Evaluation of Canine Cortical Bone Graft Remodeling

A stable cortical bone fracture model was developed to evaluate the remodeling rate of cortical bone grafts. Samples of cortical bone were harvested with a trephine and press fit into predrilled holes in the femoral diaphyses of four live dogs. The percentages of new bone, unremodeled graft bone, porosity, forming bone surface area, and resorbing bone surface area were determined morphometrically and compared in cortical autografts, cortical allografts sterilized with 84% ethylene oxide (EO), and allografts sterilized with 12% EO. The host-graft interfaces healed without formation of fibrous tissue or cartilage, indicating a stable fracture surface. The amount of new bone formed in cortical autografts and allografts sterilized with 84% EO was significantly greater than the amount of new bone in allografts sterilized with 12% EO. There was no significant difference between the amounts of new bone formed in the allografts sterilized with 84% EO and the cortical autografts. No significant differences were detected in percentages of porosity or bone surface areas.     

Healing of Cortical Bone Grafts in the Dog The Role of Azathioprine

Sixteen unrelated beagles, randomly divided into groups of four, were used in evaluating the role of therapeutic immunosuppression in the healing of fresh cortical bone allografts over a 16-week period. The four groups included: nontreated allograft, treated allograft, nontreated autograft, and treated autograft. A 2.7-cm tibial cortical graft was fixed orthotopically using a dynamic compression plate. Healing was evaluated by radiography and by gross and histologic studies at 2, 4, 8, and 16 weeks after surgery. The treated dogs were immunosuppressed with azathioprine for eight weeks postsurgery. The conclusions were that: temporary immunosuppression did not significantly alter healing of fresh cortical bone autografts; healing of fresh cortical bone allografts in immunosuppressed dogs was similar to healing of fresh cortical bone autografts; slight differences were observed in the healing of bone grafts in all groups after eight weeks; and cellular reaction typical of graft rejection was found in nontreated allografts, but healing still occurred.     

Cortical Bone Allografting in the Horse

Half and full cylindrical frozen cortical bone allografts were transplanted into groups of horses. All horses accepted, resorbed, and began replacement of their grafts to varying degrees, according to frequent radiographic and monthly histologic evaluation. Clinically, all the recipients appeared to return to varying degrees of function. This method of bone allografting is suggested as an adjunct to current methods of fracture fixation in the horse.     

Preliminary study of ethylene oxide sterilization of full-thickness cortical allografts used in segmental femoral fracture repair

Full-thickness canine cortical allografts were cleanly harvested, sterilized with ethylene oxide, and stored at room temperature. The allografts were incorporated into canine segmental femoral fracture repairs and compared clinically, radiographically, and morphologically with control femoral cortical autografts for function of the limb, graft acceptance, and bone union. Sterility was maintained and the cortical allografts were well accepted by the host animals, resulting in full use of the limb which was subjected to surgical operation. The allografts showed healing patterns similar to those of the autografts, as determined by radiographic, gross, and histologic evaluation of the proximal and distal host-graft interfaces. Evaluations were made monthly. The host-graft interfaces of the allografts and autograft were filled with woven bone with adjacent vascular invasion and remodeling of the graft at the final 4th-month evaluation.     

Bone allografts and adjuvant cisplatin for the treatment of canine appendicular osteosarcoma in 18 dogs

The results achieved in 18 dogs following the use of frozen bone cortical allografts for limb-sparing resection of non-metastatic canine appendicular osteosarcoma are presented. Three to five cisplatin doses (70 mg/m2) were administered, starting the day after surgery. The mean and median survival times were 478 and 266 days (range 80 to 2,611 days), respectively. The survival rate was 94 per cent at three months, 78 per cent at six months, 35 per cent at 12 months, 23 per cent at 18 months and 19 per cent at 24 months; the disease-free interval was 80 to 1,246 days (mean 365 days, median 266 days). Lung metastasis developed in 55 per cent of the dogs within one year. Complications were observed in 14/18 dogs (78 per cent), comprising local recurrence (28 per cent), allograft infection (39 per cent) and implant failure (11 per cent). Despite complications, limb sparing is a useful alternative to amputation in selected cases of appendicular osteosarcoma.     

