Proximal Interphalangeal Arthrodesis in Horses: A Meta-Analysis of Retrospective Studies.

The aim of this study was to determine the clinical outcomes reported in retrospective studies of proximal interphalangeal arthrodesis (PIA) in horses through a meta-analysis of retrospective studies. CAB Abstracts, PubMed, ScienceDirect, Web of Science, and Scopus were searched. The primary outcomes included survival and surgical site infection (SSI) rates, return to activities, and time of hospital stay and casting. Subgroups were formed for fractures and other conditions. Meta-analyses were performed with fixed and random effects models to estimate proportions, mean values, and effect size by odds ratio (OR) with 95% confidence intervals (CI). Twenty-one full articles were included, totaling 458 horses. The survival rate was 90% (95% CI [86%-93%]), return to activities was 65% (95% CI [61%-70%]), and SSI was 12% (95% CI [8%-16%]). The mean hospitalization was 25 days (95% CI [18-35 days]) and time of casting was 29 days (95% CI [21-42 days]). The OR of survival (P = .769), return to activities (P = .576), and SSI (P = .467) were similar between cases of fractures and other conditions. PIA is an efficient and safe method to treat injuries in the pastern region, with a high survival rate and low SSI. However, the rate of return to soundness for intended use was modest, being potentially lower for fracture cases. Thus, investigations of more efficient interventions are needed to improve this outcome.

Treatment of a Mandibular Diastemal Fracture Using Locking Compression Plate and Cerclage Wire in a Mare.

This report describes the combination of two surgical fracture repair techniques and the postoperative management of a mandibular diastemal fracture in a two-year-old mare. The mare was referred to a veterinary hospital with a laceration over the body of the right mandible. Radiographic assessment revealed two mesial fracture lines involving the second premolar tooth and a ventrally displaced bone fragment. The mare was treated under general anesthesia and the fracture was corrected using open reduction and plate fixation. A 3.5 mm narrow 15-hole locking compression plate with seven locking screws were used in a bridge form. Cerclage wire was also used to anchor the incisor teeth to the second and third premolar teeth. The cerclage wire and incisor teeth were covered with polymethylmethacrylate to prevent implant failure and avoid injury to the oral mucosa. Implants were removed 55 days after surgery and the mare was discharged from hospital five days later. The mare returned for cerclage wire removal after 90 days and was allowed to resume exercise thereafter. The combination of two surgical techniques, proper implant choice and appropriate postoperative management, including use of pelleted feed, contributed to successful bone healing and return to function.

Locking compression plate fixation of critical-sized bone defects in sheep. Development of a model for veterinary bone tissue engineering.

PURPOSE: To develop a segmental tibial bone defect model for tissue engineering studies in veterinary orthopedics using single locking compression plate (LCP) fixation and cast immobilization. METHODS: A 3-cm bone defect was created in the right tibia of 18 adult Suffolk sheep. A 10-hole, 4.5-mm LCP was applied to the dorsomedial aspect of the bone. Four locking screws were inserted into the proximal and three into the distal bone fragment. Operated limbs were immobilized with casts. Animals were submitted to stall rest, but were allowed to bear weight on the operated limb. During the recovery period, animals were checked daily for physiological parameters, behavior and lameness. Follow-up radiographs were taken monthly. RESULTS: Surgical procedures and postoperative recovery were uneventful. Animals adapted quickly to casts and were able to bear weight on the operated limb with no signs of discomfort or distress. No clinical or radiographic complications were detected over a 90-day follow-up period. CONCLUSIONS: Surgical creation of tibial segmental bone defects followed by fixation with single LCP and cast immobilization was deemed a feasible and appropriate model for veterinary orthopedic research in tissue engineering.

