Femoral bone adaptation to unstable long-term cemented total hip arthroplasty in dogs

OBJECTIVE: To evaluate femoral adaptation after unstable long-term cemented total hip arthroplasty (cTHA) in dogs. STUDY DESIGN: Clinical study. ANIMALS: Four dogs. METHODS: Paired femurs were examined from client-owned dogs that were donated to a retrieval program after death from causes unrelated to their cTHA. Mean (+/-SEM) dog age was 10.0+/-1.5 years and implant duration was 6.0+/-1.4 years. Implanted femurs had radiographic changes associated with implant loosening and gross mechanical instability at femur retrieval. Femurs were evaluated at 3 levels relative to implant length. Cortical area and medullary area were measured at each level, and cortical porosity was assessed at each level in 4 quadrants and in 3 regions. Implanted femurs were compared with the contralateral non-implanted femurs. RESULTS: Cortical area and cortical porosity were increased at all levels in femurs with unstable implants. Implanted femurs had increased porosity in all quadrants and regions at the proximal 2 levels, and increased porosity in only the cranial quadrant and mid-cortical area at the distal level, when compared with contralateral non-implanted femurs. Corresponding medullary areas were not different. CONCLUSIONS: Significant histomorphometric changes occur in femurs after unstable cTHA. The patterns of periosteal bone formation and endosteal bone resorption support mechanisms of stress shielding and wear debris-mediated osteolysis as factors that may contribute to femoral adaptation and implant loosening. CLINICAL RELEVANCE: Despite popularity and excellent return to function with cTHA, aseptic loosening remains a serious long-term complication. Substantial net bone loss and unfavorable environment with unstable cTHA may make revision surgery less successful.     

Alterations in bone remodeling in the femur after medullary reaming and cemented hip arthroplasty in dogs.

OBJECTIVE: To determine whether medullary reaming alone, or followed by cemented hemiarthroplasty, influenced porosity, vascularity, and new bone formation in the proximal portion of the femur in dogs. ANIMALS: 12 adult mixed-breed dogs. PROCEDURE: Unilateral femoral head and neck excisions were performed, followed by femoral medullary reaming in 6 dogs and femoral medullary reaming and cemented hemiarthroplasty in 6 dogs; the contralateral femur was used as a control. All dogs were euthanatized 28 days after surgery, and femurs were harvested. Vascularity, porosity, and new bone formation were quantified for all femurs of dogs from both groups at 3 proximal-to-distal levels, 3 regions (periosteal, midcortical, and endosteal), and 4 quadrants (cranial, caudal, medial, and lateral) of the femur. RESULTS: Medullary reamed and cemented hemiarthroplasty femurs had significant increases in vascularity and porosity at all levels and in new bone formation at levels 2 and 3. Porosity was increased significantly in the periosteal region of the cemented hemiarthroplasty (9.7+/-0.7%), compared with control (2.3+/-0.2%) and medullary reamed (8.4+/-0.7%) femurs. Porosity was increased in the caudal and medial quadrants in the medullary reamed and cemented hemiarthroplasty femurs; vascularity results were similar. CONCLUSION: Increased porosity, vascularity, and new bone formation in reamed and cemented hemiarthroplasty-treated femurs supports the theory that surgical trauma associated with medullary reaming is an important factor in early cortical bone loss after hip arthroplasty. CLINICAL RELEVANCE: Femoral remodeling associated with reaming and broaching is appreciable but may be only a temporary response, whereas other factors may be responsible for chronic cortical bone loss.     

Radiographic Assessment of a Canine Uncemented Porous-Coated Anatomic Total Hip Prosthesis

Thirty uncemented porous-coated anatomic total hip prostheses in 24 dogs were evaluated radiographically at 6 months, 12 months, or 18 months after arthroplasty. All dogs were fully weight bearing and free of lameness at the time of follow-up. Radiographs were assessed for prosthetic component alignment, percentage of femoral canal fill, resorptive and formative bony changes, and changes at the implant bone interface. No evidence of infection, loosening, or failure of component fixation was seen. Settling of the acetabular component and subsidence of the femoral stem was seen early after surgery. Cortical atrophy was seen in all femurs and was the most significant bony remodeling change. Early results of clinical and radiographic evaluation of uncemented total hip arthroplasty in dogs have been encouraging.     

