A comparison of anatomical lateral distal femoral angles obtained with four femoral axis methods in canine femora.

OBJECTIVES: To report the repeatability and reproducibility of four different anatomical proximal femoral axis (a-PFA) methods for measuring anatomical lateral distal femoral angle (a-LDFA), and to compare a-LDFA values produced by each method at three different femoral elevation angles. METHODS: Digital radiographs were obtained of seven dry canine femora at 0°, 12.5° and 25° elevations. Using image analysis software, landmarks defining four different a-PFA and the condylar axis were identified by two independent observers on two separate occasions. Corresponding a-LDFA were calculated for each femur, elevation and a-PFA. Repeatability and reproducibility parameters were calculated and compared statistically, along with the effect of technique and elevation on a-LDFA value. RESULTS: Interobserver repeatability coefficients were subjectively better for three of the a-PFA methods at 2° compared to the fourth at 3.1°. Median a-LDFA increased significantly (p ≤ 0.002) with increasing femoral elevation for all a-PFA methods, with a median increase of 3.3°. The median difference in a-LDFA between a-PFA methods yielding the highest and lowest measurements was 2.6° over all three elevations. CLINICAL SIGNIFICANCE: The combined effects of a-PFA choice, femoral elevation and measurement reproducibility may produce typical errors of ± 2.6°, which could have implications for the selection of candidates for corrective osteotomies. Clinicians need to be aware that values obtained with one method and femoral elevation may not be equivalent to values obtained with other methods or elevations.

Late gestation undernutrition can predispose for visceral adiposity by altering fat distribution patterns and increasing the preference for a high-fat diet in early postnatal life.

We have developed a sheep model to facilitate studies of the fetal programming effects of mismatched perinatal and postnatal nutrition. During the last trimester of gestation, twenty-one twin-bearing ewes were fed a normal diet fulfilling norms for energy and protein (NORM) or 50% of a normal diet (LOW). From day 3 postpartum to 6 months (around puberty) of age, one twin lamb was fed a conventional (CONV) diet and the other a high-carbohydrate-high-fat (HCHF) diet, resulting in four groups of offspring: NORM-CONV; NORMHCHF; LOW-CONV; LOW-HCHF. At 6 months of age, half of the lambs (all males and three females) were slaughtered for further examination and the other half (females only) were transferred to a moderate sheep diet until slaughtered at 24 months of age (adulthood). Maternal undernutrition during late gestation reduced the birth weight of LOW offspring (P<0·05), and its long-term effects were increased adrenal size in male lambs and adult females (P<0·05), increased neonatal appetite for fat-(P=0·004) rather than carbohydrate-rich feeds (P<0·001) and reduced deposition of subcutaneous fat in both sexes (P<0·05). Furthermore, LOW-HCHF female lambs had markedly higher visceral:subcutaneous fat ratios compared with the other groups (P<0·001). Postnatal overfeeding (HCHF) resulted in obesity (.30% fat in soft tissue) and widespread ectopic lipid deposition. In conclusion, our sheep model revealed strong pre- and postnatal impacts on growth, food preferences and fat deposition patterns. The present findings support a role for subcutaneous adipose tissue in the development of visceral adiposity, which in humans is known to precede the development of the metabolic syndrome in human adults.

Pathology and biofilm formation in a porcine model of staphylococcal osteomyelitis.

A porcine model was used to examine the potential of human and porcine Staphylococcus aureus isolates to induce haematogenously spread osteomyelitis. Pigs were inoculated in the right femoral artery with one of the following S. aureus strains: S54F9 (from a porcine lung abscess; n = 3 animals), NCTC-8325-4 (a laboratory strain of human origin; n = 3 animals) and UAMS-1 (a human osteomyelitis isolate; n = 3 animals). Two pigs were sham inoculated with saline. At 11 or 15 days post infection the animals were scanned by computed tomography before being killed and subjected to necropsy examination. Osteomyelitis lesions were present in the right hind limb of all pigs inoculated with strain S54F9 and in one pig inoculated with strain NCTC-8325-4. Microscopically, there was extensive loss of bone tissue with surrounding granulation tissue. Sequestrated bone trabeculae were intermingled with colonies of S. aureus as demonstrated immunohistochemically. By peptide nucleic acid fluorescence in situ hybridization bacterial aggregates were demonstrated to be embedded in an opaque matrix, indicating that the bacteria had formed a biofilm. Development of experimental osteomyelitis was therefore dependent on the strain of bacteria inoculated and on the formation of a biofilm.

