A Modification of the Cheli Craniolateral Approach for Minimally Invasive Treatment of Osteochondritis Dissecans of the Shoulder in Dogs: Description of the Technique and Outcome in 164 Cases

Abstract

Objective The aim of this study was to describe a novel minimally invasive surgical approach for the treatment of shoulder osteochondritis dissecans (OCD) in dogs and to retrospectively review our clinical cases treated with this approach.

Study Design The study describes a modification of Cheli surgical approach (1985), developed to reduce the degree of invasiveness as well as the incidence of postoperative complications observed in other surgical approaches to the shoulder joint. Medical records of dogs that underwent our minimally invasive approach to the scapulohumeral joint for treatment of OCD from May 2001 to May 2019 were retrospectively reviewed for intraoperative findings and complications. Clinical outcome and complications were also evaluated in the operated dogs with a minimum of a 2-month-follow-up evaluation.

Results A total of 164 shoulders in 141 dogs (23 bilateral), 103 males and 38 females, were examined and treated with our modified craniolateral approach for the treatment of OCD of the humeral head. In all cases, the modified craniolateral approach allowed visibility and adequate exposure of the caudal humeral head surface. Radiographic and clinical follow-up evaluations were available in 123/164 (75%) cases. The clinical outcome was consistent with other reports using different surgical approaches for OCD lesions of the humeral head in dogs.

Clinical Significance This technique provided a reliable approach for surgical treatment of canine shoulder OCD and can be considered a valid alternative to other surgical approaches including arthroscopy.

Keywords

osteochondritis dissecans - shoulder - dog - arthrotomy - minimally invasive approach

Authors' Contributions

A.V. contributed to conception of study, study design and acquisition of data. L.V. designed the study and acquired the data. All authors did data analysis and interpretation. They drafted, revised and approved the submitted manuscript. A.V. is publically accountable for relevant content.

Publikationsverlauf

Eingereicht: 29. April 2020

Angenommen: 24. August 2020

Artikel online veröffentlicht:
24. November 2020

• References

• 1 Novotny D, Runyon CL. Osteochondritis dissecans in the dog. Iowa State Univ Vet 1986; 48 (01) 12
• 2 Marcellin-Little DJ, Levine D, Canapp Jr SO. The canine shoulder: selected disorders and their management with physical therapy. Clin Tech Small Anim Pract 2007; 22 (04) 171-182
• 3 LaFond E, Breur GJ, Austin CC. Breed susceptibility for developmental orthopedic diseases in dogs. J Am Anim Hosp Assoc 2002; 38 (05) 467-477
• 4 Smith CW, Stowater JL. Osteochondritis dissecans of the canine shoulder joint: a review of 35 cases. J Am Anim Hosp Assoc 1975; 11: 658-662
• 5 Kunkel KA, Rochat MC. A review of lameness attributable to the shoulder in the dog: part one. J Am Anim Hosp Assoc 2008; 44 (04) 156-162
• 6 Johnston SA. Osteochondritis dissecans of the humeral head. Vet Clin North Am Small Anim Pract 1998; 28 (01) 33-49
• 7 Olivieri M, Ciliberto E, Hulse DA, Vezzoni A, Ingravalle F, Peirone B. Arthroscopic treatment of osteochondritis dissecans of the shoulder in 126 dogs. Vet Comp Orthop Traumatol 2007; 20 (01) 65-69
• 8 Rudd RG, Whitehair JG, Margolis JH. Results of management of osteochondritis dissecans of the humeral head in dogs: 44 cases (1982–1987). J Am Anim Hosp Assoc 1990; 26: 173-178
• 9 Beale B, Hulse D, Schulz K, Whitney WO. Arthroscopically assisted surgery of the shoulder joint, in Small animal arthroscopy. Philadelphia, PA: Saunders; 2003: 23-49
• 10 Beale B, Hulse D, Schulz K, Whitney WO. Arthroscopically assisted surgery of the shoulder joint, in Small animal arthroscopy. Philadelphia, PA: Saunders; 2003: 23-49
• 11 van Bree HJ, Van Ryssen B. Diagnostic and surgical arthroscopy in osteochondrosis lesions. Vet Clin North Am Small Anim Pract 1998; 28 (01) 161-189
• 12 Caywood DD, Schenk MP, Wilsman NJ. et al. Craniomedial approach to the canine scapulohumeral joint. Vet Surg 1980; 9: 74-76
• 13 McLaughlin Jr R, Roush JK. A comparison of two surgical approaches to the scapulohumeral joint in dogs. Vet Surg 1995; 24 (03) 207-214
• 14 Probst CW, Flo GL. Comparison of two caudolateral approaches to the scapulohumeral joint for treatment of osteochondritis dissecans in dogs. J Am Vet Med Assoc 1987; 191 (09) 1101-1105
• 15 Tomlinson J, Constantinescu G, McClure R. et al. Caudal approach to the shoulder joint in the dog. Vet Surg 1986; 15 (04) 294-299
• 16 Amsellem P. Complications of reconstructive surgery in companion animals. Vet Clin North Am Small Anim Pract 2011; 41 (05) 995-1006 , vii
• 17 Punzet G. Klinik und chirurgische behandlung der osteochondrosis dissecans des humeruskopfes beim Hund. Wien Tierarztl. Mschr. 1974; 24: 75-82
• 18 Cheli R, Mortellaro CM, Fonda D. Nuovo accesso cranio-laterale per l'artrotomia scapolo-omerale nel cane. Summa (Milano) 1985; 2: 91-94
• 19 Vezzoni A. A new antero-lateral approach to the shoulder joint of the dog. Proceedings XI WSAVA Congress, Paris, 1986: 61
• 20 Frisbie DD, Trotter GW, Powers BE. et al. Arthroscopic subchondral bone plate microfracture technique augments healing of large chondral defects in the radial carpal bone and medial femoral condyle of horses. Vet Surg 1999; 28 (04) 242-255
• 21 Cook JL, Evans R, Conzemius MG. et al. Proposed definitions and criteria for reporting time frame, outcome, and complications for clinical orthopedic studies in veterinary medicine. Vet Surg 2010; 39 (08) 905-908
• 22 Biezyński J, Skrzypczak P, Piatek A, Kościółek N, Drozdzyńska M. Assessment of treatment of osteochondrosis dissecans (OCD) of shoulder joint in dogs--the results of two years of experience. Pol J Vet Sci 2012; 15 (02) 285-290