Vascular and Morphologic Changes in Canine Femora after Uncemented Hip Arthroplasty

The effects on femoral remodeling of medullary reaming and insertion of a porous endopros-thesis in uncemented hip arthroplasty (UHA) were measured. A unilateral hip hemiarthroplasty (HA) was performed in 12 dogs, with six dogs receiving full-sized and six dogs receiving undersized femoral endoprostheses. A prosthetic head and neck, or acetabular cup, was not implanted. A control group of six dogs underwent femoral head and neck excision (FHNE) only. All dogs were killed 4 weeks after the surgical procedure. Porosity, vascularity, and bone formation were quantified in each femur of the dogs that had been operated on and in each femur of two unoperated dogs. Full-sized did not differ from undersized HA bones in vascularity, porosity, or bone formation. Femurs in which hemiarthroplasties had been performed (full-sized and undersized) had a three-fold increase in porosity, vascularity, and bone formation compared to the contralateral and the FHNE femurs. Changes in porosity and vascularity were greatest (p < .05) at the metaphyseal level and in the medial and caudal quadrants. There was a strong correlation (R² 0.77 to 0.93, and p − .0001) between the increase in porosity and vascularity. These results support the hypothesis that medullary reaming followed by uncemented prosthetic stem implantation contribute to remodeling of the proximal portion of the femur after UHA.     

Time course of changes in growth factor mRNA levels in muscle of steroid-implanted and nonimplanted steers

We used a muscle biopsy technique in conjunction with real-time PCR analysis to examine the time course of changes in muscle IGF-I, IGFBP-3, myostatin, and hepatocyte growth factor (HGF) mRNA in the longissimus muscles of Revalor-S-implanted and nonimplanted steers on d 0, 7, 12, and 26 after implantation (nine steers/treatment group). Administration of a Revalor-S implant increased (P < 0.01) ADG and improved (P < 0.05) feed efficiency, 36 and 34%, respectively, compared with steers that received no implant during the 26-d trial. Daily dry matter intake did not differ (P > 0.15) between nonimplanted and implanted steers. Steers receiving the Revalor-S implant had increased (P < 0.001) circulating IGF-I concentrations compared with nonimplanted steers. The longissimus muscles of steers receiving the Revalor-S implant contained increased (P < 0.001) IGF-I mRNA levels compared with longissimus muscles of nonimplanted steers over the 26-d duration of the study. Longissimus muscle IGF-I mRNA levels in implanted steers were increased (P < 0.003) relative to d-0 concentrations on d 7 and 12 (101% and 128%, respectively), and byd 26, longissimus muscle mRNA levels were more than three times (P < 0.0001) those in the longissimus muscles of the same steers on d 0. There was no treatment effect on the level of IGFBP-3, myostatin, or HGF mRNA in the longissimus muscle at any time point; however, levels of IGFBP-3, myostatin, and HGF mRNA increased with time on feed. Based on current and previous studies, we hypothesize that the increased IGF-I level in muscle of implanted steers by d 7 of implantation stimulates satellite cell proliferation and maintains a high number of proliferating satellite cells at a point in the growth curve where satellite cell numbers and activity are normally dropping off. This would prolong the period of rapid muscle growth, resulting in the observed increased rate and efficiency of muscle deposition in implanted steers.     

Growth factor messenger RNA levels in muscle and liver of steroid-implanted and nonimplanted steers

