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Resorbable cages for spinal fusion: an experimental goat model.

OBJECT: A biomechanical cadaveric study and an in vivo monosegmental spinal fusion study were performed to evaluate a novel bioresorbable poly(L-lactic acid) (PLLA) cage. METHODS: The yield strength of a spinal segment was chosen as the main design parameter for the resorbable cages to be used in a goat model. In a 3-year in vivo study the authors found fusion to be significantly faster and more complete when using PLLA cages compared to titanium cages with the same dimensions. In the PLLA group, the intervertebral grafting height did not change and bone remodeling within the cage was completed 2 years after implantation. In terms of degradation of the PLLA, similar features were observed in vivo and in vitro. CONCLUSIONS: Degradation was almost completed 3 years after implantation. Tissue reaction was mild during the 3-year period.

Absorbable Implants↗

Experimental scoliosis in an immature goat model: a method that creates idiopathic-type deformity with minimal violation of the spinal elements along the curve.

STUDY DESIGN: Experimental scoliosis was created in an immature goat model. OBJECTIVES: To create a progressive, structural, idiopathic-type, lordoscoliotic curve convex to the right in the thoracic spine of the immature goat while maintaining the anterior and posterior elements of the spine along the maximal curve in a pristine state. SUMMARY OF BACKGROUND DATA: Progressive scoliotic curves in a small animal model have been created using a posterior asymmetric tether. However, attempts in larger animal models have had less success and typically required violation of the spinal elements. METHODS: Scoliosis was created in 40 Spanish Cross X female goats (age 1-2 months, weight 8-12 kg) using a left posterior asymmetric tether from T5 to L1. Convex rib resection and concave rib tethering from T8 to T13 were performed before compression across the rigid construct. Goats were followed over a 6- to 15-week period with serial radiographs to document progression of the deformity. RESULTS: Of the 40 goats that underwent posterior assymetric tethering with rib procedures, 7 (18%) encountered substantial complications (five deaths and two neurologic injuries). Of the 33 available for analysis, 27 goats (82%) developed progressive, structural, idiopathic-type, lordoscoliotic curves in convex to the right in the thoracic spine. All curves demonstrated characteristic radiographic features of idiopathic scoliosis including significant displacement of the apical vertebra from the midline, wedging of both the vertebral bodies and discs, rotation, and decreased flexibility. Initial scoliosis after posterior asymmetric tethering measured 42 degrees on average (range 33-50 degrees ) and progressed to 60 degrees on average (range 44-73 degrees ) over 6 to 15 weeks. The average progression of +18 degrees (range 6-37 degrees ) was statistically significant (P < 0.001). CONCLUSIONS: This study establishes an experimental model for scoliosis that creates progressive, structural, idiopathic-type, lordoscoliotic curves convex to the right in the thoracic spine of the immature goat with high statistical significance (P < 0.001). In addition, this method of experimental scoliosis creation avoids violation of the spinal elements throughout the maximal portion of the curve providing an ideal opportunity subsequent study of the deformity.

Animals↗

Radiographic, histologic, and chemical evaluation of bioresorbable 70/30 poly-L-lactide-CO-D, L-lactide interbody fusion cages in a goat model.

