Corticocancellous bone biopsy from the 12th rib of standing horses

Assessment of tuber coxae bone biopsy in the standing horse

OBJECTIVE

To describe a biopsy technique in standing horses with minimal morbidity that consistently provides a substantial bone biopsy with intact, undamaged architecture.

STUDY DESIGN

Experimental, prospective study.

ANIMALS

Ten Thoroughbred horses.

METHODS

Biopsies were obtained from the tuber coxae of 10 sedated, standing horses using an oscillating saw. Bilateral biopsies, separated by 60 days, were evaluated with micro-computed tomography (microCT). The first biopsy was prepared for decalcified histology; the second for undecalcified histology. Both biopsies were evaluated qualitatively for histologic quality.

RESULTS

The biopsy technique did not result in any significant complications, was well tolerated and all biopsies were of good histologic quality.

CONCLUSION

Cortical and trabecular bone biopsies can be successfully collected from the tuber coxa using a simple technique that creates minimal morbidity and allows sequential samples to be collected. The biopsies were larger than those described previously, provided adequate bone for multiple histologic sections, and had intact, undamaged architecture on examination with microCT and light microscopy.

Problems in quantifying bone response to exercise in horses: a review

Detecting changes in bone during growth, training, rest from competition (spelling), and disease in horses requires imaging techniques that have a high level of accuracy and precision. Currently, most imaging techniques used in horses do not possess such characteristics and are more suitable for detecting end-stage disease than subtle changes. Some are incapable of detecting changes in bone size. Non-planar techniques should be used for estimating or determining bone strength. This review outlines available imaging techniques and shows why cross-sectional procedures are required to accurately estimate bone strength. If these can be validated and improved for use in the standing horse, serial examination can be used to show the magnitude of changes in bone strength that occur during training or varying management regimens. Such knowledge can then be used to improve training and spelling regimens for equine athletes, hopefully resulting in a reduction in racing or athletic injury.

Evaluation of a Technique for Collection of Cancellous Bone Graft from the Proximal Humerus in Horses

OBJECTIVES

To describe a technique for collecting cancellous bone graft from the proximal humerus in horses.

STUDY DESIGN

Prospective evaluation of an experimental bone graft collection technique.

ANIMAL POPULATION

Eight horses, 3-15 years, weighing 495-605 kg.

METHODS

Horses were anesthetized and positioned in lateral recumbency. The lateral aspect of the proximal humerus was exposed by a 7-10-cm incision extending distally from the greater humeral tubercle, followed by sharp dissection through the omotransversarius muscle and between the infraspinatus and deltoideus muscles. A 12-mm cortical defect was incrementally created in the lateral proximal humerus. Human bone graft harvesting equipment (Acumed, Beaverton, OR) was drilled through this defect to collect a core of cancellous bone. In five horses additional cancellous bone was then collected with conventional instruments. Bone samples were weighed and histologically examined. Horses were monitored and graded for quality of anesthetic recovery, incisional complications, and postoperative lameness.

RESULTS

Total mean (+/-SD) surgical time for harvesting bone with the Acumed system and traditional techniques (n=5) was 38+/-6 minutes (range, 32-47 minutes). Mean cancellous bone weight collected with the Acumed system was 3.6+/-0.8 g (range, 2.0-4.6 g), and cancellous bone collected conventionally was 25.6+/-7.5 g (range, 16.8-34.2 g). Minimal incisional complications or postoperative lameness were observed. Mortality was 12.5%; one horse fractured the operated humerus during anesthetic recovery.

CONCLUSION

The Acumed system provided limited cancellous bone when used with the technique described. However, the quantity of cancellous bone collected with traditional harvesting instruments was comparable to other sites used in horses. The procedure was associated with minimal postoperative incisional complications or lameness, but because one horse suffered a catastrophic humeral fracture further research is required to assess the effects of this procedure on humeral breaking strength.

CLINICAL RELEVANCE

Based on the risk of catastrophic fracture, this technique cannot be recommended for use in clinical cases, especially if an unassisted recovery from general anesthesia is planned.

Sternal bone biopsy in standing horses

OBJECTIVE

To develop a technique for sternal bone biopsy in standing horses.

STUDY DESIGN

Experimental study.

ANIMALS

Five adult horses.

METHODS

Horses were restrained in a standing stocks and sedated. The sternal biopsy site, identified by ultrasonographic examination, was clipped and prepared for aseptic surgery and infiltrated with local anesthetic. An electric bone biopsy drill (Osteocore; Institut Straumann AG, CH-4437, Waldenburg, Switzerland)), which yielded 4-mm-diameter bone specimens, was used to obtain sternal biopsies through a small skin incision. Sections (7 microm) of the bone specimens were stained with toluidine blue and Goldner's green trichrome and observed microscopically to determine suitability for histological and histomorphometric evaluation.

RESULTS

The most suitable sternal biopsy site was at the 4th or 5th sternebra. The surgical procedure was easy to perform and well tolerated by the horses, and adequate samples were obtained on the first attempt. The only complications were incisional edema in all horses and wound drainage in 1 horse.

CONCLUSIONS

Sternal bone biopsy may be successfully performed in standing horses, and the technique described in this report yields architecturally intact bone specimens.

CLINICAL RELEVANCE

The sternum is an accessible site for cancellous bone biopsy specimens in standing horses.