Ribonuclease protection assays were used to measure steady-state semimembranosus muscle and/or hepatic levels of IGF-I, IGFBP-3, IGFBP-5, hepatocyte growth factor (HGF), and myostatin messenger RNA (mRNA) in steers implanted from 32 to 38 d with Revalor-S, a combined trenbolone acetate and estradiol implant. Insulin-like growth factor-ImRNA levels were 69% higher (P < 0.01, n = 7) in the livers of implanted steers than in the livers of nonimplanted steers. Similarly, IGF-I mRNA levels were 50% higher (P < 0.05, n = 7) in the semimembranosus muscles of implanted steers than in the same muscles from nonimplanted steers. Hepatic IGFBP-3 mRNA levels were 24% higher (P < 0.07, n = 7) in implanted steers than in nonimplanted steers. Hepatic HGF and IGFBP-5 mRNA levels did not differ between implanted and nonimplanted steers. Similarly, muscle IGFBP-3, IGFBP-5, HGF, and myostatin mRNA levels were not affected by treatment. Previous data from these same steers have shown that circulating IGF-I and IGFBP-3 concentrations were 30 to 40% higher (P < 0.01, n = 7) in implanted steers than in nonimplanted, control steers. Additionally, the number of actively proliferating satellite cells that could be isolated from the semimembranosus muscle was 45% higher (P < 0.01, n = 7) for implanted steers than for nonimplanted steers. Viewed together, these data suggest that increased muscle IGF-I levels stimulate increased satellite cell proliferation, resulting in the increased muscle growth observed in Revalor-S implanted steers.     

Effects of flax supplementation and a combined trenbolone acetate and estradiol implant on circulating insulin-like growth factor-I and muscle insulin-like growth factor-I messenger RNA levels in beef cattle

We evaluated effects of a 5% (dry matter basis) ground flaxseed supplement (flax) and a trenbolone acetate and estradiol-17beta implant, Revalor-S, on circulating IGF-I and muscle IGF-I messenger RNA (mRNA). Sixteen crossbred yearling steers (initial BW = 397 kg) were assigned randomly to one of four treatments: 1) flax/implant; 2) nonflax/implant; 3) flax/nonimplant; and 4) nonflax/nonimplant. Serum was harvested from blood collected on d 0 (before implant or flax addition), 14, and 28, and used in subsequent analyses of circulating IGF-I. Biopsy samples (0.5 g) were obtained from the longissimus muscle on d 0, 14, and 28. Total RNA was isolated from the muscle samples, and real-time quantitative-PCR was used to assess relative differences in IGF-I mRNA. Flax supplementation had no effect (P > 0.10) on circulating IGF-I concentrations. Following implantation, sera from implanted steers had 52 and 84% greater (P < 0.05) IGF-I concentrations than sera from nonimplanted steers on d 14 and 28, respectively. On d 28, local muscle IGF-I mRNA levels increased 2.4-fold (P < 0.01) in biopsy samples obtained from implanted compared with nonimplanted steers. Muscle biopsy samples from nonflax cattle had 4.4-fold higher (P < 0.01) levels of IGF-I mRNA than those from flax cattle on d 28. To determine whether a component of flax, alpha-linolenic acid (alphaLA), was directly responsible for IGF-I mRNA down-regulation, we incubated primary cultures of bovine satellite cells, from implanted and nonimplanted steers, in two concentrations of alphaLA (10 nM and 1 microM). An implant x dose interaction (P < 0.05) was observed for IGF-I mRNA concentrations in bovine satellite cells cultured for 72 h with alphaLA. Satellite cells from nonimplanted steers had similar (P > 0.10) IGF-I mRNA concentration regardless of the level of alphaLA exposure; however, satellite cells from implanted steers exposed to 10 nM and 1 microM alphaLA had 2.5- and 2.0-fold greater IGF-I mRNA levels, respectively, than cells from implanted steers that were not exposed to alphaLA (P < 0.05). Administration of a Revalor-S implant increased circulating IGF-I and local muscle IGF-I mRNA concentrations in finishing cattle. However, muscle IGF-I mRNA levels were decreased by flax supplementation. Muscle cell culture experiments suggested that alphaLA was not responsible for the IGF-I mRNA down-regulation.     

