Treatment of a Massive Osteochondritic Lesion in the Lateral Femoral Condyle with a Custom Resurfacing Implant and Patient-Specific Instrumentation
Osteochondrosis dissecans (OCD) lesions in the femoral condyle are common in large breed dogs. The reconstruction of very large, or irregularly shaped, defects can be extremely challenging. In the human knee, metallic focal resurfacing implants are available.
The objective of this case study was to resurface a large OCD lesion in a young large breed dog with a custom made metallic implant and to determine the short- and long-term clinical outcome.
A 1.5-year-old, neutered female, Bucovina Shepherd Dog, (46 kg) was referred for treatment of bilateral femoral condyle OCD. Computed tomography (CT), identified the presence of very large subchondral defects in the most caudal aspect of the lateral femoral condyle (12 mm x 15 mm [left] and 10 mm x 18 mm [right]). A custom implant was designed and manufactured by BioMedtrix LLC. Patient specific surgical guides were designed and fabricated by 3D printing. The implant was positioned on the prepared femoral condyle after lateral synovectomy and meniscectomy. After recovery the patient was discharged with antibiotics and analgesia.
Post-operative radiographs confirmed satisfactory prosthesis positioning. Although mild lameness is still evident on force plate examination at 6 and 12 weeks post-surgery, clinical recovery has been very good.
A custom resurfacing implant is a reasonable option for managing extensive defects in the lateral femur. 3D printing of surgical guides is fast, easy and affordable.