graft (group I, n=14) were compared with radiographs of consecutive TTA in which the gap was filled with autologous cancellous bone graft (group II, n=14). Two scoring techniques (A, B) were used. Score A was used to grade the overall osteotomy healing (0=no healing, 4=healed osteotomy). Score B evaluated, independently of each other, healing in 3 sites: proximal to the cage (B1), between cage and plate (B2), and distal to the plate (B3). Case series: nongrafted TTA (4–25 weeks, n=39) were evaluated for healing (Score A). Data was analyzed using t‐tests and ANOVA. Significance was set at P≤.05. Results: Prospective study: Score A, B2, and B3 showed no difference in healing between groups at 6.8 weeks and 4.2 months. Score B1 revealed, in both rechecks, a significantly higher density in group II. Case series: Radiographs at 11.59±5.99 weeks scored 3.3 (2–4). No healing related complications were observed. Conclusion: The osteotomy gap created during TTA healed within expected time regardless of bone graft use.     

Comparison of bone healing by demineralized bone matrix and autogenous cancellous bone in horses

OBJECTIVE: The purpose of this study was to compare bone healing induced by equine demineralized bone matrix (DBM) to autogenous cancellous bone graft (ACB) or no graft (control) in a rib-defect model in horses. STUDY DESIGN: The osteogenic properties of ACB and DBM were evaluated in bilateral 19-mm circular defects created in the outer cortex of the 6th and 8th ribs of each horse. ANIMALS OR SAMPLE POPULATION: Eight mature horses. METHODS: Three rib defects in each horse were randomly treated with each of the 3 treatment groups, and the fourth rib defect received a random treatment. Rib sections, including the defects, were harvested 56 days after implantation and examined for bone mineral density, percent ash and calcium and graded for signs of radiographic and histological healing. RESULTS: All ribs were fractured at the defect site and were classified as nonunion fractures 56 days after implantation. There were no significant differences among groups in bone mineral density and signs of radiographic or histological healing. There was an increased volume of bone in control and ACB-treated sites compared with DBM-treated sites. Rib defects treated with ACB were significantly higher in percent ash and calcium than those treated with DBM. DBM elicited no inflammatory reaction, and remodeling occurred around the periphery and within vascular channels of the decalcified particles. CONCLUSION: DBM particles remodel from the periphery, which may explain the significantly lower percent ash, calcium, and bone when compared with ACB, because 2- to 4-microL pieces of DBM may act as space-occupying masses until completely mineralized. There was no evidence of enhanced healing associated with the use of DBM in this model. CLINICAL RELEVANCE: Particles of 2 to 4 mm DBM should not be used as an aid to fracture repair because particles of this size interfere with normal mineralization. However, our model of nonunion fracture healing may be useful in future studies.     

Molecular analysis of defect healing in rat diaphyseal bone.

Spatial expression of messenger ribonucleic acid (mRNA) for osteoblastic marker in drill hole defect healing of adult male rats was analyzed by in situ hybridization. The defect was filled with hematoma 3 days after surgery, expressing Type I collagen mRNA. Hematoma was replaced with fibrous tissue on day 7, and then with new trabecular bone on day 10, originated from the intra-medullary space, respectively. mRNA for Type I collagen, parathyroid hormone 1 receptor (PTHIR), and alkaline phosphatase (ALP) were expressed in the same cell population of fibrous tissue adjacent to newly-formed trabecular bone, and in osteoblasts lining the newly-formed trabecular bone. Hematopoietic marrow with osteoclasts subsequently invaded the region, also from the intra-medullary space, replacing all the new trabecular bone by day 21, except for a thin sub-periosteal layer. mRNA for Type I collagen, PTH1R and ALP was expressed on the periosteal surface of thin layer. Although cartilage formation was not histologically visible, mRNA for Type II collagen was weakly detected in the majority of osteoblasts lining the newly-formed trabecular bone.     

Effects of a fixed compression load on the osteogenic effect of autogenous cancellous bone grafts in dogs.

A standardized cortical defect was created on the caudal cortex of the proximal portion of each ulna in 5 adult mixed-breed dogs. One gram of autogenous cancellous bone graft (ACBG) was obtained from the greater tubercle of the ipsilateral humerus. The cortical defect in the ulna of 1 limb was filled with 1 g of ACBG that had been compressed with 2-MPa pressure for 30 seconds. One gram of noncompressed ACBG was placed into the contralateral ulnar cortical defect. The compressed and noncompressed ACBG recipient sites were radiographed at weekly intervals. Dogs were euthanatized 8 weeks after surgery, and the ACBG recipient sites were harvested for histomorphometric analysis. Optical densitometry was performed on all radiographs. There was no significant difference between compressed and noncompressed ACBG with optical densitometry or histomorphometric analysis for total bone area. We concluded that there was no difference in osteogenic capability between compressed and noncompressed ACBG of equal mass.     

Evaluation of the proximal portion of the femur as an autogenous cancellous bone donor site in dogs.

