Subchondral bone refers to the layer of bone just beneath the cartilage in the joints of horses. It plays a role in supporting the overlying cartilage and distributing loads across the joint surface during movement. Changes or damage to the subchondral bone can affect joint function and are often associated with conditions such as osteoarthritis. In horses, the health of subchondral bone is of interest for understanding joint disorders and improving lameness diagnosis and management. This page compiles peer-reviewed research studies and scholarly articles that examine the structure, function, and pathological changes of subchondral bone in equine joints.
Shamis LD, Bramlage LR, Gabel AA, Weisbrode S.Arthrotomies of middle carpal joints were done on 13 horses, and a 1-cm partial thickness, round defect was made on the radial facet of both third carpal bones. In one joint, 1-mm diameter 1-cm deep holes were drilled within the defect, and one joint was used as a control. horses were assigned to 2 groups--group 1 (n = 6 horses), 5 drill holes; group 2 (n = 7 horses), 11 drill holes. At 1 and 3 weeks after surgery, differences between joints in synovial fluid total protein values, WBC counts, or results of mucin precipitate tests were not significant (P = 0.005). Physically and radiographicall...
van Suntum M, Hartung K.Subchondral bone cysts or cyst like lesions are an important hint in the radiographic diagnosis of degenerative joint disease. In this study we set artificial lesions of different size in the subchondral bone of different joint surfaces of horses, and we then tried to determine from which size on these lesions could be made visible on radiographs in different projections. It shows that the possibility of visualization of such lesions is frequently overestimated, cyst like lesions have to be quite large, before they can be seen on routine radiographs.
Specht TE, Nixon AJ, Colahan PT, Moore BG, Brown MP.Four horses with subchondral cyst-like lesions in the medial radial facet of the distal portion of the radius were examined. Joint effusion and signs of pain from flexion of the antebrachiocarpal joint were not observed, but lameness was observed in 3 of the 4 horses. Regional nerve blocks and intra-articular anesthesia were used to localize the lesions, and conservative treatment resulted in soundness for performance.
White NA, McIlwraith CW, Allen D.Fifty-one horses and unilateral or bilateral femorotibial arthrotomy with medial condyle bone cyst curettage. A total of 60 cyst were treated. Treated horses responded to the surgery three to 12 months postoperatively. In 42 horses lameness was reduced or eliminated, enabling them to return to an remain in their intended function. Of these 42 horses 35 are sound, four of which have not started training, and seven showed partial improvement, two of which had no long term follow up. Of the remaining nine horses, two showed no reduction in lameness and seven were not followed up. Arthrotomy was s...
Rose PL, Auer JA, Hulse D, Hightower D, Schenk RK.beta-Tricalcium phosphate (TCP) was evaluated as a synthetic bone grafting material in horses. Sixteen horses were randomly assigned to 4 groups of 4 horses. In each horse, an 11-mm by 10-mm circular defect with a smooth margin was created surgically in the weight-bearing surface of both third metacarpal bones (McIII) and the left third metatarsal bone. The defect in the left McIII was filled with TCP, the defect in the right McIII was filled with a mixture of 50% autogenous cancellous bone (ACB) and 50% TCP, and the defect in the left third metatarsal bone was not filled to serve as a control...
Nixon AJ, Adams RM, Teigland MB.Bilateral subchondral cystic lesions of the femoral head in a horse resulted in lameness. The lesions had resulted in degenerative disease in the left coxofemoral joint. The cause of lameness was confirmed by use of intra-articular anesthesia, joint fluid analysis, and radiography. Subchondral cystic lesions involving the femoral head should be considered in the differential diagnosis of equine lameness localized in the upper portion of the hind limb.
Rose PL, Hightower D, Auer JA, Hulse D, Schenk RK.In the present study, radionuclide scintigraphy and radiography were used to evaluate the rate and degree of healing that occurred in surgically created subchondral bone defects in horses. Following radionuclide scintigraphy and radiography the horses were killed, and histomorphometric analysis was performed on the defect sites. The histomorphometric results were compared to the radionuclide scintigraphic and radiographic results to determine which noninvasive technique provided the most accurate information concerning healing of the bone defects. It was concluded that radionuclide scintigraph...