In vitro evaluation of hydroxyapatite, chitosan, and carbon nanotube composite biomaterial to support bone healing / Avaliação in vitro do biomaterial compósito à base de hidroxiapatita, quitosana e nanotubo de carbono como adjuvante no reparo ósseo

Hydroxyapatite, chitosan, and carbon nanotube composite biomaterial were developed to improve bone healing. Previous studies suggested that a combination of biomaterials and mesenchymal stem cells (MSCs) can potentially help promote bone regeneration. In the present study, we first developed hydroxyapatite, chitosan, and carbon nanotube composite biomaterial. Then, the effect of different concentrations of the extract on the viability of Vero cells (ATCC CCL-81) and MSCs obtained from sheep bone marrow using methylthiazol tetrazolium (MTT) and propidium iodide (PI) assays were evaluated. The biomaterial group demonstrated an absence of cytotoxicity, similar to the control group. Samples with 50% and 10% biomaterial extract concentrations showed higher cell viability compared to samples from the control group (MTT assay). These results suggest that the presence of this composite biomaterial can be used with MSCs. This study also concluded that hydroxyapatite, chitosan, and carbon nanotube composite biomaterial were not cytotoxic. Therefore, these could be used for performing in vivo tests.(AU)

O compósito à base de hidroxiapatita, quitosana e nanotubo de carbono foi desenvolvido com o intuito de auxiliar na consolidação óssea. Estudos anteriores sugerem que a combinação de substitutos ósseos e células-tronco mesenquimais (CTM) podem auxiliar a potencializar e promover a regeneração óssea. No presente estudo, o biomaterial foi desenvolvido e a viabilidade e a citotoxicidade de células Vero (ATCC CCL-81) e CTM obtidas de medula óssea provenientes de ovinos utilizando ensaios metil-tiazol-tetrazólio, MTT e iodeto de propídeo (PI) foram avaliadas em diferentes concentrações de extrato desse compósito. O compósito demonstrou ausência de citotoxicidade com comportamento semelhante ao grupo controle. Amostras com 50% e 10% de concentração de extrato do compósito mostraram resultados maiores comparados ao grupo controle (ensaio MTT). Esses resultados também sugerem que a presença do biomaterial pode ser utilizada em associação a CTM. Assim, esse estudo conclui que o compósito apresentado de hidroxiapatita, quitosana e nanotubo de cabono não foi considerado citotóxico e pode ser utilizado em teste in vivo.(AU)

Proximal interphalangeal arthrodesis in seven horses: A retrospective study in Brazil (2011-2019) / Artrodese interfalangeana proximal em sete equinos: um estudo retrospectivo no Brasil (2011-2019)

ABSTRACT: This study discussed several cases of proximal interphalangeal arthrodesis in horses at a veterinary hospital in Brazil. The medical records of seven horses that underwent proximal interphalangeal arthrodesis between 2011 and 2019 were analyzed for indication, technique, and complications. Short- and long-term outcomes were obtained from both the medical records and telephone interviews with the owners. A dynamic compression plate (DCP) was used in one of the seven horses that underwent surgical arthrodesis, and locking compression plates (LCP) were used in the others. Hospital discharge was recorded in 71.4% (5/7) of the horses, with an average hospital stay of 79 ± 45 days. Casting was maintained for 59 ± 26 days. Contact with owners was possible in four cases, two of which regained their prior level of function. The proximal interphalangeal arthrodesis may improve a horse's well-being, especially when it is considered an early intervention, minimizing the chances of immediate postoperative complications. Additional cases of surgical arthrodesis should be evaluated in long term to better characterize the outcomes of this procedure in Brazil.