Effect of surgical technique and use of a rigid centralizing device on stem positioning and geometric reconstruction in the sagittal plane during total hip replacement in canine cadavers

OBJECTIVE: To determine the effect of surgical technique and use of a rigid centralizing device on stem positioning and geometric reconstruction in the sagittal plane during total hip replacement in dogs. SAMPLE POPULATION: Bilateral femurs from 8 adult mixed-breed canine cadavers. PROCEDURE: Femurs were prepared for femoral stem implantation, using 4 variations in technique. Proximal femoral reconstruction and femoral stem positioning were evaluated on radiographs. RESULTS: Implants evaluated in this study accurately reconstructed displacement of the femoral head of the intact canine femur in the sagittal plane. Centralization of the distal aspect of the stem was optimized by use of an undersized femoral stem. Ostectomy at the level of the lesser trochanter resulted in the smallest diaphysis-to-implant angle. Anteversion and retroversion of implants significantly decreased the distance between the distal tip of the implant and the adjacent cortex, compared with normoversion. The centralizing device significantly increased the minimum distance between the distal tip of the implant and adjacent cortex but did not improve the odds of actually centralizing the tip of the implant. CONCLUSIONS AND CLINICAL RELEVANCE: Malpositioning of implants in the sagittal plane may be minimized through ostectomy at the lesser trochanter and use of an undersized implant positioned in normoversion. Use of a polymethylmethacrylate centralizing device will help eliminate contact between the implant tip and adjacent cortex. Implantation of an undersized femoral component, avoidance of substantial anteversion or retroversion, and use of a rigid centralizing device are recommended when using the prosthesis described-for total hip replacement of dogs.     

Comparison of the fit and geometry of reconstruction of femoral components of four cemented canine total hip replacement implants

OBJECTIVE: To compare fit and geometry of reconstruction of femoral components of 4 canine cemented total hip replacement implants and determine which implants are most compatible with current principles of cemented arthroplasty. SAMPLE POPULATION: Paired femurs from 16 adult mixed-breed dogs. PROCEDURE: Femurs were prepared for femoral stem implantation of either the Bardet, BioMedtrix, Mathys, or Richards II implant. Mediolateral and craniocaudal radiographs were obtained with femoral components in situ. Cross-sectional analysis of implant fit was performed on transected cemented specimens. Computer-aided analyses of digitized images were performed. RESULTS: The Bardet and Richards II implants reconstructed the original femoral head position significantly better than the other 2 implants. None of the implants allowed neutralization of the implant axis in the sagittal plane or were routinely centralized in the femoral canal.The Bardet implant had the smallest minimum distal tip offset in the sagittal plane. Greatest tip to cortex distance was provided by the Richards II implant in the transverse plane and the Mathys implant in the sagittal plane. The thinnest cement mantle regions for all implants were in the central longitudinal third of the femoral stem. CONCLUSIONS AND CLINICAL RELEVANCE: The Bardet and BioMedtrix implants had stem design characteristics that were most compatible with principles of cemented stem fixation. None of the implants completely satisfied the theoretically optimal conditions of centralization and neutralization of the femoral stem. Innovative design modifications, therefore, may be needed if these conditions are important to the long-term success of canine total hip replacement.     

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.     

Effect of pre- and postweaning zeranol implant on steer calf performance

One hundred ninety-five steer calves were assigned to five zeranol implant treatment (trial 1). Treatments were no implants (0000), two implants during the finishing period (00XX), three implants during growing and finishing periods (0XXX), one implant at 1 to 2 mo of age during the suckling period and two during the finishing period (X0XX) or four implants (XXXX). The growing period implant was administered at weaning. Weaning weights (211 vs 208 kg) of implanted and nonimplanted suckling calves were not different (P greater than .05). Calves implanted at weaning, before shipment to the feedlot, had greater (P less than .05) weight loss in shipment than nonimplanted calves. In the feedlot, finishing-period daily gains of steers implanted in the growing and finishing period (0XXX) were greater (P less than .05) than gains of steers that had received a suckling period implant (X0XX and XXXX). Nonimplanted steer gains were less (P less than .05) than gains of steers from the other four treatment groups. Postweaning daily gains and final weights were 1.18 and 517 (0000), 1.26 and 533 (00XX), 1.32 and 551 (0XXX), 1.26 and 540 (X0XX) and 1.25 and 533 kg (XXXX), respectively. Gains and final weights of nonimplanted steers were less (P less than .05) than gains of steers implanted only in the feedlot growing and finishing periods (0XXX). In a second trial, 82 steers were assigned either to a 0XXX or XXXX implant scheme. Weaning weights were 11 kg greater (P less than .05) for the implanted steers.(ABSTRACT TRUNCATED AT 250 WORDS)     

