298 Canine Sports Medicine and Rehabilitation
cells, supplying growth factors, contributing to
extracellular matrix formation, promoting angio
genesis, and providing anti‐inflammatory and
antifibrotic effects.
In a study of 55 dogs treated with ADPC/PRP,
all had improved fiber patterns at 90 days post
treatment, 82% showed a reduction in supraspi
natus size, and 88% were sound with no signifi
cant difference in thoracic limb total pressure
index (TPI).^1 Four months after treatment, 96%
of the performance and sporting dogs were able
to return to occupation (Canapp et al., 2016b).
While there has been a positive response from
the use of cultured adipose‐derived stem cells,
there have been many challenges clinically that
made users look for alternative means of stem
cell processing. These challenges included high
morbidity associated with fat collection, 2‐week
turnaround time, shipping issues (such as con
taminated, lost, or damaged cells in transit), as
well as increasing laboratory costs. Due to the
low morbidity of BMAC collection, quick in‐
house processing, lower costs, and success of
BMAC/PRP in humans, some have elected to
institute this mode of treatment.
Osteochondritis dissecans of the shoulderOsteochondritis dissecans (OCD) of the humeral
head occurs when the ossification process within
the joint produces an excessive amount of carti
lage. The excessive cartilage formation stems
from failed transformation of cartilage to bone
during endochondral ossification. As the cartilage
accumulates, it becomes easily fissured by normal
activity. These fissures lead to detachment of the
cartilage from the humeral head, which creates a
cartilage flap. OCD is generally considered to be
hereditary and commonly occurs bilaterally in
young dogs ranging from 5 to 12 months of age.
OCD disproportionately affects large‐breed male
dogs (Rochat, 2012). Lameness generally presents
gradually and becomes worse after exercise.Cause
Shoulder OCD etiology is still being estab
lished, but two likely causes have been
observed. The first is the rapid growth that
occurs during adolescence. Early develop
ment is significantly influenced by hormones,Case Study 12.1 Traumatic fragmented medial coronoid processSignalment: 3 ‐y.o. M/I Malinois (Police K9).History: Presented with 2‐month history of intermit-
tent left thoracic limb lameness. Previous diagnosis:
suspect mild shoulder soft tissue injury.Examination: Gait: Mild weight‐bearing lameness in
left thoracic limb at walk.
Posture: Stands slightly off‐loading left thoracic limb.
Palpation: Normal ROM all joints. Mild discomfort
with full extension and abduction of left shoulder and
on direct palpation over left medial coronoid process.
Forelimb circumference: Left, 33 cm; right, 34 cm.
Radiographic findings: shoulders and elbows WNL,
no significant bone remodeling.Arthroscopy: Left elbow: Fissure through tip of medial
coronoid, nondisplaced subchondral fragment; mild
humeroulnar incongruency; cartilage change distal
medial humeral condyle WNL.
Left shoulder: Mild inflammation of bicipital tendon
sheath and cranial joint capsule; medial glenohumeralligament and subscapularis tendon intact, no gross
evidence of pathology.Diagnosis: Traumatic fragmented medial coronoid
process and mild bicipital tenosynovitis.Treatment: Arthroscopic elbow debridement and
curettage. Rechecks every 4 weeks postoperatively.
Enrolled in rehabilitation program.
4 weeks: Mild elbow joint effusion, generalized mild
atrophy of left thoracic limb, ROM of left elbow and
shoulder WNL, no pain or discomfort on palpation.
8 weeks: Decreased joint effusion, improved mus-
cle mass in left thoracic limb, ROM of left elbow and
shoulder WNL, no pain or discomfort on palpation.
12 weeks: Decreased joint effusion; increased
muscle mass; left elbow and shoulder ROM WNL.
No discomfort on direct palpation; no lameness
noted. Gradual return to full duty.Case follow‐up: Active duty 4+ years postsurgery.(^1) Please refer to Chapter 2 for a comprehensive explanation of TPI and evaluating objective gait analysis.