Vachon A, Bramlage LR, Gabel AA, Weisbrode S.To determine the effect of subchondral bone drilling (forage) on the cartilage repair process after injury has occurred, a cartilage defect (1 cm in diameter) was created on the radial facet of the proximal surface of each third carpal bone in 6 adult horses. In one of the third carpal bones (right or left thoracic limb) of each horse, a 1-cm cartilage defect was created, and 5 holes (1 mm in diameter and 10 mm deep) were drilled through the subchondral bone into the cancellous bone. In the other thoracic limb, an identical defect was created, but not drilled. Analyses of cell numbers and type...
Bertone AL, McIlwraith CW, Powers BE, Stashak TS, Aanes WA, Turner AS.Subchondral osseous cystic lesion of the elbow was diagnosed as a cause of lameness in 6 horses. Persistent lameness and signs of degenerative joint disease developed in the first 3 horses treated conservatively with confinement. Subsequently, 3 horses were each treated by extra-articular enucleation of the cystic cavity via the proximal-medial aspect of the radius. Compared with conservative management, better long-term success (determined by return of athletic soundness and less evidence of degenerative joint disease) was achieved with surgical curettage of elbow subchondral cystic lesions.
Dyson S.The results of a detailed investigation of 58 horses with suspected shoulder lameness are described. Lameness was found to originate distal to the shoulder region in 22 horses. No diagnosis was reached in five horses. Genuine shoulder problems occurred in 29 horses. The clinical signs of shoulder lameness are described and contrasted with lower limb lameness. The limitations of currently available diagnostic techniques are discussed. Problems identified in the shoulder region included osteochondritis dissecans, subchondral bone cysts, arthrosis, fracture, luxation, septic arthritis and soft ti...
Kold SE, Hickman J, Melsen F.Four full thickness cartilage defects, two linear and two elliptical, and four subchondral cavity defects were created at the point of weightbearing of the medial femoral condyle in four experimental ponies. This study showed that subchondral bone cysts can develop following full thickness (cartilage only) linear cartilage defects at a weightbearing location. Subchondral bone cysts did not develop following the removal of an elliptical piece of cartilage, exposing the subchondral bone. Primary subchondral defects created in communication with the joint cavity did not heal by replacement with b...
Kold SE, Hickman J.The results of surgical treatment of 10 subchondral bone cysts, all located in the medial femoral condyle, are presented. A cancellous bone graft was used in nine cases and a two component acrylic bone cement was used in the case of an extremely large cyst. Eight out of the 10 cases made a satisfactory clinical recovery.
Kold SE, Hickman J.The clinical features, diagnosis and radiological findings of eight cases of a subchondral bone cyst involving the medial condyle of the femur are described. Surgical treatment, which comprised performing an arthrotomy of the femorotibial joint, curetting and packing the cystic cavity with an autogenous cancellous bone graft, is described.
Jeffcott LB, Kold SE, Melsen F.The gross and histological appearance of subchondral bone cysts in six Thoroughbred or partbred horses is described. The lesions were all situated in the centre of the medial femoral condyle and were not associated with any other damage to the articular surface of the femorotibial or femoropatellar joints. In three cases the cysts were unilateral but had an early non-cystic lesion present in the opposite stifle. All the cysts had a narrow channel at their distal extremity which communicated with the femorotibial joint. The more recently developed ones were fluid filled and contained fibrous st...
Svalastoga E.Microangiographical investigations of the navicular bone in horses with navicular disease show, compared to similar investigations of normal navicular bones, that, in general, the vascular pattern is preserved but the vessels are dilated with "pooling" of the contrast medium subchondrally under facies flexoria. Similar changes may be observed in cases of human arthrosis. The present investigation therefore supports the view that navicular disease is a disease which resembles arthrosis.
Svalastoga E, Smith M.The subchondral bone pressure in the navicular bone of horses with navicular disease is compared with corresponding pressures in normal horses. An increased intraosseous pressure and a lengthened pressure drop time was demonstrated in patients with navicular disease, which indicates the existence of a venous stasis. Compared with similar investigations in humans with arthrosis it is concluded that navicular disease is a condition resembling arthrosis. The classical clinical symptoms are explained as an expression of resting pains. Treatments are suggested which theoretically can render the pat...
Verschooten F, De Moor A.Twenty-nine horses were examined over a period of 8 years and found to have cystic lesions in the stifle (14 cases) or pedal bone (15 cases). The lesions are described and illustrated with radiographs. In the stifle 12 lesions were found on the femoral condyles (11 medially and one laterally) and 10 were typical subchondral cysts. One lesion was observed in the tibia and 3 in the patella. Bone cysts wee found unilaterally in the pedal bone (14 in the forelimbs and one in the hindlimb). All but 2 of the horses with lesions in the stifle or pedal bone were lame. The only treatment was rest. For ...
