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.     

Ethylene Oxide Sterilization of Cortical Bone for Bone Banking Technique and Results in Three Dogs and One Cat

A protocol for clean harvesting, ethylene oxide sterilization, and room temperature storage of canine and feline cortical bone for use as allografts in fracture repair is described. Three dogs and one cat received cortical allografts prepared in this manner for reconstruction of severely comminuted mid-diaphyseal femoral fractures. Function of the affected limb returned to normal, and radiographic evaluations of the allografted femurs showed union at the host-graft interface and incorporation of the allograft.     

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.     

Short-term evaluation of dorsal acetabular augmentation in 10 canine total hip replacements

OBJECTIVE: To report the use of dorsal acetabular augmentation (DAA) in canine total hip arthroplasty (THA) and to evaluate the clinical and radiographic outcome after a minimum of 1 year follow-up. STUDY DESIGN: Clinical study. ANIMALS: Nine dogs that had THA. METHODS: Ten hips requiring acetabular augmentation for optimum acetabular cup implantation for THA were evaluated retrospectively. The excised femoral head and neck was used as the corticocancellous bone graft for index THA surgeries, and the dorsal crest of the ipsilateral ilial wing was used as the bone graft in 1 dog that had a revision surgery. Clinical and radiographic follow-up examinations were performed at approximately 8 weeks and 1 year postoperatively. Long-term radiographic examinations included use of a standing dorsal acetabular rim (DAR) projection for assessment of graft-recipient boundary. Functional clinical outcome was assessed using direct patient evaluation and telephone interview. RESULTS: One dog failed to regain limb function after surgery. Suspected aseptic loosening of the acetabular cup was observed on radiographs approximately 12 weeks postoperatively. Excluding this single explantation, follow-up physical and radiographic examinations indicated good implant and graft positioning and normal function for all dogs. CONCLUSIONS: Acetabular augmentation permitted implantation of an appropriately sized acetabular cup while maintaining complete DAR coverage of the prosthesis. Nine out of 10 hips had a successful outcome with minimal radiographic and no functional abnormalities. Further follow-up is necessary to determine the long-term outcome of DAR augmentation in canine THA. CLINICAL RELEVANCE: Acetabular augmentation with an autogenous corticocancellous bone graft constructed from the femoral head and neck can provide complete DAR coverage to permit use of an appropriately sized acetabular cup in THA.     

Transplantation of the Canine Distal Ulna as a Free Vascularized Bone Graft

An autogenous free vascular bone graft of the canine distal ulna was evaluated. The vascularity of the graft was based on a musculoperiosteal sheath supplied solely by the caudal interosseous artery and vein. Four autogenous heterotopic (ulna to tibia) vascular transfers were performed. Two avascular transfers were performed to provide baseline criteria from which the success of vascularized transfers could be assessed. Clinical lameness evaluation, serial radiographs, bone scintigraphy, and sequential fluorochrome bone labeling were performed after surgery in both vascular and avascular transfers. All dogs were free of lameness in the donor limb by the 26th postoperative day. Serial radiographs revealed rapid graft incorporation and hypertrophy in all vascularized grafts and severe bone resorption in nonvascularized grafts. Histology, microangiography, and evaluation of fluorochrome bone labels were performed 90 days after surgery to determine graft viability, incorporation and temporal remodeling patterns. Microangiography and fluorochrome assessment complemented the histological findings. Based on these findings the distal ulnar bone graft was determined to be both viable and structurally adequate for selected cases of long bone reconstruction.     

Epiglottic Augmentation in the Horse

Epiglottic augmentation with injectable bovine collagen or an autogenous or allogenous auricular cartilage graft was performed in 12 horses with endoscopically and radiographically normal epiglottises. The grafting procedures were easy to perform and did not cause apparent discomfort. Cartilage graft extrusion or resorption may have occurred, but was not seen by endoscopy and lateral laryngeal radiography. Only collagen implants remained evident endoscopically, as smooth round submucosal bulges ventral to the epiglottic cartilage. Two horses with collagen implants, and all horses with cartilage autografts and allografts, were euthanatized at week 16. One horse with a collagen implant was euthanatized at week 4 and one at week 6. The epiglottis appeared thickened in three horses with collagen implants, two horses with autogenous grafts, and three horses with allogenous grafts. Pharyngeal lymphoid tissue was hyperplastic in two horses with autografts and three horses with allografts, but not in horses with collagen implants. Collagen grafts persisted as one or two smooth bulges 8 mm in diameter. Collagen incited a brisk foreign body reaction that was surrounded by a fibrous connective tissue capsule. Epiglottises of the horses with collagen implants were significantly thicker 20 mm from the tip than those of normal horses and horses with allografts. Cartilage graft incorporation was not evident grossly and was seen on microscopic examination in only one autograft. Thickening was caused by submucosal fibrosis.     

