Muscular morphometric study of the canine shoulder for the design of 3D-printed endoprostheses in dogs with osteosarcoma of the proximal humerus: a pilot cadaveric study by MRI.

OBJECTIVE: Osteosarcoma frequently affects the proximal humerus in dogs. In veterinary medicine, no therapeutic option for the treatment of osteosarcoma satisfactorily preserves limb function. 3D-printed personalized endoprosthesis offers a promising treatment option. Morphometric data, necessary for the design of the endoprosthesis, are currently lacking in canine patients. Our objective was to acquire the morphometric data necessary to refine the design of the endoprosthesis. ANIMAL: A single canine cadaveric thoracic limb. PROCEDURES: Sagittal proton-density, and sagittal, dorsal, and transverse T1-weighted sequences of the thoracic limb were acquired with a 1.5 Tesla Magnetic Resonance Imaging (MRI) unit. Nineteen muscles of interest were subsequently identified using medical imaging software (Mimics©) and their volume was reconstructed in 3D using computer-aided design (CATIA©). Mormophetric data were recorded for each of the 19 muscles. The same canine cadaver was then dissected to measure the same parameters. RESULTS: All muscles were successfully identified with data consistent with the dissected cadaveric data. Certain muscles were more challenging to isolate on MRI, namely the heads of the triceps brachii, superficial pectoral, and latissimus dorsi. The relative distribution of muscle volumes was similar to historical data. Muscle tissue density was not significantly affected by freezing (1.059 g/cm3). CLINICAL RELEVANCE: MRI is a useful tool to collect morphometric data but imperfect if used alone. This approach was the first attempt to validate more general morphometric data that could be used to refine the design of custom 3D-printed prostheses for limb-sparing of the proximal humerus. Further imaging studies are warranted to refine our model.

Personalized endoprostheses for the proximal humerus and scapulohumeral joint in dogs: Biomechanical study of the muscles' contributions during locomotion.

Osteosarcoma represents one of the most common bone tumours in dogs. It commonly occurs in the proximal humerus, the most affected anatomic site. Until recently, amputation or limb-sparing surgery leading to an arthrodesis coupled with chemotherapy were the only available treatments, but they often lead to complications, reduced mobility and highly impact dog's quality of life. Prototypes of both articulated and monobloc (no mobility) patient-specific endoprostheses have been designed to spare the limb afflicted with osteosarcoma of the proximal humerus. This study focuses on the biomechanical effects of endoprostheses and shoulder muscle kinematics. For each of the endoprosthesis designs, a minimal number of muscles needed to ensure stability and a certain degree of joint movement during walking is sought. A quasi-static study based on an optimization method, the minimization of the sum of maximal muscle stresses, was carried out to assess the contribution of each muscle to the shoulder function. The identification of the most important muscles and their impact on the kinematics of the prosthetic joint lead to an improvement of the endoprosthesis design relevance and implantation feasibility.