Relationship between bone strength and dual-energy X-ray absorptiometry measurements in pigs.

Computed tomography and a 3-point bending test were performed on the metacarpal bones of adult production pigs to test the hypothesis that bone strength is strongly correlated with areal bone mineral density (BMD) in this population. The aim of the study was to subject material from adult production pigs grouped by BMD to 3-point bending, to test this hypothesis and determine any correlations. In all, 168 individual computed tomography scans and mechanical tests were performed on the collected material. For evaluation purposes, the material was divided into the categories low, medium, and high BMD (<1, 1 to 1.4, and >1.4 g/cm(2), respectively). The results showed a difference in the maximum load, in the stress at maximum load, and stiffness among each BMD group (P < 0.001) and in elastic modulus between the low BMD group and the 2 other groups (P < 0.001). A correlation between both intrinsic and extrinsic measures of bone strength and BMD was thus demonstrated. The projected change in each of the variables reported, for a 0.1 g/cm(2) alteration in BMD (within the BMD range evaluated in this study), is as follows: maximum load, 708 N; stress at maximum load, 50 N/mm(2); stiffness, 391.6 N/mm; and elastic modulus, 108 N/mm(2) (P < 0.001). The results confirm the relationship between BMD and bone strength and indicate that BMD screening can be used in fracture risk assessments in production pigs.

Dual-energy X-ray absorptiometry of the pig: Protocol development and evaluation.

As part of a prospective study in bone mineralisation in adult pigs it was necessary to establish guidelines and to define sites for bone mineral measurements. Particular requirements were that, the protocol should be suitable for a mass screening programme in both postmortem specimens and in live animals, and should deliver results of known reliability. Estimates of bone mineral content (BMC) and bone mineral density (BMD) in areas within the 4th metacarpal bone yielded coefficients of variation (CV) in the order of 7% for both regions and estimates in regions which included the entire metacarpal-phalangeal area yielded CV values in the order of 0.7% and 0.6% for BMC and BMD, respectively. A region of interest taken from the coccygeal vertebrae yielded coefficient of variation values of 3% and 2% for BMC and BMD, respectively. Accuracy of dual-energy X-ray absorptiometry (DXA) was estimated using a standard curve derived from BMC determined by ashing. There was a high correlation between mineral content determined by DXA and by ashing (R(2)=0.99, p<0.0001). The results suggest that the regions used in this study are suitable for use in large, mass screening, prospective studies.

Inclination and anteversion of collum femoris in hip dysplasia and coxarthritis.

Femoral neck angles were measured radiographically in 41 dogs examined for hip dysplasia. Steep femoral neck inclination was found to be a phenomenon of hip dysplasia and coxofemoral joint laxity. The altered biomechanics of a steep femoral neck inclination may be a factor in the pathogenesis of hip dysplasia and secondary osteoarthritis.

Articular cartilage changes following meniscal lesions. Repair and meniscectomy studied in the rabbit knee.

A well-defined, longitudinal lesion in the avascular part of the medial meniscus of the right knee was made in 30 rabbits. After 3 months, the lesion was repaired surgically in 12 rabbits, was untreated in 12 rabbits, and a meniscectomy was performed in 6 rabbits. The articular cartilage was studied macroscopically and microscopically at 3-month intervals. Cartilage changes 3 months after meniscectomy were more pronounced than after meniscal repair or than in untreated lesions. However, meniscal repair did not reverse the cartilage changes.

Resorption of intraarticular diffusible and microcolloid tracers. Rabbit studies of normal and synovitic knees.