Effects of Plate Luting on Cortical Vascularity and Development of Cortical Porosity in Canine Femurs

A 4.5 mm, six hole dynamic compression plate was applied to the lateral aspect of one femur in 16 dogs. The plate was luted with polymethylmethacrylate (PMMA) in eight dogs. Four dogs each from the luted and nonluted groups were euthanatized at weeks 5 and 10. Plated femurs were sectioned and processed for microradiography, microangiography, and correlated histology. At week 5, there was decreased vascularity in the outer one third of the cortex beneath luted plates and normal to increased vascularity in the inner two thirds of the cortex. Increased cortical porosity and a decreased percentage of osteocyte-filled lacunae were found in the cortex beneath luted plates at week 5. At week 10, vascularity was increased throughout the cortex under luted plates. Under nonluted plates, there was normal to increased vascularity at both time periods. Luting a bone plate with PMMA decreased vascularity to the outer one third of the cortex beneath the plate at week 5, and resulted in accelerated resorption of bone.     

The Effects of Cerclage Wiring on the Immature Canine Diaphysis A Biomechanical Analysis

When cerclage wiring is used in skeletally immature dogs, the wires become imbedded in the cortical bone due to radial appositional bone growth.
Six groups of five dogs each received one or two extraperiosteal cerclage wires at the mid-diaphysis of the left femur at the age of five months. Ten dogs were killed immediately, ten dogs were killed at eight weeks postoperatively, and ten at twelve weeks. Both femora from each animal were collected and subjected to torsional loading to failure within.5 seconds. The maximum torque, shear stress, energy absorption, angular deformation, and torsional stiffness were determined and subjected to í test analysis.
Application of the wires predictably caused an increase in weight and cortical bone thickening at the implant site, which was primarily due to endosteal bone deposition in the 8-and 12-week groups. The 8-and 12-week wired bones were stiffer and failed at a lower angular deformation than did their corresponding control femurs, but the zero-time bones did not show this tendency. Significantly less shear stress accumulation and energy absorption at failure were present In the 8-and 12-week implants, but no difference was seen in the zero-time femora. The 8-week groups showed a greater difference between the wired and control femurs than did the 12-week groups. No significant difference was found between one-and two-wire implants in the study.
The results indicate that confinement of dogs with clinically wired fractures of immature canine femurs should extend past eight weeks.     

The interfacial strength in sputtering-hydroxyapatite-coating implants with arc-deposited surface

Titanium columns (Ti-6A1-4V) were treated with arc-deposition to roughen the surface enough to anchor the bone, and then coated with hydroxyapatite (HA) at a thickness of 5 micro m by the sputtering technique. Columns were implanted into dog femurs, and fixation of columns to bone due to bone-ingrowth was assessed histologically and with the push-out test. The HA-coated columns were inserted in the shafts of the right femurs of 2 dogs. As a control, columns that were only arc-deposited (non-coated columns) were inserted into the left femurs. The interfacial strength was higher for the HA-coated columns than for the non-coated columns. Coating a rough surface with an HA layer using a sputtering technique reinforces interfacial strength between bone and implants.     

Cemented Total Knee Replacement in 24 Dogs: Surgical Technique, Clinical Results, and Complications

Objective— To characterize the performance of cemented total knee replacement (TKR) in dogs.
Study Design— Preclinical research study.
Animals— Skeletally mature, male Hounds (25–30 kg; n=24) with no preexisting joint pathology.
Methods— Dogs had unilateral cemented TKR and were evaluated at 6, 12, 26, or 52 weeks (6 dogs/time point) by radiography, bone density analysis, visual gait assessment, and direct measurement of thigh circumference and stifle joint range of motion as indicators of functional recovery. At study end, the stability of the cemented tibial component was determined by destructive mechanical testing.
Results— Joint stability was excellent in 16 dogs (67%) and good in 8 dogs. None of the tibial components had evidence of migration or periprosthetic osteolysis whereas 1 femoral component was loose at 52 weeks. There was an early and significant decrease in tibial bone density, likely because of disuse of the operated limb. Dogs returned to full activity by 12 weeks. The tibial cement–bone interface maintained its strength over 52 weeks.
Conclusions— Cement provides stable fixation of the tibial component in canine TKR.
Clinical Relevance— Cemented TKR yields adequate clinical function and stifle joint excursion in the dog. Clinical studies are needed to determine the long-term fate of cemented TKR implants, to assess the influence of implant design on implant fixation and wear, and to obtain objective functional data.     