STUDY DESIGN: A study of lumbar interbody fusion using polylactic acid-based bioresorbable fusion cages in a goat model. OBJECTIVE: To evaluate the effect of polylactic acid polymer composition, and internal stabilization on the rate and quality of interbody fusion. SUMMARY OF BACKGROUND DATA: A spinal cage should provide an appropriate biomechanical environment to facilitate interbody fusion. Previous studies have shown that bioresorbable polylactic acid-based cages can provide adequate stability for spinal fusion. However, at present and to our knowledge, the best bioresorbable materials, optimal cage stiffness, and desired period over which the cage should biodegrade are unknown. METHODS: Interbody fusions were performed at L3-L4 level in 35 skeletally mature Dutch milk goats. Titanium and poly-L-lactide-CO-D,L-lactide (PLDLLA) cages were implanted at random as stand-alone cages. In addition, PLDLLA cages were implanted with anterior fixation. The goats were euthanized at 3, 6, or 12 months. Radiographic, magnetic resonance imaging, histologic, and histomorphometric analyses were performed on retrieved segments. Chemical analysis was used to assess degradation of the retrieved PLDLLA cages. Beforehand, chemical and mechanical degradation of the PLDLLA cages were assessed in vitro. RESULTS: At 3 months, bone graft was almost completely remodeled. Endochondral bone formation was observed in all specimens. At 6 months, 50% of the PLDLLA stand-alone cages and 83% of the PLDLLA anterior fixation cages were fused. At 12 months, 38% of the PLDLLA stand-alone and 83% of the titanium cages realized fusion. A very mild and dispersed foreign body reaction was seen in all PLDLLA specimens. E-beam sterilized PLDLLA cages degraded more rapidly in vivo as compared to both, PLDLLA cages in vitro, and ethylene oxide sterilized poly-L-lactic acid cages in vivo. CONCLUSIONS: Within the 3-6-month period, PLDLLA stand-alone cages provided insufficient mechanical stability, which manifested as cracking and deformation of the cages and lower fusion rates. This result implies that within this time, additional stabilization is required; supplemental internal fixation proved sufficient to obtain successful fusion. In all cases, only a mild host response was seen, indicating good biocompatibility.

Absorbable Implants↗

Anterior cervical interbody fusion with rhBMP-2 and tantalum in a goat model.

BACKGROUND CONTEXT: Tricortical autogenous iliac crest has long served as the gold standard for arthrodesis after cervical discectomy. The added morbidity resulting from bone graft harvest may be eliminated by the use of a biocompatible synthetic bone graft substitute with osteoconductive abilities, and when used with an osteoinductive agent, such as recombinant bone morphogenic protein (rhBMP)-2, it may facilitate arthrodesis similar to autograft. PURPOSE: To determine by radiographic and histologic analysis whether tantalum with and without rhBMP-2 can facilitate bony ingrowth and arthrodesis in an animal model. STUDY DESIGN/SETTING: Single-level anterior cervical discectomy and fusion was performed using a tantalum bone graft substitute with and without rhBMP-2 in a previously established goat model for anterior cervical fusion. METHODS: Eight goats underwent single-level anterior cervical discectomy and stabilization with a porous tantalum implant. There were four goats in each experimental group. Group A underwent anterior cervical stabilization with tantalum alone, whereas in Group B rhBMP-2 was added to the tantalum implant. The goats were sacrificed at 12 weeks, and their cervical spines were removed for histologic and radiological analysis. RESULTS: Only one of four goats in Group A had any bony ingrowth into the tantalum. Three of four goats in Group B demonstrated bony ingrowth. The average extent of bony ingrowth at the perimeter of the tantalum in Group A was 2.5% compared with 12.5% in Group B. Similarly, the volume of bony ingrowth within the tantalum was 2.5% in Group A and 10% in Group B. The difference was not statistically significant. CONCLUSIONS: The data in this pilot study suggest that tantalum may function as a synthetic osteoconductive bone graft substitute. The addition of rhBMP-2 may facilitate osteoinduction within a synthetic osteoconductive implant. The sample size in this study was too small for statistical significance. The present animal model as used in this study was inadequate for cervical arthrodesis where rigid implant fixation is desired.

Animals↗

Reduced anterior tibial translation associated with adaptive changes in the anterior cruciate ligament-deficient joint: goat model.