Evaluation of full cortical allografts in 25 dogs

Twenty-five dogs received 26 cortical allografts from Apr 9, 1976 through Jan 31, 1982. Cortical allografts were used to reconstruct fractures of the femur, humerus, tibia, radius, and ulna. These grafts were used to replace comminuted fragments; to lengthen bones; to correct malunions, delayed unions, and nonunions; and in one case, to replace bone lost to sequestrum formation in an infected fracture site. All fractures were stabilized by use of standard ASIF techniques and dynamic compression plates. Frozen bone allografts were used in all cases. These were harvested aseptically and stored in a household freezer for 3 days to one year before use. Clinically normal function was achieved in 96% of the dogs.     

Antigenicity of cortical bone allografts in dogs and effect of ethylene oxide-sterilization.

The aims of the present study were to determine the antigenicity of cortical bone allografts and the effect of ethylene oxide-sterilization (EO-sterilization). Cortical bone allografts from one donor dog were implanted in a muscle pouch in four groups of four dogs each. The grafts were either fresh, EO-sterilized, demineralized or demineralized and EO-sterilized. The immune response against the grafts was determined by measuring the antibody response against surface antigens of donor cells and by the mixed lymphocyte reaction. Dogs receiving EO-sterilized grafts or bone matrix did not demonstrate an immune response. Only two of the four dogs with fresh cortical bone grafts showed a very weak immune response. This suggests a priming of the host by the fresh bone grafts. However, implanting skin grafts from the donor dog subdermally, in one dog of each of the groups, four months after implanting the bone grafts did not induce a secondary immune response. Macroscopic and histologic examination of the bone grafts five months after their implantation consistently revealed graft resorption (activity of osteoclasts) and vascularization of the fresh bone grafts, but not of EO-sterilized fresh grafts. For most EO-sterilized grafts, a strong inflammatory reaction was present in the tissues surrounding the graft and this was not apparent around the non-sterilized grafts. The absence of resorption and the presence of the inflammation seemed to be unwanted effects of the EO-sterilization. The EO-sterilisation did not affect osteoinduction since osteocytes were observed in the EO-sterilized demineralized grafts. Results indicate that cortical bone allografts used in the present study are very weak antigens and that the EO-sterilization procedure used has no effect on osteoinduction, but decreases bone resorption.     

Bone sequestration in horses and cattle

The site of occurrence of 490 bone sequestra in horses and cattle was investigated. Most sequestra occurred in the proximal half of the third metatarsal bone and the third metacarpal bone. The most common clinical features included swelling, presence of a draining tract, impaired function and delayed wound healing. These diagnostic features, and the preferred time to confirm the diagnosis by radiological examination are discussed. The surgical treatment is relatively simple and the prognosis favourable in most cases. It is suggested that soft tissue injury and the presence of infection are of greater importance than cortical trauma and reduced peripheral cortical circulation in the pathogenesis of sequestration.     

Cortical allograft and endoprosthesis for limb-sparing surgery in dogs with distal radial osteosarcoma: a prospective clinical comparison of two different limb-sparing techniques

OBJECTIVE: To compare surgical and oncologic outcome in dogs with osteosarcoma (OSA) of the distal aspect of the radius treated with limb-sparing surgery, using either a cortical allograft or endoprosthesis, and postoperative chemotherapy; and to evaluate predictive factors for outcome. STUDY DESIGN: Prospective cohort study. ANIMALS: Dogs (n = 20) with spontaneous, non-metastatic OSA of the distal aspect of the radius. METHODS: Dogs were prospectively randomized for limb-sparing surgery with either a cortical allograft (n = 10) or endoprosthesis (10) and full-course adjuvant chemotherapy using single or dual agent protocols of cisplatin, carboplatin, and/or doxorubicin. Surgical (intraoperative findings, postoperative infection, construct failure) and oncologic (local tumor recurrence, metastasis, survival) outcomes were compared. The influence of intraoperative and postoperative variables on surgical and oncologic outcome were evaluated. RESULTS: No clinically significant differences in surgical and oncologic outcome were detected between groups. The percentage of radius replaced by the implant was significantly greater in the endoprosthesis group (60.9% compared with 48.6%, P = .008). Median survival time (MST) for dogs with construct failure, regardless of implant type, was 685 days and significantly greater than MST of dogs without construct failure (322 days, P = .042; hazard ratio [HR] 16.82). Median metastasis-free interval and MST (685 days versus 289 days; P = .034, HR 24.58) were significantly greater in dogs with postoperative infection. Disease-free and overall limb-salvage rates were 70% and 85%, respectively. Overall MST was 430 days. CONCLUSIONS: For dogs with OSA of the distal aspect of the radius, a cortical allograft or endoprosthesis can be used for limb-sparing surgery. Construct failure and postoperative infection significantly improve survival time regardless of implant type. CLINICAL RELEVANCE: An endoprosthesis is an attractive alternative to cortical allografts for limb-salvage of the distal aspect of the radius in dogs because surgical and oncologic outcomes are similar, but the endoprosthesis is an immediately available off-the-shelf implant which is not complicated by the bone harvesting and banking requirements associated with cortical allografts. Mechanisms whereby postoperative infection improves survival time requires further investigation and, if elucidated, may provide the opportunity to improve the outcome of dogs and humans with OSA.     