Jeffcott LB, Kold SE.The clinical and radiological characteristics of stifle lameness in 86 horses are described. The majority of these cases had been lame for some weeks before referral. The most frequent diagnoses made were osteochondrosis dissecans (13 per cent) and subchondral bone cyst (38 per cent). Both of these conditions were seen principally in Thoroughbreds at or before the onset of training. The other bone lesions encountered were osteoarthritis (3 per cent), fractures (4 per cent) and "epiphysitis" (1 per cent). The commonest soft tissue condition was an atypical or partial upward fixation of the pate...
Jeffcott LB, Kold SE.Thirty-three cases with subchondral bone cysts in the stifle are reported. The condition was most commonly seen in young Thoroughbreds and produced intermittent lameness of varying degree. Radiographically distinct areas of radiolucency were found in the distal femur or proximal tibia adjacent to the femorotibial joint. Lesions were usually unilateral but 5 horses had cysts in both stifles. The cases could be divided into 2 distinct groups. Horses in Group A (28 cases) had a large circular or dome-shaped cyst in the medial femoral condyle with a distinct communication with the femorotibial joi...
O'Brien TR, Hornof WJ, Meagher DM.Subchondral lesions were identified in the distal palmar region of the third metacarpus in 21 fetlock joints of 15 Thoroughbred horses. The lesions were more commonly identified on the lateromedial and flexed lateral projection, with the flexed lateral projection permitting optimal visualization of the lesion. Lesions appeared as poorly marginated, radiolucent defects and were located at the level of the base of the proximal sesamoid bones. The shape and distribution of the radiolucent defects were: crescent, 4; flattened, 4; shallow concavity, 5; deep concavity, 3; oval, 3; and circular, 2. S...
Rejnö S, Strömberg B.An investigation was made of the pathology of osteochondritis dissecans of young foals and horses with clinical signs of the lesion. A randomly selected material of fetuses and young foals without clinical signs was also examined. It was demonstrated that osteochondritis dissecans is primarily a cartilaginous disease, as previously described in pigs and dogs. Thickening, disturbance of endochondral ossification, degeneration and necrosis of the cartilage were the four main features of osteochondritis dissecans. Cracks and fissures occurred in the degenerated and necrotic parts of the cartilage...
Ross MW.To correlate scintigraphic and clinical findings of the metatarsophalangeal joint (MTPJ) in Standardbreds, radiographic findings in horses with confirmed MTPJ lameness, and determine if stress reaction and more advanced bone remodelling occurred in the MTPJ, medical records of 114 Standardbreds admitted between September 1993 and April 1995 in which bone scintigraphy included standing lateral and plantar views of the metatarsophalangeal joint (MTPJ) were reviewed. Images obtained using a large field of view gamma camera were evaluated visually for location, definition and intensity of increase...
Norton NM, Santschi E, Fischer KJ.The etiology of subchondral bone cysts (SBCs) is not fully understood. Mechanical trauma and fluid pressure are two mechanisms believed to cause their formation and growth. The equine stifle joint provides a natural animal model for studying SBCs. Computed tomography images of an extended yearling cadaveric stifle joint were segmented using ScanIP to isolate bones and relevant soft tissues. Three model geometries were created to simulate cyst sizes of approximately 0.03 cm (C1), 0.5 cm (C2), and 1 cm (C3). A uniform pressure resulting in 3000 N force was applied at the proximal end of the fem...
Ekman S, Skiöldebrand E, Heinegård D, Hultenby K.One of the most common causes of lameness in racehorses is osteoarthritis (OA). Pathogenesis is not clear and pathological processes of the different joint tissues interact in often progressive events. The interface between cartilage and newly synthesised bone has been shown to be particularly enriched in bone sialoprotein (BSP), a cell-binding matrix protein. Objective: To establish whether changes in the concentration of BSP may serve as a marker for early biochemical changes of the subchondral bone. Methods: Articular cartilage, cartilage/bone interface and subchondral bone of the proximal ...
Nocera I, Puccinelli C, Sgorbini M, Bagnoli E, Citi S.In adult horses, specific ultrasound (US) features and reference values have been reported for the appearance of the joint cartilage and thickness according to the type of joint, such as femoropatellar and tarsocrural. The US appearance of the fetlock has been described in several diseases. The present research evaluates the US features of the metacarpal/tarsal-phalangeal joints in healthy racehorses according to age and breed, since no information is available in the literature. Seventy-one fetlocks in 28 healthy horses (15/28 thoroughbreds and 13/28 standardbreds) were assessed. The horses w...