Adaptive changes in the menisci and adjacent posterior capsule were documented within anterior cruciate ligament-deficient knee (stifle) joints in the goat model. These physical changes in the menisci and capsule developed over time and were associated with reduction in the initial (time zero) abnormal anterior tibial translation following transection of the anterior cruciate ligament. At 50 N of applied force, the normal goat knee joint has a total anterior-posterior translation of 0.6+/-0.1 mm (+/- SEM) at 45 degrees of flexion and 0.3+/-0.1 mm at 90 degrees. The translation immediately after transection (time zero) with 50 N of force was 8.2+/-0.5 mm at 45 degrees and 4.9+/-0.9 mm at 90 degrees. Within 8 months after transection and at 50 N of force, the treated knees had reduced translation values of 5.3+/-0.6 mm at 45 degrees of flexion and 2.9+/-0.5 mm at 90 degrees, or 35 (p<0.001) and 40% reductions, respectively, compared with the values at time zero. Magnetic resonance images of the ligament-deficient stifle joints, as well as gross measurements and image analysis after dissection, consistently demonstrated increases in cross-sectional area and volume of the menisci compared with the contralateral controls. These secondary changes were most pronounced in the posterior portion of the medial menisci, and histologic evaluation demonstrated hypercellularity with the accumulation of poorly organized collagen, reduced safranin O staining (proteoglycan matrix synthesis), a thickened capsule and capsule attachment, and increased vascularity at the meniscal capsule interface.

Adaptation, Physiological↗

Characterization of hamstring reflexes during anterior cruciate ligament disruption: in vivo results from a goat model.

The existence of an anterior cruciate ligament-hamstring reflex arc, the extent to which these reflexes can protect the knee, and the extent to which they are affected by rupture of the anterior cruciate ligament remain controversial. We evaluated the temporal components of the anterior cruciate ligament-hamstring synergy by simulating an injury to the ligament in a goat model. Reflexive hamstring activation in anesthetized goats was evaluated when the anterior cruciate ligament was loaded with static subfailure, dynamic subfailure, and dynamic failure loads. Reflexive hamstring activation was not found in response to static subfailure loading but was observed in response to dynamic subfailure and failure loading. The latency of the reflex evoked by dynamic failure loading was shorter than that evoked by dynamic subfailure loading. The findings suggest that the extent to which the hamstring reflexes can protect the knee may be bounded by the ability of these muscles to generate force rapidly and the amplitude and time-course of the loads applied to the knee joint. The present data present a framework for further investigation of the contribution of anterior cruciate ligament-hamstring reflexes to the stability of the knee joint under high loads and loading rates.

Animals↗

A comparison of patellar tendon autograft and allograft used for anterior cruciate ligament reconstruction in the goat model.

Similar-sized patellar tendon autografts and fresh-frozen allografts were used to reconstruct the anterior cruciate ligament of one knee in 40 female goats. Evaluations of the reconstructions and contralateral controls at the 6-week and 6-month postoperative periods included anterior-posterior translation, mechanical properties determined during tensile failure tests, measurement of cross-sectional area, histology, collagen fibril size and area distribution, and associated articular cartilage degenerative changes. Six months after anterior cruciate ligament reconstruction, the autografts demonstrated a smaller increase in anterior-posterior displacement, values of maximum force to failure two times greater, a significant increase in cross-sectional area, a more rapid loss of large-diameter collagen fibrils, and an increased density and number of small-diameter collagen fibrils compared to the allografts. Clinical significance. More surgeons are allowing their patients to return to running and sports 6 months after anterior cruciate ligament reconstruction. While the structural and material properties of autografts and allografts at time zero are similar, in the goat model during the first 6 months they differ. The allografts demonstrate a greater decrease in their implantation structural properties, a slower rate of biologic incorporation, and the prolonged presence of an inflammatory response. At 6 months the autograft demonstrates a more robust biologic response, improved stability, and increased strength to failure values.

Animals↗

A multidisciplinary study of the healing of an intraarticular anterior cruciate ligament graft in a goat model.