RESUMO: Este estudo teve como objetivo apresentar e discutir casos de artrodese interfalangeana proximal em equinos atendidos em um Hospital Veterinário no Brasil. Os prontuários de sete equinos submetidos à artrodese interfalangeana proximal foram analisados quanto à indicação, técnica e complicações, entre 2011 e 2019. As informações sobre os desfechos de curto e longo prazo foram obtidas pela avaliação dos prontuário e entrevista telefônica com os proprietários. Em um dos sete cavalos submetidos à artrodese cirúrgica foi utilizado implantes DCP, e nos demais, LCP. A alta hospitalar foi registrada em 71,4% (5/7), com média de permanência hospitalar de 79±45 dias. A imobilização externa durou 59±26 dias. O contato com os proprietários foi possível em quatro casos, dos quais, em dois, os animais voltaram às suas funções. A artrodese interfalangeana proximal pode melhorar a qualidade de vida dos equinos, principalmente quando se considera a intervenção precoce, minimizando as chances de complicações pós-operatórias imediatas. Casos adicionais devem ser avaliados ao longo prazo para melhor caracterizar os resultados desse procedimento no Brasil.

What is the Evidence of Hyaluronic Acid and Polyacrylamide Hydrogel in Intra-articular Therapy in Equines? Systematic Literature Review.

A systematic review was conducted to investigate evidence to support or refute the use of hyaluronic acid and polyacrylamide hydrogel as intra-articular therapy in equines, which are frequent treatment options in the routine of veterinarians of equines in cases of osteoarthritis. In total, 19 studies were included, among clinical and in vitro studies, as well as a retrospective series of cases. The outcomes of the included studies provided fragile evidence supporting the recommendation for intra-articular use of hyaluronic acid. No study was included showing any clinical outcome in diseased synovial tissues of the polyacrylamide hydrogel. There is no concrete evidence of benefits, treatment protocols, and mechanisms of action of hyaluronic acid in the joint therapy in equines.

Gross Osteology and digital radiography of the common Capybara (Hydrochoerus hydrochaeris), Carl Linnaeus, 1766 for scientific and clinical application / Osteologia bruta e radiografia digital da capivara comum (Hydrochoerus hydrochaeris), Carl Linnaeus, 1766 para aplicação científica e clínica

Being able to study anatomical structures of wildlife species for science and clinical practice is of great importance. We aimed to describe the normal gross osteology of the common adult capybara Hydrochoerus hydrochaeris (Linnaeus, 1766), using macerated bone specimens and high-resolution digital radiography. The complete axial and appendicular skeleton was further compared with previously reported anatomical findings. For this purpose, we used three adult capybara cadavers (two females and one male), with a mean bodyweight of ±50 kg. Some H. hydrochaeris-specific morphological characteristics, especially in the skull region, show evidence of adaptation to aquatic life, such as an elongated head shape, with eyes, ears, and nose, located dorsally, to stay above water. Additionally, the entire bone structure demonstrates the size and weight support of the largest rodent and its adaptation with respect to foraging and locomotion behaviors. As a semi-aquatic herbivore, classified as cursorial (having limbs adapted for running), the authors believe it should be reclassified as cursorial-swimming/diving. Moreover, we argue to consider a differentiation between H. hydrochaeris silvestris to H. hydrochaeris synanthrope, due to substantial weight variation, in some cases > 100%. This inevitably has an impact on the development of bone structure, thus influencing habitual adaptation, and consequently, its clinical implications and animal handling. Radiography exams helped in the identification of bone structures, which otherwise were not observed in anatomical specimens, such as ossa sesamoidea, including the ossiclelunulae. Likewise, the radiographs were particularly helpful in overall better comprehension of the intubation and catheterization procedures. We believe this work can contribute as a reference to anatomical studies for students and professionals acting in clinic, surgery, and research.(AU)