The proximal portion of the femur was evaluated as a source of autogenous cancellous bone in dogs. Bilateral oval cortical defects were created in the lateral subtrochanteric area of the femur in 16 dogs. Cancellous bone was removed and the weight recorded. Cancellous bone was similarly harvested from the proximal portion of the humerus in 7 of these dogs. Subtrochanteric femoral defects in 11 dogs were randomly assigned to receive cancellous bone graft obtained from the femur (n = 4) or the humerus (n = 7). Subtrochanteric defects in 5 dogs were not grafted. Radiographic assessment of subtrochanteric defects was performed at 4-week intervals, and histologic assessment at 4, 8, 16, and 24 weeks after surgery. Nongrafted donor sites healed by ingrowth of trabecular bone during the first 12 weeks after surgery. By week 24, the lateral cortical wall had reformed, but remodeling was incomplete. Donor sites grafted with cancellous bone healed similarly, but with more rapid healing and more complete remodeling evident by week 24. Although the mean weight of cancellous bone harvested from the proximal portion of the femur (0.82 +/- 0.22 g) was significantly (P less than 0.05) less than that harvested from the proximal portion of the humerus (1.38 +/- 0.29 g), there was no qualitative histologic or radiographic difference in bony healing of grafted defects. We determined that the proximal portion of the femur can be safely used to provide moderate amounts of cancellous bone, and that a second bone graft can be collected from the same subtrochanteric donor site after 12 weeks.     

Evaluation of a technique for collection of cancellous bone graft from the proximal humerus in horses

OBJECTIVES: To describe a technique for collecting cancellous bone graft from the proximal humerus in horses. STUDY DESIGN: Prospective evaluation of an experimental bone graft collection technique. ANIMAL POPULATION: Eight horses, 3-15 years, weighing 495-605 kg. METHODS: Horses were anesthetized and positioned in lateral recumbency. The lateral aspect of the proximal humerus was exposed by a 7-10-cm incision extending distally from the greater humeral tubercle, followed by sharp dissection through the omotransversarius muscle and between the infraspinatus and deltoideus muscles. A 12-mm cortical defect was incrementally created in the lateral proximal humerus. Human bone graft harvesting equipment (Acumed, Beaverton, OR) was drilled through this defect to collect a core of cancellous bone. In five horses additional cancellous bone was then collected with conventional instruments. Bone samples were weighed and histologically examined. Horses were monitored and graded for quality of anesthetic recovery, incisional complications, and postoperative lameness. RESULTS: Total mean (+/-SD) surgical time for harvesting bone with the Acumed system and traditional techniques (n=5) was 38+/-6 minutes (range, 32-47 minutes). Mean cancellous bone weight collected with the Acumed system was 3.6+/-0.8 g (range, 2.0-4.6 g), and cancellous bone collected conventionally was 25.6+/-7.5 g (range, 16.8-34.2 g). Minimal incisional complications or postoperative lameness were observed. Mortality was 12.5%; one horse fractured the operated humerus during anesthetic recovery. CONCLUSION: The Acumed system provided limited cancellous bone when used with the technique described. However, the quantity of cancellous bone collected with traditional harvesting instruments was comparable to other sites used in horses. The procedure was associated with minimal postoperative incisional complications or lameness, but because one horse suffered a catastrophic humeral fracture further research is required to assess the effects of this procedure on humeral breaking strength. CLINICAL RELEVANCE: Based on the risk of catastrophic fracture, this technique cannot be recommended for use in clinical cases, especially if an unassisted recovery from general anesthesia is planned.     

Comparable bone healing capacity of different bone graft matrices in a rabbit segmental defect model

We compared the bone healing capacity of three different demineralized bone matrix (DBM) products applied using different carrier molecules (hyaluronic acid [HA] vs. carboxymethylcellulose [CMC]) or bone compositions (cortical bone vs. cortical bone and cancellous bone) in a rabbit segmental defect model. Overall, 15-mm segmental defects in the left and right radiuses were created in 36 New Zealand White rabbits and filled with HA-based demineralized cortical bone matrix (DBX), CMC-based demineralized cortical bone matrix (DB) or CMC-based demineralized cortical bone with cancellous bone (NDDB), and the wound area was evaluated at 4, 8, and 12 weeks post-implantation. DBX showed significantly lower radiopacity, bone volume fraction, and bone mineral density than DB and NDDB before implantation. However, bone healing score, bone volume fraction, bone mineral density, and residual bone area at 4, 8, and 12 weeks post-implantation revealed no significant differences in bone healing capacity. Overall, three DBM products with different carrier molecules or bone compositions showed similar bone healing capacity.     

Preliminary study of quantitative aspects and the effect of pulsed electromagnetic field treatment on the incorporation of equine cancellous bone grafts

The quantitative aspects of equine cancellous bone graft incorporation and the possibility of influencing graft incorporation by daily exposure to a pulsed electromagnetic field (PEMF) was studied in eight yearling ponies. In order to be able to quantify formative aspects of graft remodelling, a double and treble tetracycline intravital labelling technique was used. Intravital radiographs were obtained at regular intervals throughout the trial, but were found to be of little assistance in assessing any differences between stimulated and non-stimulated grafts. The ponies were humanely destroyed at regular intervals between nine and 241 days after installation of the graft. Light microscopy and fluorescent light microscopy were used to evaluate quantitative aspects of graft incorporation and to compare PEMF-stimulated grafts with control grafts. There was a small but statistically significant effect of PEMF-stimulation on cancellous bone graft incorporation. In view of this, these observations can only be considered as indicative of a possible trend, but should encourage further studies using different signal modalities.