The resorption of two radiotracers (99mtechnetium-labeled microcolloid particles to study lymphatic transport and 51 chromium-EDTA to study diffusion) from the knee joint and the subcutaneous tissue of rabbits was investigated simultaneously. In 12 rabbits, synovitis was induced in the right knee 6 weeks or 3 months before the investigation; 6 rabbits served as controls. The final number of Tc-particles in the normal knees and in the subcutaneous tissue in the three groups did not differ; but removal from the synovitic knees was increased. The final number of Cr-EDTA particles did not differ within or between groups. The initial decrease was highest in the knees with acute synovitis (P less than 0.05). The results indicate (1) that in synovial tissue lymphatic transport is of little importance, (2) that leakage through the synovial membrane increases in synovitis, and (3) that a subcutaneous depot can be used as a reference instead of injections into a normal knee.

Repair of three-month-old experimental meniscal lesions in rabbits.

Repair of three-month-old longitudinal meniscal lesions in the central avascular portion of the knee joint was investigated in 18 rabbits. Three months after a longitudinal incision was made in the avascular portion of the meniscus, no healing was observed. At that time a full-thickness radial cut from the lesion to the joint capsule, without using synovial flaps or implants, was performed in ten of the 18 rabbits. Three months later, nine of the ten menisci had healed mainly with cartilaginous tissue, although the repaired areas were different from the normal fibrocartilage both histologically and at gross inspection. Synovitis with hyperplasia of the lining cells, which was present in all cases at the time of repair, may play an important role in the healing process.

Procollagen type-III aminoterminal peptide in serum and synovial fluid of dogs with hip dysplasia and coxarthrosis.

Hip dysplasia is an affection of the coxofemoral joint that progresses until stabilization is caused by fibrosis and osteoarthritic changes. This stabilization process can be examined by clinical and radiographic methods. The capability of evaluating the procollagen concentrations in liquids, such as serum and synovial fluid, has further offered the basis for an objective biochemical evaluation of the stabilization process. Our study was performed to evaluate whether determination of procollagen concentrations was suitable for the use in practice. The procollagen type-III aminoterminal peptide (P-III-NP) concentration was measured in serum and in synovial fluid from coxofemoral joints in 20 dogs. Dogs were grouped on the basis of evidence of dysplasia and osteoarthritic changes of the hip: (1) a control group of 6 dogs without clinical or radiographic signs of hip dysplasia, and (2) dysplastic group of 14 dogs, which was further grouped with respect to the coxofemoral joint laxity, as determined by the Ortolani test. Synovial fluid concentration of P-III-NP was significantly (P less than 0.05) higher in fluid from dysplastic joints than in fluid from normal joints. Serum concentrations of P-III-NP were significantly (P less than 0.05) higher in dogs in which results of the Ortolani test were positive.

Effects of variation in systemic blood pressure on intraosseous pressure, PO2, and PCO2.

Several regulatory mechanisms have been shown to influence the intraosseous circulation. The influence of general hypovolemia on bone circulation and possible regulatory effects were investigated by recording the intraosseous pressure and PO2 and PCO2 continuously by mass spectrometry in rabbits. Hypovolemia was induced by repeated bleedings. The intraosseous and arterial pressures were found to be linearly related. The intraosseous PO2 already decreased after the first step of bleeding and decreased more than 50% of the initial value after an average blood loss of 40 ml. The intraosseous PCO2 showed an opposite pattern. The experimental PO2 vs. arterial pressure curves were similar to curves obtained by a computer simulation that assumes the blood flow to be proportional to the intraosseous pressure.

Two lymphoscintigraphic agents compared in vitro and in vivo in rabbit knees.

Two 99mTc-labelled colloidal radiopharmaceuticals [99mTc-albumin colloid (A) and 99mTc-rhenium sulfide colloid (B)] were compared in vitro in saline, plasma, and synovial fluid with regard to particle size, radiochemical purity, protein binding level, and stability at varying acidity. The purpose was to compare the two compounds in studies of lymphatic drainage from the knee joint of rabbits. Particle size for A was uniform at about 10 nm, but for B it varied between 40 and 80 nm. The radiochemical purity was lowest for B (90%-95%), with a small fraction of minor particles. B was protein bound, which was only the case for A in joint fluid from synovitic knees. A faster disappearance of A than B was observed from the knee joint, with lesser retention in the regional lymph nodes. A negligible uptake of colloid was seen in the liver. The major fraction of radioactivity absorbed from the knee was excreted in the urine. The differences between in vitro and in vivo stability are probably due to phagocytosis in the synovial membrane.