We evaluated knee function, tensile properties, and histologic appearance of a healing intraarticular bone-patellar tendon-bone autograft after anterior cruciate ligament reconstruction in a goat model. The patellar tendon graft was fixed such that both bone-to-bone (femoral tunnel) and bone-to-tendon (tibial tunnel) healing could be studied. The total anteroposterior translation significantly increased from 3 to 6 weeks, ranging from increases of 28.8% to 46.7%. In situ forces in the replacement graft decreased as much as 22.2% at 6 weeks. Conversely, tensile properties of the femur-anterior cruciate ligament graft-tibia complex did not change significantly from 3 to 6 weeks. However, the mode of failure changed from the graft pulling out of the tibial tunnel at 3 weeks to a mix of midsubstance failures (N = 2) and pullouts (N = 5) at 6 weeks. Histologic evaluations revealed progressive and complete incorporation of the bone block in the femoral tunnel, but only partial incorporation of the tendinous part of the graft in the tibial tunnel. The differences demonstrated at 3 and 6 weeks may be a result of the remodeling process of the midsubstance of the graft as the interfaces within the osseous tunnels mature.

Analysis of Variance↗

Antimicrobial efficacy of external fixator pins coated with a lipid stabilized hydroxyapatite/chlorhexidine complex to prevent pin tract infection in a goat model.

BACKGROUND: Pin tract infection is a common complication of external fixation. An antiinfective external fixator pin might help to reduce the incidence of pin tract infection and improve pin fixation. METHODS: Stainless steel and titanium external fixator pins, with and without a lipid stabilized hydroxyapatite/chlorhexidine coating, were evaluated in a goat model. Two pins contaminated with an identifiable Staphylococcus aureus strain were inserted into each tibia of 12 goats. The pin sites were examined daily. On day 14, the animals were killed, and the pin tips cultured. Insertion and extraction torques were measured. RESULTS: Infection developed in 100% of uncoated pins, whereas coated pins demonstrated 4.2% infected, 12.5% colonized, and the remainder, 83.3%, had no growth (p < 0.01). Pin coating decreased the percent loss of fixation torque over uncoated pins (p = 0.04). CONCLUSION: These results demonstrate that the lipid stabilized hydroxyapatite/chlorhexidine coating was successful in decreasing infection and improving fixation of external fixator pins.

Animals↗

Intraoperative force-setting did not improve the mechanical properties of an augmented bone-tendon-bone anterior cruciate ligament graft in a goat model.

It has been hypothesized that load affects the mechanical properties of an anterior cruciate ligament graft while it remodels. The goal of this study was to use an existing goat model to evaluate the effect of intraoperative set force on the postoperative mechanical properties of an autograft that had been augmented with a synthetic segment. The following questions were addressed. Do augmented autografts set with a high force intraoperatively have improved structural and material graft properties and lower anterior-posterior knee laxity at 3 months after surgery, compared with autografts set with a low intraoperative force? How do the structural and material properties of these implanted autografts compare with the mechanical properties of an intact anterior cruciate ligament or an unimplanted control autograft? The anterior cruciate ligament was reconstructed in seven goats with use of a composite graft consisting of a bone-patellar tendon-bone autograft and a synthetic augmentation device. A force-setting technique was used intraoperatively to establish the load-sharing between the autograft and augmentation segments such that the autograft carried either a high (16.5 N in four animals) or low (1.5 N in three animals) level of force, while the total force in the composite graft remained constant. Tensile testing was performed at 3 months after surgery to determine the material and structural properties of the autograft, the intact anterior cruciate ligament from the normal contralateral knee, and a control bone-patellar tendon-bone graft of similar size that was harvested from the contralateral knee at the time of necropsy and had never been implanted in the joint. The structural and material properties of the autografts initially set to high or low loads at surgery were not significantly different after 3 months of implantation. The strength and stiffness of the implanted tendons were an average of 24 and 20% of the strength and stiffness of the normal anterior cruciate ligament and 31 and 62% of the control tendons, respectively. Intraoperative set force in an augmented anterior cruciate ligament graft at the levels chosen in this study did not significantly affect weakening of the autograft at 3 months.