Burba DJ, Collier MA, Debault LE, Walls RC.An in vivo biopsy technique was developed to harvest cylindrical osteochondral core samples (2 mm diameter x 2 mm depth) from the articular surfaces of radial carpal bones in adult horses for use in osteoarthritis drug kinetic studies. A 25 degree arthroscope was introduced into the midcarpal joint through the dorsolateral surface, and a custom-built motorized core drill was introduced through the dorsomedial surface to create the osteochondral core samples. A total of 24 core samples were sequentially harvested in vivo, and 16 at postmortem, from eight horses on four different occasions withi...
Specht TE, Nixon AJ, Colahan PT, Moore BG, Brown MP.Four horses with subchondral cyst-like lesions in the medial radial facet of the distal portion of the radius were examined. Joint effusion and signs of pain from flexion of the antebrachiocarpal joint were not observed, but lameness was observed in 3 of the 4 horses. Regional nerve blocks and intra-articular anesthesia were used to localize the lesions, and conservative treatment resulted in soundness for performance.
Fortin-Trahan R, Lemirre T, Santschi EM, Janes JG, Richard H, Fogarty U, Beauchamp G, Girard CA, Laverty S.There is a knowledge gap about how equine MFC subchondral radiolucencies (SR) arise and evolve. Osteoclasts are believed to have a role but have not been studied in situ. Objective: To measure and compare osteoclast density and the percentage of chondroclasts in healthy and MFC SR specimens from juvenile Thoroughbreds. Methods: Cadaveric study. Methods: Medial femoral condyles (MFC) from a tissue bank of equine stifles were studied. Inclusion criteria were MFCs (≤8 months old) with a computed tomography SR lesion and histological focal failure of endochondral ossification (L group). Contral...
Shaktivesh , Malekipour F, Whitton C, Lee PVS.Standard fatigue testing of bone uses a single load and frequency applied until failure. However, in situ, the subchondral bone of Thoroughbred racehorses is subjected to a combination (or a spectrum) of loads and frequencies during training and racing. Objective: To investigate the use of a fatigue testing method for equine third metacarpal (McIII) subchondral bone under a spectrum of loading conditions which a racehorse is likely to experience during a fast workout. Methods: In vitro biomechanical experimental study. Methods: McIII subchondral bone specimens (n = 12) of racehorses were ha...
Lescun TB, Ward MP, Adams SB.To compare gentamicin concentrations achieved in synovial fluid and joint tissues during IV administration and continuous intra-articular (IA) infusion of the tarsocrural joint in horses. Methods: 18 horses with clinically normal tarsocrural joints. Methods: Horses were assigned to 3 groups (6 horses/group) and administered gentamicin (6.6 mg/kg, IV, q 24 h for 4 days; group 1), a continuous IA infusion of gentamicin into the tarsocrural joint (50 mg/h for 73 hours; group 2), or both treatments (group 3). Serum, synovial fluid, and joint tissue samples were collected for measurement of gentami...
Collier MA, Haugland LM, Bellamy J, Johnson LL, Rohrer MD, Walls RC, Bartels KE.This study was performed to investigate the effects of holmium:yttrium-aluminum-garnet (Ho:YAG) laser energy on articular cartilage and subchondral bone adjacent to traumatically created cartilage lesions in a continuous weight-bearing model. The 2.1-microns wavelength was delivered efficiently and precisely in hand-controlled contact and near-contact hard tissue arthroscopic surgery in a saline medium. Bilateral arthroscopy was performed on normal antebrachiocarpal and intercarpal joints of four adult horses. One hundred twenty traumatic lesions were created on three weight-bearing articular ...
van de Lest CH, van den Hoogen BM, van Weeren PR, Brouwers JF, van Golde LM, Barneveld A.Osteochondrosis (OC) is a disturbance in the process of endochondral ossification, a process in which cartilage is mineralised and transformed into bone. In this process different biochemical events occur, of which the cartilage component has been studied so far almost exclusively. In this study we concentrated on the biochemical characterisation of normal and osteochondrotic subchondral bone, by analysis of enzyme activities, DNA content and phospholipids (PL). In subchondral bone, lysyl oxidase and both total and bone alkaline phosphatase activity were significantly increased in all degrees ...
