Ch 61e Stifle OCD

Question 1

Etiology and Pathogenesis

Answer 1

• 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.

Question 2

Epidemiology

Answer 2

• fourth most common location of OCD
• male, large- and giant-breed dogs
• 5 and 9 months
• Great Dane, Labrador Retriever, Golden Retriever, and Newfoundland

Question 3

Diagnosis

Answer 3

• 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

Question 4

treatment
- non-surgical
- surgical (3)

Answer 4

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

Question 5

Treatment of Osteochondrosis Dissecans of the
Canine Stifle Using Synthetic Osteochondral
Resurfacing
Egan 2018

fitzpatrick

Answer 5

first-generation (G1)
and second-generation (G2) SOR
- Fourteen stifles (nine dogs)
- At 12 weeks, 13 of 14 stifles displayed implant stability,
with no subchondral bone changes or evidence of lucency around any implant. Eight of nine dogs achieved a good-excellent clinical outcome.

Complications included one
minor surgical site infection and one infective arthritis which required implant removal

2nd look arthrocopy: Fibrocartilage in-growth was apparent in the
small defects between the implant and the lesion margins.
There was no evidence of cartilage damage of the opposing tibial surface or to the meniscus.

showed significant progression of osteophytosis in both
G1-SOR and G2-SOR implants groups

The
exact critical defect size, intermsofdepth andwidth relative to
the total surface area, which allows erosion of neophyte
fibrocartilage against the opposing articular surface in the
stifle, is unknown. The critical defect size in the dog has been
reported to be 4 mm.

Question 6

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

Answer 6

(COR; DePuy Synthes)
retropective
Twenty stifles (18 dogs)
single graft transfer was done in six stifle joints and mosaicplasty in 14
reused it after ethylene oxide sterilization

no major and three minor postoperative complications.
At 6months, 12 of 13 dogs had
no lameness or discomfort, and four of 13 stifles had radiographic evidence of
moderate osteoarthritis.

Additional surgical procedures
were performed in the same surgical session to treat
concurrent diseases of the affected stifle in seven cases (i.e. TPLO)

Cranial cruciate ligament disease
has been reported after OAT

cartilage thickness at the lateral andmedial
aspects of the canine femoral condyle of 0.61 and 0.79mm,
respectively, ranging between 30 and 40% of the condylar
cartilage thickness, further long-term studies should be
made to evaluate early degeneration because of mechanical
overload