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Cylindrical Press-Fit Osteochondral Allografts for Resurfacing the Equine Metatarsophalangeal Joint

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Abstract:

Objective

To investigate the feasibility of resurfacing the equine fetlock joint using cylindrical, orthotopic, press-fit, osteochondral allografts. Study Design

Experimental study. Animals

Ten mature, mixed-breed horses. Methods

Cylindrical, osteochondral grafts (6.5-mm diameter) were harvested aseptically from cadaveric equine metatarsophalangeal joints. Allografts were transplanted into 6 horses; 4 horses were sham operated. The surgical approach involved creation of a bone block at the origin of the medial collateral ligament and luxation of the metatarsophalangeal joint. Grafts were placed into the medial and lateral metatarsal condyles. Radiographs were taken at 8 and 25 weeks, and lameness was evaluated at 25 weeks. Horses were killed at 25 weeks. Analyses included gross evaluation, microradiography, paravital staining, light microscopy, and cartilage biochemistry. Results

No complications occurred that could be attributed to the surgical procedure. Graft congruency with the surrounding articular cartilage was fair to excellent. Two horses were sound at 25 weeks. Most grafts had more than 90% articular cartilage coverage, and histologic and microradiographic analysis revealed good graft incorporation and articular cartilage survival. Sulphated glycosaminoglycan concentration was decreased in grafted tissue. Conclusions

We attribute the viability of osteochondral allografts in the equine fetlock to adequate congruency, stable graft fixation, and the use of orthotopic tissue. Host response to the allograft bone tissue did not affect cartilage viability. Clinical Relevance

Before clinical use, improvements to instrumentation are required that would decrease damage to grafts and minimize technique-associated incongruencies of the articular surface at the time of grafting. Larger grafts would also likely be required to resurface a greater surface area.

©Copyright 2003 by The American College of Veterinary Surgeons

Document Type: Research Article

DOI: http://dx.doi.org/10.1053/jvet.2003.50032

Affiliations: From the Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada, and the Department of Clinical Studies, University of Pennsylvania, Kennett Square, PA.

Publication date: May 1, 2003

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