Animals↗

Assessment of donor cell and matrix survival in fresh articular cartilage allografts in a goat model.

The long-term survival of allografts of articular cartilage has been proposed to be dependent on the survival of the cells that maintain the unique structural and material properties of the allograft. In this study, we assessed cell survival in 24 fresh articular cartilage allografts of the medial plateau in a Spanish-goat model. A DNA-probe technique was used to distinguish clearly between DNA from donor (allograft) and host cells. The intraarticular survival of viable allograft chondrocytes in the transplanted articular cartilage started to diminish as early as 3 weeks after transplantation; however, there was considerable variation in the amount of donor cell DNA detected in the allografts at 6 and 12 months following transplantation. This contrasts with our experience with fresh allografts of ligament, tendon, and meniscus, in which no donor DNA was detected 4 weeks after transplantation. DNA from host cells was present in all articular cartilage allografts, as evidenced by detectable unique host DNA patterns. Histological and histochemical assays showed that none of the transplants demonstrated normal structure and composition at 1 year after transplantation. The grafts in which large quantities of donor DNA were present appeared grossly superior to those with no or reduced remaining demonstrable donor DNA.

Animals↗

Pasteurella haemolytica ultraviolet-irradiated vaccine by parenteral and aerosol routes compared in the goat model.

Positive control 1 (PC1) (n = 9) goats were injected transthoracically into the left lung with live Pasteurella haemolytica biovar A, serovar 1 (PhA1) in polyacrylate (PA) beads on days 0 and 21. Positive control 2 (PC2) (n = 6) goats were nebulized with live PhA1 and PA beads on days 0 and 21. Negative control (NC) goats (n = 6) were each injected transthoracically into the left lung with PA beads alone on days 0 and 21. Four groups (n = 6) were administered PA beads mixed with ultraviolet (UV) killed PhA1 on days 0 and 21. The treatment doses of bacteria for these groups were principal group 1 (PR1) injected into the left lung (7.7 x 10(10) cfu); PR2, 7.7 x 10(10) UV-killed PhA1 injected subcutaneously (SC); PR3, 7.7 x 10(10) UV-killed PhA1 injected SC only on day 21; PR4, nebulized with PA beads mixed with 5.6 x 10(10) cfu of UV-killed PhA1; and PR5, nebulized with PA beads mixed with 5 x 10(8) cfu of UV-killed PhA1. All goats were challenged transthoracically in the right lung with 1 x 10(8) cfu of live PhA1 on day 42 and necropsied on day 46. The sizes of consolidated lung lesions at the challenge site were used as a measure of immunity. The data show that the introduction of live PhA1 into the lungs of goats, either by injection or aerosolization, offers excellent protection against a subsequent homologous challenge. The data also demonstrate that two transthoracic injections (21 days apart) of UV-killed PhA1 (PR1), and subcutaneous injection of UV-killed PhA1(PR2) also offer excellent protection against a subsequent homologous live PhA1 challenge. One SC injection of UV-killed PhA1 (PR3) appears to offer only partial protection against a subsequent homologous live PhA1 challenge. Inhalation of UV-killed PhA1 mixed with PA beads (PR4 and PR5) induced no protection in goats against a subsequent live PhA1 transthoracic challenge.

Aerosols↗

Thoracoscopic multilevel anterior instrumented fusion in a goat model.