Lymphatic transport from normal and synovitic knees in rabbits.

The resorption pattern of synovial fluid through the lymphatic system from normal and synovitic knee joints in rabbits was studied with 99mtechnetium-rhenium-sulfur colloid injected intraarticularly and monitored for 14 hours with a gamma camera. On the normal side the regional lymph nodes were visualized after 1 hour and after 14 hours still 75 percent activity remained in the knee. In the synovitic knees no lymphatic transport could be detected; and the radiotracer was unstable with rapid liberation of technetium, which was excreted in the urine. This radiolysis was not found in vitro in synovitic joint fluid. The lymphatic transport from normal rabbit knees is low. We found a clear difference in lymphatic transport between normal and synovitic knee joints.

The effect of intracapsular pressure and extension of the hip on oxygenation of the juvenile femoral epiphysis. A study in the goat.

We have investigated the effect of joint tamponade and of traction in extension on the oxygen and carbon dioxide tensions in the femoral head of the immature goat, using mass spectrometry. Tamponade of 75 mmHg caused the oxygen tension in the femoral head to drop from 48 +/- 4 mmHg to 29 +/- 3 mmHg. Traction in extension further decreased the oxygen tension. Both these changes were highly significant. The partial pressure of carbon dioxide increased, but to a lesser extent and only effusion together with traction gave a statistically significant effect. Our study showed that joint effusion can produce hypoxia in the bone as a result of impaired blood flow to the femoral head. The application of traction increases this haemodynamic effect.

Improved method to estimate oxygen consumption, diffusing capacity and blood flow of synovial membrane.

The joint cartilage is depending on the oxygen diffusing from the capillaries of the synovial membrane through the synovial tissue and synovial fluid. In the present study we describe a new method to calculate the diffusing capacity (DO2), oxygen consumption (VO2) and blood flow of the synovial membrane. The principle of the method is to perfuse the joint cavity with two saline solutions, one with high and one with low oxygen and nitrogen partial pressures and to measure the oxygen and nitrogen partial pressures in the perfusate flowing out of the joint. Using a model of gas exchange between the joint and the membrane a set of equations was derived expressing the relationship between the blood flow, diffusing capacity and oxygen consumption and the oxygen and nitrogen flowing to and from the joint in the two different perfusion situations. In 12 rabbit knee joints we found a blood flow of 0.388 ml/min (SEM 0.027), VO2 of 0.495 microliters/min (SEM 0.196) and DO2 of 0.024 microliter/min/Torr SEM 0.003 (mean).

Oxygen consumption, diffusing capacity and blood flow of the synovial membrane in osteoarthritic rabbit knee joints.

In osteoarthritis the changes of the synovial membrane may seriously alter the oxygen transfer characteristics from the capillaries of the membrane to the synovial fluid and hence impede or deprive the joint cartilage of its sole source of oxygen. In the present study we have estimated the blood flow (Q), diffusing capacity (DO2) and oxygen consumption (VO2) of the synovial membrane in the chronic non effusive stage of experimental osteoarthritis. In 14 osteoarthritic knee joints we found a statistically significant increase in oxygen consumption, compared to previously reported results from normal joints, whereas the diffusing capacity and the blood flow were unchanged. The implication of this is that the partial pressure difference required to overcome the increased oxygen consumption was increased with a factor 4.3 and that the oxygenation of the joint cartilage was reduced with approx. 30 Torr.

Arterial hypoxia does not affect subchondral pressure and regional blood flow.

The influence of arterial hypoxia on bone marrow pressure, regional blood flow and oxygen and carbon dioxide tensions was investigated by simultaneous and continuous measurements in the femoral condyles of 8 rabbits. Arterial hypoxia was obtained by hypoventilation. The subchondral gas tensions and regional blood flow were measured by a previously described technique based on mass spectrometry. Arterial hypoxia caused a significant decrease in subchondral oxygen tension and an increase in subchondral carbon dioxide tension. There was no significant change in bone marrow pressure and regional blood flow.