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.     

Effects of tissue antigen matching on the healing of fresh cancellous bone allografts in dogs

The radiographic and histologic healing patterns of fresh cancellous bone allografts were compared with those of fresh cancellous autografts in dogs. Two groups of allografts were studied: 1 group of littermate pairs with minor histocompatibility mismatches, and 1 group of unrelated pairs with major histocompatibility mismatches. Pairs were chosen on the basis of preoperative serologic typing and mixed lymphocyte cultural assay of lymphocyte-defined compatibility. Generally, grafts with minor mismatches and autografts achieved bony union in 6 weeks with grafted bone serving as a scaffold for new bone formation. Grafts with major mismatches were resorbed and replaced by fibrocartilage. Healing of osteotomy sites grafted with mismatched bone occurred by ingrowth of host periosteal and endosteal new bone.     

Holding Power of Threaded External Skeletal Fixation Pins in the Near and Far Cortices of Cadaveric Canine Tibiae

We compared the pin-bone interfaces at the near and far cortical penetration sites of positive-profile end-threaded external fixation pins in cadaveric canine tibiae. The holding power of the pins in each cortical surface was independently measured in 21 pin-bone sections. Scanning electron microscopy (SEM) was used to compare subjectively the microstructural appearance of the pin-bone interfaces at the near and far cortical penetration sites in eight pin-bone sections. The far cortical penetration site provided greater holding power than did the near cortical site. SEM evaluation suggested more bony microfractures and debris with less pin-bone interlock in the near cortical penetration sites than in the corresponding far cortical penetration sites. This study showed that after low-speed power insertion of positive-profile end-threaded pins in canine cadaveric tibiae, the near cortical penetration site contributes approximately 25% less to the overall holding power of the pin than does the far cortical penetration site.     

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.     

The Effect of Long-Term Bone Plate Application for Fixation of Radial Fractures in Dogs

This study was divided into two phases. In the in vitro phase, a stainless steel bone plate was applied to the cranial surface of the radius in 14 canine limbs. The effect of the presence of a bone plate on bone density analysis using radiographic photodensitometry (RP) was evaluated by comparing the density measurement of the unplated limb to the density measurement of the plated limb. The optical density of the plated bones was 12% greater than that of the unplated bones. This information was used as a correction factor for the in vivo study. In the in vivo phase, 23 dogs with radial and ulnar fractures were examined for complications associated with the long-term application of a stainless steel plate applied to the cranial surface of the radius. In 14 dogs, RP analysis was used to compare the plated limb with the normal, contralateral limb. No significant differences in radial cortical bone density existed between the plated limb and the contralateral limb after taking into account the effect a bone plate had on photodensitometry readings. There was no significant correlation between the change in radial cortical density and the duration of bone plate application, suggesting that a steady state between bone loss and bone production occurs after long-term plate fixation of the fractured canine radius. The majority (87%) of the dogs with a plate applied to the radius greater than 1 year had normal limb usage when standing, walking, or running.     

Feline model for the study of frozen osteoarticular hemijoint transplantation: qualitative and quantitative assessment of bone healing

Twenty-four outbred cats underwent massive osteoarticular allograft and control autograft transplantation, using the right distal femur with its articular cartilage, capsule, and medial collateral ligament intact. The cats were monitored clinically and radiographically for 1 year. Groups of cats (4 allografts and 2 control autografts) were euthanatized at 3-, 6-, 9-, and 12-month intervals. At necropsy, the grafts were photographed and assessed for bone healing and replacement by standard radiography, quantitative 99mTc bone scans, microradiography, and histologic examination of decalcified and nondecalcified specimens. The osteosynthesis site of the allografts usually healed by 5 months, compared with the autografts that healed by 3 months. As illustrated by quantitative bone scans, creeping appositional new bone slowly invaded and replaced the allograft bone. Seemingly, the cat can be used as an acceptable and clinically comparable model for the massive osteoarticular allografts currently being used for the reconstruction of joints damaged or destroyed by neoplasm surgery in limb-sparing procedures in human beings. This model may also be used to assess the rate and method of bone healing.     