Osteoarticular Allogeneic Bone Grafting in Dogs

A review of the clinical and pathologic evaluation of allogeneic bone grafts is presented with particular emphasis upon partial joint replacement. The histologic evaluation of cortical bone transplantation is reviewed. Radiographic evaluation of cortical bone transplants is presented in an attempt to understand the normal events that take place in incorporation of the graft by the host. The histologic and radiographic correlation is related to the healing process. Current methods of graft collection and storage are reviewed. While collection of the graft is fairly uniform, there are many varied treatment and storage procedures. General surgical procedures used in performing full cortical bone grafts are reviewed. The clinical use of an osteoarticular allogeneic bone graft in the elbow of a dog is presented, with a review of the operative and postoperative evaluation of the clinical patient.     

Endoprosthesis (EN) in frontlimb-sparing surgery for distal radial tumours in the dog: preliminary results

In veterinary medicine, limb-sparing techniques are most implemented when the uninvolved limbs are affected by other orthopaedic or neurological disorders, in large breeds or when the owner declines amputation. This report describes the surgical technique used for implantation of an endoprosthesis following tumour resection in the distal radius in 3 dogs using both standard and angle-stable plates. Endoprosthesis offers an easy and readily available surgical alternative to cortical allografts. Despite post-operative complications, this technique resulted in a good quality of life in all 3 dogs.     

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.     

Effects of a 98% solution of glycerol or sterilization with ethylene oxide on FeLV in bone allografts and effects on bone incorporation of allografts in cats

OBJECTIVES: To compare virucidal effects and bone incorporation properties of cortical bone allografts transplanted into specific-pathogen-free (SPF) cats. Allografts consisted of untreated bone from a SPF cat (negative-control group) and bone from 5 FeLV-infected cats that was subjected to sterilization with ethylene oxide (ETO), preservation with glycerol, or no treatment (positive-control group). SAMPLE POPULATION: Bones from the aforementioned groups and twenty 8-week-old SPF cats (5 cats/group) implanted with an allograft from 1 of the aforementioned groups. PROCEDURE: After implantation, blood samples were collected weekly to monitor FeLV p27 antigen and antibody titers. Quantification of FeLV provirus was performed on blood samples at weeks 0, 4, and 8 and donor bone samples at time of implantation. Cats were euthanatized 8 weeks after transplantation, and graft sites were evaluated. RESULTS: All results for negative-control cats were negative. All ETO group cats had negative results for antigen and provirus in blood, whereas 1 cat had a low antibody titer. Although 3 ETO-treated allografts were positive for provirus, the DNA appeared denatured. One cat in the glycerol group had positive results for all tests in blood samples. All glycerol-preserved allografts were positive when tested for provirus. All results for positive-control group cats were positive. Differences in incorporation of bone grafts were not observed. CONCLUSIONS AND CLINICAL RELEVANCE: Glycerol preservation of FeLV-infected bone allografts did not eliminate transmission of retrovirus to recipients. In contrast, ETO sterilization appeared to denature DNA and prevent infection. Treatments did not affect incorporation of bone grafts in young cats.     

骨疏康对蛋鸡骨代谢的影响

为研究中药骨疏康对蛋鸡骨代谢的影响，选择90只58周龄的蛋鸡，随机分为3组。对照组饲喂基础日粮，骨疏康组在基础日粮中添加1％的骨疏康，依普拉芬组在基础日粮中添加25mg／kg的依普拉芬。试验为期90d。结果显示，与对照组比较，骨疏康组和依普拉芬组血清Ca、P、AKP、TRACP、BGP水平显著降低，肱骨、胫骨、股骨的骨指数、骨放射密度、皮质骨厚度、皮质骨面积、皮质骨面积比例以及血清中IGF-1水平显著升高，而骨疏康组与依普拉芬组之间无显著差异，表明骨疏康能显著抑制产蛋后期蛋鸡的骨吸收，促进骨形成，改善骨代谢。     

