Evaluation of a technique for collection of cancellous bone graft from the proximal humerus in horses.
Authors: Harriss Fiona K, Galuppo Larry D, Decock Hilde E V, McDuffee Laurie A, Macdonald Melinda H
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Cancellous Bone Graft Harvesting from the Proximal Humerus in Horses Cancellous bone grafting is an established therapeutic tool in equine orthopaedic surgery, yet donor site options remain limited; Harriss and colleagues investigated whether the proximal humerus could serve as a viable source through a novel surgical approach. Eight horses underwent general anaesthesia and surgical exposure of the lateral proximal humerus, where researchers attempted bone collection using both a specialised human bone harvesting system (Acumed) and conventional instruments, with detailed analysis of graft yield, surgical time, and postoperative complications. Whilst the traditional instruments successfully collected mean cancellous bone weights of 25.6 g—comparable to other equine donor sites—the Acumed system yielded only 3.6 g per horse, and critically, one animal suffered a catastrophic humeral fracture during anaesthetic recovery. Although incisional healing and postoperative lameness were generally satisfactory, the authors concluded this technique cannot be recommended clinically due to the fracture risk, particularly given the biomechanical compromise created by harvesting from a load-bearing bone. The work highlights an important principle for practitioners: whilst the proximal humerus anatomy permits adequate graft collection, the anatomical and mechanical consequences of creating a cortical defect in this site render it unsuitable for routine use, and further biomechanical testing would be necessary before reconsideration.
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Practical Takeaways
- •The proximal humerus is not a reliable donor site for cancellous bone grafting due to unacceptable risk of catastrophic fracture during anesthesia recovery
- •If cancellous bone harvesting from this site is considered, conventional instruments outperform the Acumed system by sevenfold, but structural integrity concerns remain
- •Alternative bone graft donor sites with established safety profiles should be selected for clinical cases
Key Findings
- •The Acumed system collected only 3.6±0.8 g of cancellous bone, substantially less than conventional instruments which yielded 25.6±7.5 g
- •One horse (12.5% mortality) suffered catastrophic humeral fracture during anesthetic recovery, indicating significant structural compromise
- •Minimal postoperative incisional complications and lameness were observed in surviving horses
- •Total surgical time for combined Acumed and conventional harvesting was 38±6 minutes