Ser capaz de estudar estruturas anatômicas dos animais da fauna para fins científicos e prática clínica é de grande importância. Objetivamos descrever a osteologia geral normal de capivaras adultas Hydrochoerus hydrochaeris (Linnaeus, 1766), usando amostras de ossos macerados e radiologia digital de alta resolução. O esqueleto axial e apendicular foi posteriormente comparado a achados anatômicos reportados anteriormente. Para esse fim, nós utilizamos de três cadáveres de capivaras adultas (duas fêmeas e um macho) com peso médio de cerca de 50 kg. cada. Algumas características morfológicas de cavidade específicas, especialmente na região do crânio, evidenciam a adaptação à vida aquática, como o formato alongado da cabeça, com olhos, orelhas e nariz localizados dorsalmente, para permanência sobre a água. O completo desenvolvimento morfológico ósseo é evidência de tamanho e suporte de peso do maior roedor, assim como de seus hábitos de alimentação e locomoção, sendo um herbívoro semiaquático, classificado como cursório (tendo membros adaptados à corrida), caso em que os autores acreditam deveria ser reclassificado como cursorial-natação/mergulho. Além disso, argumentamos que deve ser considerada uma diferenciação entre H. hydrochaeris silvestris e H. hydrochaeris sinantropo, devido ao fato da variação substancial de peso, em alguns casos> 100%, inevitavelmente terá um impacto no desenvolvimento da estrutura óssea, influenciando, assim, a adaptação habitual e, consequentemente, suas implicações clínicas e manejo animal. A radiografia auxiliou na correlação e identificação de estruturas ósseas que não observadas em espécimes anatômicos, como o osso sesamóide, incluindo o ossículo lunar. Ademais, as radiografias foram particularmente úteis para uma melhor compreensão geral de procedimentos de intubação e cateterização. Acreditamos que este trabalho possa contribuir como referência de estudos anatômicos para estudantes e profissionais atuantes em clínica, cirurgia e pesquisa.(AU)

Power Doppler sonography in the assessment of neovascularization following surgical fracture repair in sheep: case report / Utilização da ultrassonografia Power Doppler no acompanhamento de neovascularização no pós-operatório de ovino submetido a osteossíntese: relato de caso

Sonography is a safe and non-invasive imaging modality, with the added benefit of providing dynamic images. Power Doppler sonography allows blood vessel identification regardless of flow intensity or direction. A one-year-old Ile de France ewe was admitted to the FMVZ-USP Veterinary Hospital with a complete tibial fracture. The animal was submitted to general inhalation anesthesia and fracture repair using a 3.5 mm locking compression plate. Power Doppler sonography was used to assess neovascularization over the course of the bone healing process. Formation of new vessels was noted between postoperative days 14 and 21; new vessels regressed progressively on subsequent assessments (postoperative days 28 and 35). Power Doppler sonography enabled early detection of newly formed blood vessels at the fracture site. The non-invasive nature of this imaging modality prevented patient stress and provided useful information on the progression of bone healing. Early neovascularization was thought to reflect successful postoperative healing of the tibial fracture described.(AU)

A ultrassonografia é técnica de imagem segura e não invasiva que fornece imagens dinâmicas. O Power Doppler é modalidade ultrassonográfica que permite a visualização de vasos sanguíneos sem depender de intensidade e direção de fluxo. Admitiu-se no Hospital Veterinário da FMVZ-USP um ovino fêmea, de raça Ile de France, com um ano de idade e apresentando fratura completa de tíbia em bisel. O animal foi submetido à anestesia inalatória para a realização de osteossíntese com placa bloqueada de 3,5 mm. Durante o período pós-operatório foram realizadas imagens de ultrassonografia Power Doppler para a avaliação da neovascularização ao longo do processo de regeneração óssea. Entre o 14º e o 21º dia do período pós-operatório, identificou-se a presença de vasos sanguíneos neoformados, que apresentaram sinais de regressão nas avaliações subsequentes (realizadas no 28º e no 35º dia pós-operatório). A ultrassonografia Power Doppler mostrou-se eficiente na detecção precoce de vasos sanguíneos neoformados na região da fratura no período pós-operatório, sendo um exame não invasivo, que não gerou estresse para o animal e que pode estar relacionado ao sucesso no reparo ósseo da tíbia do animal submetido à osteossíntese.(AU)