Effects of an Estradiol Implant on Locoweed Consumption,Toxicity, and Recovery in Growing Beef Steers

Two experiments were conducted to determine effects of an estradiol implant (Compudose®) on locoweed consumption and toxicity in growing steers. In Exp. 1, 16 crossbred steers (185.3 ± 6.1 kg) were randomly assigned to two replicated treatments and received either an estradiol implant or no implant. Steers were assigned to one of four pastures and were rotated through all pastures, which differed in locoweed distribution, to allow equal access. Bite counts were recorded twice daily at 0600 and 1700 h during a period when steers were likely to consume locoweed. For bite counts, steers were observed for 5 min each, starting at 0600 and at 1700 h, and the number of bites taken of cool- and warm-season grasses, forbs, and locoweed were recorded. Blood was collected on d 0, 7, 28, 35, 63, and 119, and individual BW was recorded on d 0, 35, 63, and 119. Proportion of bites of locoweed consumed by implanted vs nonimplanted steers did not differ (P>0.10). Likewise, ADG, serum alkaline phosphatase activity, and thyroxine concentrations did not differ (P>0.10) between implanted and nonimplanted steers. In Exp. 2, 20 crossbred steers (212.3 ± 6.1 kg) were divided into four groups and individually fed in a 2 × 2 factorial arrangement of treatments. Treatments included: 1) estradiol implant + locoweed, 2) implant, no locoweed, 3) no implant + locoweed, and 4) no implant, no locoweed. Steers were implanted at d 0 and fed either a ground forage diet containing 80% sudangrass hay and 20% locoweed, or a diet of 100% sudangrass hay. Implanted steers had improved ADG vs nonimplanted steers (P<0.10) through 63 d on trial, but no differences were observed in steers fed locoweed vs sudangrass hay diets (P>0.90; locoweed x implant, P>0.10). Alkaline phosphatase activity was greater (P<0.05) for steers fed locoweed vs those not receiving locoweed on d 7, 14, and 21, whereas, thyroxine concentration was lower (P<0.06) in steers fed locoweed than those not fed locoweed on d 14 and 21. Estradiol concentrations were greater in implanted steers vs those not implanted (P<0.05). These results suggest no effect of an estrogen implant on locoweed consumption or on severity of locoweed toxicity by beef steers.     

Retrospective analysis of canine miniature total hip prostheses

OBJECTIVE: To determine the practicality and clinical outcome of miniature total hip replacement (THR) in dogs. STUDY DESIGN: Retrospective study. Sample Population- Seventeen client-owned dogs that had miniature THR. METHODS: Patient data surveyed included signalment, body weight, diagnosis, implant size, surgical technique, and intraoperative and postoperative complications. Radiographic evaluation included angle of lateral opening of the acetabular component, implant positioning, cement mantle quality, and femoral displacement measurement and ratio. Client questionnaire and orthopedic examination were used to obtain long-term follow-up information. RESULTS: Miniature THR was performed to address hip dysplasia and secondary osteoarthritis. In 1 dog, a staged bilateral procedure was performed. Mean body weight was 19 kg (range, 12 to 25 kg). Penetration or fissure of the femoral cortex was the most common intraoperative complication and occurred in 3 dogs. In 3 dogs, there was excessive coxofemoral laxity after reduction of the prosthesis. This instability was addressed specifically in 2 dogs by capsulorrhaphy or capsular prosthesis. Postoperative convalescent complications (craniodorsal luxation, 2 dogs; acetabular cup displacement, 1 dog) were related to surgical errors. Aseptic loosening of the femoral implant was diagnosed in 1 dog at 18 months. Mean follow-up time was 17 months (range, 4 to 42 months). Fifteen of 18 (83%) miniature THRs had good or excellent outcomes. CONCLUSIONS: Miniature THR should be considered a satisfactory alternative to femoral head and neck ostectomy in medium-size dogs affected by hip dysplasia and secondary osteoarthritis. The population of medium-size dogs that might derive more benefit from THR than FHO has yet to be defined. CLINICAL RELEVANCE: Miniature THR is a viable treatment option in medium-size dogs with hip dysplasia.     

