Biomechanical comparison of orthofix pins and cortical bone screws in a canine humeral condylar fracture model.

OBJECTIVE: To compare shear stability of simulated humeral lateral condylar fractures reduced with either a self-compressing pin or cortical bone screw. STUDY DESIGN: In vitro biomechanical tests. SAMPLE POPULATION: Bilateral cadaveric canine humeri (n=18) without evidence of elbow disease. METHODS: Lateral condylar fracture was simulated by standardized osteotomy. Bone fragments were stabilized with a self-compressing pin or a cortical bone screw (2.7 or 3.5 mm) inserted in lag fashion. Specimens were mounted in a materials testing system and the condylar fragment displaced in a proximal direction until failure. Mechanical testing variables derived from load-deformation curves were compared between stabilization methods using a Student's paired t-test. RESULTS: There were no statistically significant differences for mechanical testing variables between pin and screw stabilized specimens at expected walk and trot loads. Three yield points subjectively coincided with yield of the interfragmentary interface (Y1), bone at the implant interface (Y2), and implant deformation (Y3). Displacements at Y1 were 48-156% greater for pin than screw stabilized specimens. Y2 and Y3 loads were higher for screw than pin stabilized specimens, but likely supraphysiologic for dogs convalescing after surgical repair. CONCLUSIONS: A self-compressing pin or a cortical bone screw inserted in lag fashion both provided adequate strength in applied shear to sustain expected physiologic loads through the repaired canine elbow during postoperative convalescence. CLINICAL RELEVANCE: Because self-compressing pins were easy to implant and mechanical properties were not significantly different than cortical screws at expected physiologic loads, pins should be considered for the repair of traumatic humeral condylar fractures.

Accuracy of computerized tomographic evaluation of canine radio-ulnar incongruence in vitro.

OBJECTIVE: To evaluate the accuracy of linear measurements obtained from computer tomography (CT) images of staged radio-ulnar incongruence in a canine cadaver forelimb model. STUDY DESIGN: CT evaluation of induced progressive radio-ulnar incongruence in canine cadaveric forelimbs. SAMPLE POPULATION: Eight cadaveric canine left forelimbs. PROCEDURE: A type 2 external skeletal fixator (ESF) with linear motors was attached to the radius in 8 cadaveric left canine forelimbs. Contiguous incremental and helical CT images of the proximal radio-ulnar articulation were acquired in the transverse, sagittal and dorsal planes. The radius was shortened by 1, 2, and 4 mm increments and scanning protocols were repeated at each increment. Digital caliper and CT image analysis measured the progressive change in distance between 2 marking spheres and the epiphyseal bone surfaces of the radio-ulnar articulation. Statistical analysis of measurements from incremental and helical CT acquisitions, and direct and reformatted images were compared with inter-sphere distance using Pearson product moment correlation coefficients. RESULTS: The reformatted incremental acquisition series at the mid-coronoid in the oblique plane had the highest correlation coefficient (r-value) at 0.908. The mid-coronoid in the dorsal plane had the second highest r-value (0.856). The coronoid incisure in the sagittal plane had an r-value of 0.826. The reformatted incremental acquisition series at the coronoid incisure in the oblique plane had the lowest r-value, 0.592. CONCLUSION: Measurement of radioulnar incongruence may be best performed using reformatted incremental acquisition CT in the mid-coronoid region in an oblique plane. CLINICAL RELEVANCE: Use of the technique reported in this study may enable determination of the association, if any, between radioulnar incongruence and developmental diseases of the canine elbow.

Biomechanical comparison of cortical radial graft versus ulnar transposition graft limb-sparing techniques for the distal radial site in dogs.

OBJECTIVE: To compare the biomechanical properties of radial graft (RG) versus ulnar transposition graft (UTG) limb-sparing techniques in the dog. STUDY DESIGN: Cadaveric study. ANIMALS: Six pairs of normal canine thoracic limbs. METHODS: In each pair of limbs, 1 limb was subjected to the RG technique and the other to the UTG technique. Limbs were tested in axial loading until failure. Modes of failure and biomechanical properties were compared between the 2 groups. Percent coverage of the metacarpal bone by the plate was retrospectively compared between the limbs that failed by fracture of the metacarpal bones and those that did not. RESULTS: RG limbs had significantly greater stiffness, yield load, maximum load, maximum energy, and post-yield energy. All UTG limbs failed by cranial bending of the plate. Half of the RG limbs failed by caudal bending of the plate and half by fracture of the third metacarpal bone at the distal end of the plate. Limbs with <80% plate coverage of the metacarpal bone were significantly more likely to fail by metacarpal fracture. CONCLUSIONS: The RG technique was biomechanically superior to the UTG technique under the conditions studied. At least 80% plate coverage of the metacarpal bone should be achieved. CLINICAL RELEVANCE: Exercise restriction and coaptation bandages should be considered for patients undergoing the UTG technique to minimize potential biomechanical complications.

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.

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.