Glenohumeral joint preservation: current options for managing articular cartilage lesions in young, active patients.

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Abstract

[Indexed for MEDLINE] 11. Vet Surg. 2010 Dec;39(8):925-35. doi: 10.1111/j.1532-950X.2010.00758.x. Osteochondral autograft transfer for treatment of osteochondritis dissecans of the caudocentral humeral head in dogs. Fitzpatrick N(1), van Terheijden C, Yeadon R, Smith TJ. Author information: (1)Fitzpatrick Referrals, Eashing, UK. noelf@fitzpatrickreferrals.co.uk OBJECTIVE: To establish whether osteochondral autograft transfer (OAT) procedures for osteochondritis dissecans (OCD) of the canine caudocentral humeral head would restore articular contour, resurface osteochondral defects, and resolve lameness in dogs with OCD. STUDY DESIGN: Case series. ANIMALS: Dogs (n=14) with caudocentral humeral head OCD (16 shoulders). METHODS: After arthroscopic assessment, the humeral head was exposed by arthrotomy. The OCD lesion was debrided and OATS(™) instrumentation used for resurfacing the defect with osteochondral core grafts collected from the stifle. Recipient sockets were created to maximally resurface articular lesions. Outcomes measures included clinical, radiographic, and arthroscopic examination at 12-18 weeks and clinical examination at 12-46 months (mean, 30.8 months) postoperatively. RESULTS: Resurfacing of the humeral head was achieved in all dogs. Subjectively, lameness resolved in 9 of 16 limbs by 5-6 weeks postoperatively, and in 13 limbs by 12-18 weeks. Radiographically, all autografts were maintained. On second-look arthroscopy, the grafted section was intact, resilient on probing, satisfactorily conformed to the adjacent articular contour, and grossly appeared consistent with hyaline or fibrocartilage depending on the graft source. Of 12 limbs available for 12-46 months reevaluation, none were considered lame and mild discomfort on shoulder manipulation was recorded for only 1 joint. CONCLUSIONS: OAT procedures are technically feasible in the caudocentral aspect of the canine humeral head. Articular contour reconstruction, resurfacing of osteochondral defects, and amelioration or resolution of short-term lameness may be achieved. © Copyright 2010 by The American College of Veterinary Surgeons. DOI: 10.1111/j.1532-950X.2010.00758.x