The function of the pituitary-testicular axis in dogs prior to and following surgical or chemical castration with the GnRH-agonist deslorelin

Chemical castration, that is the reduction of circulating testosterone concentrations to castrate levels by administration of a GnRH-agonist implant, is a popular alternative to surgical castration in male dogs. Detailed information concerning the pituitary-testicular axis following administration of a GnRH-agonist implant is still scarce. Therefore, GnRH-stimulation tests were performed in male dogs, prior to and after surgical and chemical castration. This approach also allowed us to determine plasma concentrations of testosterone and oestradiol in intact male dogs for future reference and to directly compare the effects of surgical and chemical castration on the pituitary-testicular axis. In intact male dogs (n = 42) of different breeds GnRH administration induced increased plasma LH, FSH, oestradiol and testosterone concentrations. After surgical castration basal and GnRH-induced plasma FSH and LH concentrations increased pronouncedly. Additionally, basal and GnRH-induced plasma oestradiol and testosterone concentrations decreased after surgical castration. After chemical castration, with a slow-release implant containing the GnRH-agonist deslorelin, plasma LH and FSH concentrations were lower than prior to castration and lower compared with the same interval after surgical castration. Consequently, plasma oestradiol and testosterone concentrations were lowered to values similar to those after surgical castration. GnRH administration to the chemically castrated male dogs induced a significant increase in the plasma concentrations of LH, but not of FSH. In conclusion, after administration of the deslorelin implant, the plasma concentrations of oestradiol and testosterone did not differ significantly from the surgically castrated animals. After GnRH-stimulation, none of the dogs went to pre-treatment testosterone levels. However, at the moment of assessment at 4,4 months (mean 133 days ± SEM 4 days), the pituitary gonadotrophs were responsive to GnRH in implanted dogs. The increase of LH, but not of FSH, following GnRH administration indicates a differential regulation of the release of these gonadotrophins, which needs to be considered when GnRH-stimulation tests are performed in implanted dogs.     

Clinical application of recombinant human bone morphogenetic protein-2 in 4 dogs

OBJECTIVE: To describe outcome in dogs with insufficient bone healing treated with recombinant human bone morphogenetic protein-2 (rhBMP-2). STUDY DESIGN: Retrospective study. ANIMALS: Four dogs clinically affected with delayed union or nonunion bone healing. METHODS: Medical records were reviewed for signalment, clinical problem, treatment, and outcome. RESULTS: Four dogs that had delayed- or nonunion of bone fracture, osteotomy, or arthrodesis were treated with either minimally invasive, fluoroscopically guided, percutaneous administration or direct surgical application of rhBMP-2. Doses used ranged from 0.2 to 1.6 mg of rhBMP-2. In 3 dogs, a calcium phosphate matrix (CPM) carrier was used whereas in 1 dog commercially prepared rhBMP-2 impregnated in an absorbable collagen sponge (INFUSE Bone Graft) was used. This latter dog had osteomyelitis associated with implant infection before rhBMP-2 administration. Rapid radiographic union was noted in all dogs with excellent long-term outcome. Adverse effects were minimal and included transient worsening of lameness after percutaneous administration of rhBMP-2 in 2 dogs. CONCLUSIONS: rhBMP-2 stimulated rapid bone formation at delayed- or nonunion sites resulting in radiographic bone union with minimal adverse effects and excellent long-term outcome in 4 dogs. CLINICAL RELEVANCE: Direct intraoperative administration or fluoroscopically guided, minimally invasive delivery of rhBMP-2 may be an effective treatment modality for bone delayed- or nonunions and could potentially be used to stimulate new bone production in a variety of orthopedic surgical conditions in dogs.