etiology of OSA in any individual dog is likely multifactorialOSA tends to arise in the major weight-bearing bones adjacent to late closing physes size and growth rate in combination create a stressful biomechanical environment in which cellular damage and microfractures amplify mitogenic stimuliOther identified risk factors include chronic osteomyelitis, osteochondrosis/osteonecrosis, previous traumatic fracture, metallic implants used for fracture repair and Tibial Plateau Leveling Osteotomy (TPLO), and radiation exposureOSA, occurring in association with metallic implants, is rare in dogs (0.075%)