Effects of static fixation and dynamization after interlocking femoral nailing locked with an external fixator: an experimental study in dogs

OBJECTIVE: To determine bone healing at 20 weeks, after either static fixation (SG) or after dynamization (DG) at 4 weeks in osteotomized canine femurs repaired with an interlocking nail (ILN) secured with a type I external skeletal fixator (ESF). STUDY DESIGN: Experimental study. ANIMALS: Ten adult beagle dogs. METHODS: After mid-diaphyseal femoral osteotomy, femurs in 10 dogs were repaired with an ILN secured with 4 (2 proximal, 2 distal) threaded custom pins (TP; 2.7-mm-diameter cortical screw with a 2-mm shaft attached to the screw head) to which 2 parallel connecting bars were attached in a type I ESF configuration. In 5 dogs, dynamization was performed at 4 weeks by removing the connecting bars and 2 distal screws. Limb function, range of motion of the stifle joint (ROMSJ), radiographic evidence of bone healing, and complications were studied for 20 weeks. RESULTS: Full limb function was achieved between 8 and 10 weeks in SG dogs, but a decreased ROMSJ was observed from 5 to 8 weeks. In DG dogs, full limb function occurred between 5 and 6 weeks except in 1 dog, and ROMSJ was considered normal in all dogs. Bone healing was not affected by dynamization. Average healing time for SG was 12.8 weeks, and for DG it was 13.6 weeks. Periosteal reaction at TP insertion points, osteolysis around the thread and head of TPs were observed in both groups. A windshield-wiper effect was observed at the tip of 1 ILN. CONCLUSION: ILN locked with a type I ESF can be used for fixation of mid-shaft femoral fractures. Dynamization at 4 weeks did not affect bone healing but did prevent stifle ankylosis and promoted earlier limb function. CLINICAL RELEVANCE: ILN locked with a type I ESF is seemingly a feasible method for repair of mid-shaft femoral fractures and may decrease risk of nail failure.     

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.     

Evaluation of a free vascularized medial tibial bone graft in dogs

OBJECTIVE: To develop a free vascularized tibial bone graft based on the periosteal saphenous blood supply. STUDY DESIGN: Preliminary anatomic study of medial tibial blood supply. In vivo comparison of a vascularized and avascular tibial bone graft. ANIMALS: Nine canine cadavers; 14 healthy adult dogs that weighed 25 to 32 kg. METHODS: An anatomic study of the vascular supply of the medial aspect of the tibia was performed using the Spalteholz technique. A bone graft consisting of the medial aspect of the tibia was transferred to a mandibular defect as a vascularized graft in 7 dogs and as an avascular graft in 7 dogs. Bone scans were performed to evaluate graft perfusion. Radiographic evaluation of the mandibles and tibias was performed. The dogs were killed after 60 days, five mandibles from each group were examined histologically, and two from each group were evaluated using the Spalteholz technique. RESULTS: The saphenous vascular pedicle provides vascular perfusion to the medial tibial cortex. Bone scans and radiographic evaluations were consistent with viable bone in the vascularized grafts, and nonviable bone in the avascular grafts. Histological examination revealed live, healing bone in vascular grafts and necrotic bone in avascular grafts. Spalteholz evaluation revealed many small arborizing vessels in the vascular grafts and no organized vasculature in the avascular grafts. CONCLUSIONS: The vascularized medial tibial cortical bone graft survived and proceeded to bony union in the mandibular body defect more readily than the avascular graft in this experimental model. CLINICAL RELEVANCE: A vascularized medial tibial bone graft is a suitable free graft for use in reconstructing bone defects in dogs.     

RADIOGRAPHIC EVALUATION OF TOTAL HIP REPLACEMENT IN THE DOG

The radiographic signs associated with implanted canine total hip prostheses include: (1) a 1 mm-or-less wide static lucent zone at the acetabular and femoral bone-cement interfaces, and (2) periosteal bone proliferation surrounding the stem of the femoral prosthesis. The radiographic signs associated with total hip replacement complications are dislocation of the femoral component, bone changes suggestive of infection involving the acetabular and femoral components, and loosening of the acetabular component. Arthrography is beneficial in determining the presence of a loose prosthesis with or without infection.     

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.     

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)     

Orthotopic Osteochondral Transplantation of the Canine Proximal Femur

An 18-week study was conducted to evaluate orthotopic osteochondral transplantation of the proximal femur in the dog. Eighteen dogs were divided into 3 groups of 6 each. The first group received autografts, the second received fresh allografts, and the third received grafts that had been frozen in a bone bank for 24–28 days. The grafts were fixed in position using dynamic compression plates. The grafted limbs were maintained in a sling and thus were nonfunctional and non-weight bearing throughout the 18-week study. Postoperatively the dogs were given oral tetracycline to assess osteo- cyte viability. The dogs were radiographed at 2–week intervals and 1 dog in each group was euthanatized every 3 weeks. The femurs were examined using standard histopathologic and fluorescent labeling techniques. All femoral heads were luxated by the 2nd postoperative week. The bones of all the femoral heads underwent avascular necrosis and degenerative changes were present in the transplanted cartilage by the 6th postoperative week. During the first 18 weeks following transplantation there was little radiographic and histologic difference among the 3 types of grafts regarding the nature and rate of bone healing. Based on the data obtained from techniques utilized in this study, the femoral head, neck, and articular cartilage did not survive, while the femoral diaphysis did survive the transplantation process. Different techniques may alter to some degree the results obtained.