In Vitro Pullout Strength of Screws Inserted in Adult Equine Third Metacarpal Bone After Overdrilling a 4.5-mm Threaded Insertion Hole

Objective—To determine and compare the in vitro pullout strength of 5.5-mm cortical versus 6.5-mm cancellous bone screws inserted in the diaphysis and metaphysis of adult equine third metacarpal (MCIII) bones, in threaded 4.5-mm cortical bone screw insertion holes that were then overdrilled with a 4.5-mm drill bit to provide information relevant to the selection of a replacement screw if a 4.5-mm cortical screw is stripped. Study Design—In vitro pullout tests of 5.5-mm cortical and 6.5-mm cancellous screws in equine MCIII bones. Sample Population—Two independent cadaver studies each consisting of 14 adult equine MCIII bones. Methods—Two 4.5-mm cortical screws were placed either in the middiaphysis (study 1) or distal metaphysis (study 2) of MCIII bones. The holes were then overdrilled with a 4.5-mm drill bit and had either a 5.5-mm cortical or a 6.5-mm cancellous screw inserted; screw pullout tests were performed at a rate of 0.04 mm/second until screw or bone failure occurred. Results—In diaphyseal bone, the screws failed in all tests. Tensile breaking strength for 5.5-mm cortical screws (997.5 ± 49.3 kg) and 6.5-mm cancellous screws (931.6 ± 19.5 kg) was not significantly different. In metaphyseal bone, the bone failed in all tests. The holding power for 6.5-mm cancellous screws (39.1 ± 4.9 kg/mm) was significantly greater than 5.5-mm cortical screws (23.5 ± 3.5 kg/mm) in the metaphysis. There was no difference in the tensile breaking strength of screws in the diaphysis between proximal and distal screw holes; however, the holding power was significantly greater in the distal, compared with the proximal, metaphyseal holes. Conclusions—Although tensile breaking strength was not different between 5.5-mm cortical and 6.5-mm cancellous screws in middiaphyseal cortical bone, holding power of 6.5-mm cancellous screws was greater than 5.5-mm cortical screws in metaphyseal bone of adult horses. Clinical Relevance—If a 4.5-mm cortical bone screw strips in MCIII diaphyseal bone of adult horses, either a 5.5-mm cortical or 6.5-mm cancellous screw, however, would have equivalent pullout strengths. A 6.5-mm cancellous screw, however, would provide greater holding power than a 5.5-mm cortical screw in metaphyseal bone.     

Lesions in dogs following renal transplantation and immunosuppression

Renal allografts were transplanted into 20 dogs (12 beagles, eight mongrels) following a prescribed protocol for pre-transplantation blood transfusions and kidney exchange. Immunosuppressive therapy (azathioprine and prednisone) was modified as needed for each dog. Seven of the beagle dogs survived for 1 year and were then euthanized; all other dogs died or were euthanized prior to 1 year post-transplantation. Graft rejection and renal failure were the greatest causes of mortality. Renal lesions which contributed to the death of some animals included renal vein thrombosis, nephrosis, and pyelonephritis. Inflammation of the lower respiratory tract (bronchitis, pneumonia, and pleuritis) was a contributory cause of death in some dogs. Cystitis and ureteritis occurred in almost half of the dogs. Prostatitis was seen in six of the 16 male dogs. Adrenal cortical atrophy, parathyroid gland hyperplasia, and bone marrow hypocellularity were seen in a majority of the dogs which survived 1 year.     

Biomechanical properties of canine cortical bone allografts: effects of preparation and storage

The effects of various preparation and storage procedures and of different storage times on structural properties of canine cortical bone allografts were determined by evaluation of the compressive load to failure of a whole diaphyseal segment, the ability of a screw to resist being pulled from a cortical segment, and the torque required to strip the threads of a screw hole in a cortical segment. Preparation and storage procedures evaluated were sterile collection and storage at -20 C; ethylene oxide sterilization and storage at room temperature (22 C); chemical sterilization (methanol and chloroform, then iodoacetic acid) and storage at -20 C; and chemical sterilization, partial decalcification, and storage at -20 C. Storage times were 1, 16, and 32 weeks for each procedure. After 1 week of storage, aseptically collected frozen bone and ethylene oxide-sterilized bone had an increase, compared with matched controls, in load to failure in compression, but pullout load or screw-stripping torque did not change. Chemically sterilized bone had not changed after 1 week of storage, whereas chemically sterilized and partially decalcified bone had a 40% to 60% decrease in compressive load to failure, pullout load, and screw-stripping torque. Chemically sterilized and partially decalcified bone remained weak after 16 and 32 weeks of storage. Significant structural alterations were not detected in aseptically collected bone after 16 or 32 weeks of storage. Ethylene oxide-sterilized bone had a reduced pullout load after 32 weeks of storage. Chemically sterilized bone had significantly reduced compressive load to failure and pullout load after 16 and 32 weeks of storage.(ABSTRACT TRUNCATED AT 250 WORDS)     

