Bioengineering an osteoinductive treatment for bone healing disorders: a small animal case series

The aim of this article was to study clinical and radiographic outcomes following treatment of bone healing disorders with a novel osteoinductive system that utilizes poly (ethyl acrylate), fibronectin and an ultra-low concentration of recombinant human bone morphogenetic protein-2. A case series of nine dogs and two cats were treated, and clinical records and radiographs were reviewed. Radiographs were scored by two blinded observers using the modified Radiographic Union Score for Tibial Fractures. Long-term follow-up was obtained using the Canine Orthopaedic Index and Feline Musculoskeletal Pain Index. Follow-up data were available for 11 treatments (10 cases). Complications: three minor, three major, one catastrophic (non-union requiring amputation). Lameness median 320 (range: 42–1,082) days postoperatively: ‘sound’ (three cases), ‘subtle’ (two), ‘mild’ (three), ‘moderate’ (one), and ‘non-weightbearing’ (one). The attending clinician judged 9 of 11 treatments achieved radiographic union; modified Radiographic Union Score for Tibial Fractures observers 1 and 2 agreed with the clinician in 8/9 and 5/9 treatments respectively. Long-term Canine Orthopaedic Index scores for five dogs median 650 (range: 544–1,724) days postoperatively: 15/64 (median) for four dogs with acceptable outcomes, 30/64 in one dog with a poor outcome. Feline Musculoskeletal Pain Index scores for two cats 433 and 751 days postoperatively: 48/60 and 60/60. Eight of 10 cases were sound or showed subtle or mild lameness in the short- or long-term, and radiographic union occurred in the majority of treatments

A Comparison of Owner-Assessed Long-Term Outcome of Arthroscopic Intervention versus Conservative Managemento f Dogs with Medial Coronoid Process Disease.

The purpose of this study was to compare the long-term outcome of dogs with medial coronoid process disease (MCPD) treated with arthroscopic intervention versus conservative management.  Medical records of dogs with MCPD treated by arthroscopic intervention or conservative management over an 8-year period were retrospectively reviewed. Long-term outcome (>12 months) was assessed via owner questionnaire including Liverpool Osteoarthritis in Dogs (LOAD) scores and Canine Brief Pain Inventory scores.  Data from 67 clinically affected elbow joints (67 dogs) diagnosed with MCPD on computed tomography were included. Forty-four dogs underwent arthroscopic intervention and 23 dogs were treated with conservative management. The median LOAD and Pain Severity Score (PSS) for dogs in the arthroscopic intervention group compared with the conservatively managed group were not significantly different (p = 0.066 and p = 0.10, respectively). The median Pain Interference Score (PIS) was significantly higher in the arthroscopic intervention group versus the conservative management group (p = 0.028). There was no significant difference after controlling for age. For LOAD, PSS and PIS, older age at diagnosis was all significantly associated with higher scores (p = 0.048, p = 0.026 and p = 0.046, respectively) and older age at time of questionnaire completion showed a stronger association with the scores (p ≤0.001 for all).  Arthroscopic intervention showed no long-term benefit over conservative management for dogs with MCPD

Successful total hip arthroplasty in a miniature horse.

ObjectiveTo describe the surgical treatment, postoperative management, and outcome of a miniature horse undergoing total hip arthroplasty (THA).Study designCase report.AnimalsA 4-year-old miniature horse stallion weighing 85 kg.MethodsThe horse presented with left coxofemoral luxation of ~6 weeks duration. Computed tomography confirmed craniodorsal luxation with marked degenerative changes to the femoral head. The horse underwent THA using cementless press fit implants, including an interlocking lateral bolt for the femoral stem.ResultsThe horse recovered well from anesthesia but suffered a coma-like episode after returning to a stable. Following treatment of presumed hypovolemia, the horse regained normal mentation and was discharged 24 days after surgery. At reassessment 12 weeks postoperatively, the horse was 2/10 left hind limb lameness at trot with good healing of the surgery site. Five months postoperatively mild (1/10) lameness remained at trot but the horse was able to canter normally on both reins. The horse has since been managed normally with no veterinary treatment required for 32 months postoperatively.ConclusionTotal hip arthroplasty is possible in miniature horses weighing up to 85 kg and can result in a good long-term outcome