STUDY DESIGN: A survival study in a caprine model for evaluation of a thoracoscopic anterior scoliosis instrumentation construct for fusion. OBJECTIVE: To compare the efficacy of performing multilevel anterior thoracoscopic "scoliosis" fusion with both allograft and autograft bone. SUMMARY OF BACKGROUND DATA: The use of minimally invasive thoracoscopic spinal surgery has been increasing. Until recently, instrumentation methods for correcting scoliosis entirely with a minimally invasive approach have not been available. Although multilevel thoracoscopic instrumentation and fusion now is in use clinically at some centers, reports of its effectiveness in an animal model are limited. METHODS: A thoracoscopically implanted multilevel screw-rod instrumentation construct was used in a goat survival model, with fusion quality evaluated 16 weeks after surgery. Autogenous iliac crest bone graft was compared with an allogenic bone graft substitute. The quality of fusion was evaluated both radiographically and biomechanically. RESULTS: Thoracoscopic insertion of a multilevel screw-rod construct was demonstrated to be technically feasible. However, with regard to the quality of fusion, only 47% of the disc space "fusion ratings" with the use of autogenous iliac crest graft were considered fully fused by computed tomography scan evaluation. This compares with no ratings of full fusion in the allograft demineralized bone group and only a single rating of full disc space fusion in the control group, which received no bone graft. Torsional range of motion was the smallest in the group receiving iliac crest bone graft and the greatest in the control animals that did not undergo bone grafting. CONCLUSIONS: The lack of complete fusion at 4 months in the autogenous iliac crest group emphasizes the importance of the discectomy and bone grafting technique. The use of demineralized bone allograft as a sole source of interbody fusion is not supported.

Animals↗

Freeze dried anterior cruciate ligament allografts. Preliminary studies in a goat model.

One ACL in each of 11 mature goats was replaced with a freeze dried bone-ACL-bone allograft. One year following implantation the goats had their knees evaluated biomechanically and for microvascularity and histologic changes. The reconstructed knees had a significantly greater total AP laxity (3.8 +/- 0.6 mm) (mean and SEM) than the controls (1.0 +/- 0.1 mm). Differences in primary AP laxity were responsible for 81% of the difference in total laxity, with only a 0.4 mm difference in secondary laxity. Neutral stiffness in the reconstructive knee was 17% of control, while stiffness at 30 newtons (N) of anterior force was approximately 50% of controls. Ligament stiffness in the linear region for the ACL allograft was 35% of the control value of 686 N/mm. The maximum load of the allografts was 571 +/- 45 N, or 25% of the contralateral ACL control strength (2301 +/- 155 N). Five of the seven allografts failed at the femoral insertion. Both elongation (83%) and energy (21%) to maximum load were less for allografts than controls. Histologic evaluation of the allografts revealed the presence of a regular oriented dense connective tissue which resembled a normal ligament. Microangiography revealed a periligamentous and endoligamentous vascular pattern reminiscent of a normal ACL and complete revascularization of the bone plugs.

Animals↗

Growth profiles and articular cartilage characterization in a goat model of Legg-Calve-Perthes disease.

Numerous animal species, including the goat, have been evaluated as potential models for human Legg-Calve-Perthes disease (LCPD). These models disrupt the vasculature of the femoral head, causing it to collapse, and therefore do not mimic all the clinical patterns of the human disease. Baseline data regarding the weight and femoral length in the growing goat are not available. This study characterized the goat's normal growth for comparison with that of humans. The growth aberrations in the proximal femur created by surgically ablating the capital physis were described and compared with the aberrations observed in human LCPD cases. Age, weight, and femoral length (test and control) data were obtained for goats approximately 1 to 14 months of age. At 4 months of age, a craniolateral surgical approach was used to expose the cranial lateral capital physis so that it could be cauterized. Postoperative radiographs were evaluated by graphic analysis to assess the resultant changes in the morphology of the proximal femur. The articular cartilage of the femoral head and acetabulum was evaluated mechanically, using indentation testing, to determine the apparent modulus of elasticity, and histopathologically regarding its thickness and proteoglycan content. The proximal femurs of goats and humans exhibit similar morphology and growth patterns. There was a positive correlation between age, weight, and femoral lengths in the goat. The surgical procedure was effective in ablating the capital femoral physis as indicated by shorter femoral lengths and fragmented, flattened, and mushroomed femoral heads. The histopathological data revealed that the articular cartilage was significantly thicker in the operated hip joints at the ventrocaudal and cranial acetabula and the dorsal and ventral femoral heads. The test cartilage exhibited significantly less positive staining for proteoglycans in the dorsocaudal and the cranial acetabula as well as the ventral femoral head. The apparent modulus of elasticity, of the test cartilage was significantly lower than the control value at the dorsocaudal acetabulum. These data show that the surgical procedure produced morphological changes that mimic those in human LCPD. The increased thickness of the articular cartilage of the LCPD femoral head may account for the articular degeneration observed in older patients with LCPD, as increased cartilage thickness is associated with decreased tissue quality.

