Ch 61e Stifle OCD Flashcards
Etiology and Pathogenesis
- characterized by aberrant development of epiphyseal cartilage in growing animals.
- most commonly located on the axial (medial) aspect of the lateral femoral condyle (96%)
- synovitis (result of exposure of subchondral bone), joint incongruity and malarticulation contribute to dysfunction and secondary osteoarthritis.
Epidemiology
- fourth most common location of OCD
- male, large- and giant-breed dogs
- 5 and 9 months
- Great Dane, Labrador Retriever, Golden Retriever, and Newfoundland
Diagnosis
- lameness, exacerbated by exercise
- joint effusion, resistance to flexion and extension of the joint with discomfort and crepitus
Radiographic
- subchondral bone defect in the axial aspect of femoral condyle,
- sclerosis of the subchondral bone
- soft tissue opacity (joint effusion, edema of the fat pad, and/or thickening of the joint capsule/synovial lining),
- mineralized free bodies (joint mice)
- osteophytosis
- commonly bilateral
treatment
- non-surgical
- surgical (3)
nonsurgical management
- only in cases where lesion associated with no clinical signs/an incidental finding
Surgical
- arthroscopically or parapatellar arthrotomy
- curettage, subchondral bone bed is debrided, Forage or micropicking to stimulate fibrcartilage
- osteochondral autograft transfer system (OATS, Arthrex)
- Synthetic Osteochondral Resurfacing
Treatment of Osteochondrosis Dissecans of the
Canine Stifle Using Synthetic Osteochondral
Resurfacing
Egan 2018
fitzpatrick
Synthetic Osteochondral Resurfacing first-generation (G1)and second (G2). 14 stifles (nine dogs)
- At 12 weeks, 13 of 14 implant stability,
- 8/9 dogs good-excellent clinical outcome (88%)
Complications: 1x minor SSI and 1x infective arthritis > implant removal
2nd look arthrocopy: Fibrocartilage in-growth at margins. No damage of the opposing tibial surface
significant progression of osteophytosis in both
critical defect size > allows erosion of neophyte fibrocartilage against the opposing articular surface is unknown. reported to be 4 mm.
A New Generation of Osteochondral Autograft
Transfer System for the Treatment of
Osteochondritis Dissecans of the Femoral
Condyle: Clinical Experience in 18 Dogs
Cinti 2022
Retrospective. 18 dogs. OATS new gen.(COR; DePuy Synthes)
single in 6 stifle joints and mosaicplasty in 14
reused it after ethylene oxide sterilization
no major and 3x minor complications.
6 months, 12/13 no lameness, 4/13 radiographic evidence of
moderate OA
Additional surgical procedures in seven cases (i.e. TPLO)
Cranial cruciate ligament disease has been reported after OAT
Different in cartilage thickness of donor to recipient site > ranging between 30 and 40% of the condylar cartilage thickness (degeneration because of mechanical overload possible?)
