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Objectives:
Large subchondral bone cysts are challenging to treat, especially in small carpal bones. Filling the cystic cavity has been developed to enhance bone healing following surgical management, using various techniques such as bone grafting. In an ovine preclinical model of subchondral bone lesion, Calcium Phosphate cement (CPC) associated with blood significantly promoted new bone formation. This approach may provide a solution for managing large cysts, particularly when screw placement is contraindicated.
Methods:
After his starting, a 3-year-old gelding developed right forelimb lameness, with positive support and flexion test and a distended carpus. Radiographic examination revealed a large subchondral bone cyst in the radial carpal bone, occupying half of the bone’s volume.
Results:
Surgical debridement and decompression of the cyst were performed through a transcortical approach under general anesthesia and fluoroscopic guidance, using the IntraOsseous BioPlasty decompression device (Arthrex). It was then filled with CPC (Graftys HBS) mixed with autologous blood under nanoscopic control of the radio-carpal joint.
Post-operatively, the horse was sound and discharged 2 weeks after. Moderate swelling of the carpus decreased over several months with bandaging. Bone healing was satisfying on control X-rays. Following a progressive rehabilitation plan, no lameness is reported 8 months after surgery.
Conclusions:
Mixing CPC with blood provides a more cohesive material with high injectability while favoring quicker resorption and replacement of the implant by newly formed bone. This first equine clinical application of CPC mixed with blood demonstrates that it may be an alternative for the treatment of large bone defects without joint communication.
34th Annual Scientific Meeting proceedings
Stream:
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Session:
Date/Time: 30-11--0001 (00:00 - 00:00) | Location:
Date/Time: 30-11--0001 (00:00 - 00:00) | Location:
Treatment of a large carpal subchondral bone cyst with calcium phosphate cement mixed with autologous blood in a horse.
Gross L1, Meurice A*1, Charbonnel A1, Gauthier O*2, De Fourmestraux C*1
1Department of Surgery, Equine Clinic, ONIRIS, National College of Veterinary Medicine, Food Science and Engineering, Nantes, France, 2Department of Surgery, Small animal Clinic, ONIRIS, National College of Veterinary Medicine, Food Science and Engineering, Nantes, France.
Objectives:
Large subchondral bone cysts are challenging to treat, especially in small carpal bones. Filling the cystic cavity has been developed to enhance bone healing following surgical management, using various techniques such as bone grafting. In an ovine preclinical model of subchondral bone lesion, Calcium Phosphate cement (CPC) associated with blood significantly promoted new bone formation. This approach may provide a solution for managing large cysts, particularly when screw placement is contraindicated.
Methods:
After his starting, a 3-year-old gelding developed right forelimb lameness, with positive support and flexion test and a distended carpus. Radiographic examination revealed a large subchondral bone cyst in the radial carpal bone, occupying half of the bone’s volume.
Results:
Surgical debridement and decompression of the cyst were performed through a transcortical approach under general anesthesia and fluoroscopic guidance, using the IntraOsseous BioPlasty decompression device (Arthrex). It was then filled with CPC (Graftys HBS) mixed with autologous blood under nanoscopic control of the radio-carpal joint.
Post-operatively, the horse was sound and discharged 2 weeks after. Moderate swelling of the carpus decreased over several months with bandaging. Bone healing was satisfying on control X-rays. Following a progressive rehabilitation plan, no lameness is reported 8 months after surgery.
Conclusions:
Mixing CPC with blood provides a more cohesive material with high injectability while favoring quicker resorption and replacement of the implant by newly formed bone. This first equine clinical application of CPC mixed with blood demonstrates that it may be an alternative for the treatment of large bone defects without joint communication.
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