Animals↗

Cruciate reconstruction using freeze dried anterior cruciate ligament allograft and a ligament augmentation device (LAD). An experimental study in a goat model.

One ACL in each of 11 mature goats was replaced with a freeze dried bone-ACL-bone allograft and a ligament augmentation device (LAD). The LAD was released from its tibial fixation at 3 months postoperation. Biomechanical, microvascular, and histological changes were evaluated 1 year following implantation. The reconstructed knees had a significantly greater total AP translation (3.1 +/- 0.5 mm) (mean and SEM) than the contralateral controls (1.0 +/- 0.1 mm). Differences in primary AP translation were responsible for 59% of the difference in total translation, with only a 0.6 mm difference in secondary translation. Neutral stiffness in the reconstructive knee was 22% of control, while stiffness at 30 N of anterior force was approximately 35% of controls. Ligament stiffness in the linear region for the ACL allograft/LAD was 53% of the control value of 691 N/mm. The maximum load of the allograft/LADs was 1,052 +/- 145 N, or 43% of the contralateral ACL control strength (2,448 +/- 144 N). Five of the six allografts failed at the femoral insertion. Energy (39%) to maximum load was less for allograft/LADs than controls but elongation to maximum load was the same as control. Histologic evaluation of the allograft/LADs revealed soft tissue cellular ingrowth into the LAD in the extraarticular portions. No bony growth into the LAD was observed. The collagen fibers of the graft appear to be arranged in a longitudinal orientation although some areas show chaotic collagen fibers. Microangiography revealed a periligamentous and endoligamentous vascular pattern reminiscent of a normal ACL and complete revascularization of the bone plugs.

Animals↗

A surgical approach to chronic aortomyoplasty in the goat model.

The left latissimus dorsi skeletal muscle of seven male goats was prepared and applied circumferentially to the descending aorta just below the subclavian artery. Stimulation of the neural pedicle of the latissimus dorsi was performed in an attempt to convert it to a fatigue-resistant cardiac-like muscle. Timing of the stimulus was in diastole. Biochemical assays established the conversion, and echocardiography demonstrated aortic compressions in the area of the muscle wrap. Although limited in numbers, the converted latissimus dorsi muscle in the extra-aortic position appears to provide diastolic augmentation.

Animals↗

Effect of neoadjuvant chemotherapy on distraction osteogenesis in the goat model.

Neoadjuvant chemotherapy potentially can have an adverse effect on bone healing in distraction osteogenesis whether given before or concomitant with distraction osteogenesis. It was the purpose of the current study to determine if administration of chemotherapy before distraction adversely affects bone generation in distraction osteogenesis. Twenty-four adult dairy goats were divided randomly into two groups: a control group having distraction osteogenesis only and a chemotherapy group, receiving one course of Adriamycin before distraction osteogenesis. The animals were sacrificed at 6 weeks, 12 weeks, or 24 weeks and the lengthened tibias were evaluated by radiologic studies, biomechanical testing, and histologic analysis. All goats receiving chemotherapy showed systemic adverse effects. In a multifactorial analysis of the lengthened bones, there was no statistically significant difference between the control goats versus goats that received chemotherapy; indicating that there was no sustained inhibitory effect on bone formation by the chemotherapy. These findings suggest that a prior course of chemotherapy with Adriamycin may not be a contraindication to limb lengthening for limb salvage after resection of an osteosarcoma.

Animals↗