Mosaicplasty in the elbow of a dog: instrumentation and evaluation of achieved joint congruency by computed tomography and computed tomographic osteoabsorptiometry.

摘要

The treatment of an elbow osteochondrosis dissecans (OCD) in a 7-month-old male Golden Retriever using osteochondral transplantation (mosaicplasty) is reported. The OCD lesion was debrided using medial arthrotomy after the animal was subjected to orthopaedic, radiologic, computed tomographic (CT) and arthroscopic tests. Two transplants, 4.5 mm in diameter, were harvested on the lateral aspect of the femoral trochlea and were transferred to the lesion. Clinical, CT and computed tomographic osteoabsorptiometry (CTOAM) tests of the transplanted bone plugs were performed after three months. It was observed that ~90% of the lesion was filled with hyaline cartilage after three months. However, it was not possible to reconstruct the shape of the joint surface properly. Three months later, a follow-up CT imaging revealed stable bone union in both transplants. The intraoperatively observed cartilage surface incongruence was also apparent on three dimensional CT reconstructions of the bony joint surface. In CTOAM, it was observed that there was a low subchondral bone density in the medial aspect of the bone plugs and was suggestive of reduced load bearing of the transplants. Lameness was not evident in the dog during examination. It is concluded that mosaicplasty enables hyaline resurfacing in OCD lesions of the elbow joint with suboptimal reconstruction of the joint congruency. The distally angled joint surface of the trochlea makes congruent implantation difficult. However, further studies are needed to confirm the long-term outcome of the procedure.