Effect of Ethylene Oxide Sterilization and Storage Conditions on Canine Cortical Bone Harvested for Banking

Two hundred seventeen cortical bones were harvested cleanly and prepared for banking for 2 months by using one of three types of packing materials, two ethylene oxide (EO) concentrations and procedures, and two storage temperatures. Bone subjected to the various treatments was compared to freshly harvested cortical bone and bone tested immediately after sterilization. Parameters evaluated were handling characteristics during preparation for and placement of a 3.5 mm cortex screw, and the percentage of weight lost as water when the bones were dried in an oven at 100 degrees C for 72 hours. Methods of sterilization, packaging material, and temperature of storage affected the handling characteristics and dehydration of the bone specimens. Twelve per cent EO at an elevated temperature and pressure, paper packaging, and room temperature storage appeared to cause the most significant changes. The use of 84% EO at room temperature and pressure, polyethylene wrapping material, and storage at -20 degrees C appeared to protect bone from dehydration. There was an increase in cracking and splitting of the bones as the percent of water loss decreased (indicating dehydration at the time of testing). Dehydration due to sterilization and storage processes may lead to difficulty in preparing bone for insertion of a bone screw and subsequently jeopardizing the stability of a repair in which such alloimplants are used.     

Morphometric Study of the Equine Navicular Bone: Age-Related Changes and Influence of Exercise

Navicular bones from the four limbs of 95 horses, classified in 9 categories, were studied. The effects of age on navicular bone morphometry and histomorphometry were estimated, after adjustment of the data to even out the effects of front and rear limbs, morphometrical type, sex, weight, and size.All the external measurements of the navicular bone decreased significantly with increasing age. From the histomorphometrical data, cortical bone volume decreased with age in most horses, whereas cancellous bone volume and, in particular, the marrow spaces increased. The increase in the cancellous bone volume could have resulted from tunnelling of the internal part of the cortex, which converted it progressively into a porous trabecular-like structure. Trabecular bone volume also decreased with age and the trabecular lattice changed dramatically to become disconnected in aged horses. These observations corresponded closely to those reported for ageing of the skeletal system in humans.However, in sporting horses, the navicular cortical bone volume increased with age and the cancellous bone volume decreased. Exercise appeared to have decreased bone resorption and increased bone formation at the endocortical junction. The cancellous bone architecture was also improved, in that the trabecular lattice and trabecular bone volume remained unchanged in aged sporting horses. Our findings confirmed that exercise may be good practice to prevent age-related bone loss.     

Vascularized ulnar bone grafts for limb-sparing surgery for the treatment of distal radial osteosarcoma

The objective of this retrospective study was to compare vascularized free or roll-in ulnar bone grafts for limb-sparing surgery in dogs with radial osteosarcoma with the cortical allograft, metal endoprosthesis, or distraction osteogenesis techniques. Overall, the ulnar graft techniques used in this study demonstrated excellent healing properties. Complications included recurrence of the tumor in 25% (2/8) of the dogs, metastasis in 50% (4/8) of the dogs, implant loosening in 37.5% (3/8) of the dogs, implant failure in 12.5% (1/8) of the dogs, and infection in 62.5% (5/8) of the dogs. Mean survival time was 29.3 mo (range, 9 to 61 mo). The mean metastasis-free interval was 33.67 mo (range, 8 to 54 mo). Tumors recurred locally in two dogs at 10 mo and 20 mo postoperatively. This study yielded similar long-term complications as other limb-sparing options (such as cortical allografts and metal endoprostheses) and allowed dogs to bear weight on the operated limb with acceptable limb function. More research is needed regarding specific healing times for ulnar vascularized grafts, time until implant removal, and the extent of radial bone that could ultimately be replaced by the ulna.