Daniel CR, Taylor SE, McPhee S, Wolfram U, Schwarz T, Sommer S, Kershaw LE.Fatigue-related subchondral bone injuries of the third metacarpal/metatarsal (McIII/MtIII) bones are common causes of wastage, and they are welfare concerns in racehorses. A better understanding of bone health and strength would improve animal welfare and be of benefit for the racing industry. The porosity index (PI) is an indirect measure of osseous pore size and number in bones, and it is therefore an interesting indicator of bone strength. MRI of compact bone using traditional methods, even with short echo times, fail to generate enough signal to assess bone architecture as water protons ar...
Auth AK, Hinnigan GJ, Smith MA, Owen KR.Low-field, magnetic resonance imaging (MRI) is an advanced imaging modality widely used to diagnose distal limb pathology in horses, but there are limited data regarding lesion distribution within the metacarpo/metatarsophalangeal joint (MCP/MTPJ) region in lame nonracehorses. The aim of this study was to describe the low-field MRI findings and lesion distribution in nonracehorses with MCP/MTPJ region pain. Clinical records from horses undergoing MRI of the MCP/MTPJ region between July 2016 and March 2023 were reviewed. Horses were included if pain causing lameness was localized to this region...
Pige C, Spriet M, Perez-Nogues M, Katzman S, Le Jeune S, Galuppo L. F-sodium fluoride ( F-NaF) positron emission tomography (PET) has been validated as a useful imaging technique in the racehorse fetlock. The use of F-NaF PET in the nonracehorse fetlock has not been reported. Objective: To describe F-NaF PET findings in nonracehorse fetlocks, to compare with computed tomography (CT) findings and to compare PET findings between horses with and without fetlock pain. Methods: Retrospective observational study. Methods: All horses undergoing F-NaF PET and CT imaging of the fetlock between October 2016 and March 2021 were included in the study. Medical records ...
Barton CK, Samol MA, Nelson BB, Piquini G, Smanik LE, Goodrich LR.To raise awareness of the potential for intra-articular subchondral bone sequestrum formation secondary to a traumatic or septic process to enable more rapid identification of this uncommon but possible outcome in future cases. Methods: A client-owned 12-year-old Appaloosa mare. Unassigned: The mare had a wound to the lateral aspect of the fourth metatarsal bone (MT4) that communicated with the distal tarsal joints. Radiographs revealed a displaced, comminuted fracture of MT4. Results: The horse underwent aggressive debridement of the wound and MT4 as well as, on 2 occasions, needle joint lava...
Andersen C, Jacobsen S, Uvebrant K, Griffin JF, Vonk LA, Walters M, Berg LC, Lundgren-Åkerlund E, Lindegaard C.Integrin α10β1-selected mesenchymal stem cells (integrin α10-MSCs) have previously shown potential in treating cartilage damage and osteoarthritis (OA) and in animal models . The aim of this study was to further investigate disease-modifying effects of integrin α10-MSCs. Methods: OA was surgically induced in 17 horses. Eighteen days after surgery, horses received 2 × 10 integrin α10-MSCs intra-articularly or were left untreated. Lameness and response to carpal flexion was assessed weekly along with synovial fluid (SF) analysis. On day 52 after treatment, horses were euthanized, and carp...
Canonici F, Marcoccia D, Bonini P, Monteleone V, Innocenzi E, Zepparoni A, Altigeri A, Caciolo D, Tofani S, Ghisellini P, Rando C, Pechkova E, Rau JV....Subchondral bone cysts in horses represent one of the main causes of lameness that can occur in different anatomical locations. The study describes the treatment in regenerative therapy of the intracystic implantation of adipose tissue mesenchymal stromal cells (AMSCs) included in platelet-rich plasma (PRP). The ability of AMSCs to differentiate in osteogenic cells was tested in vitro and in vivo. Given the aim to investigate the application of AMSCs in bone defects and orthopedic pathologies in horses, a four-year-old male thoroughbred racing horse that had never raced before was treated for ...
Sauer FJ, Hellige M, Beineke A, Geburek F.Few case reports describe equine coxofemoral joint osteoarthritis (CFJOA). Objective: To evaluate diagnostic findings and outcome of horses with CFJOA and to provide a score facilitating radiographic assessment. Methods: Retrospective case series. Methods: History, clinical signs, ultrasonographic, radiographic and intra-articular anaesthesia findings, treatments, outcome, and necropsy results of horses with CFJOA presented between 2002 and 2023 were collated. Radiographic findings were categorised to develop a radiographic score which was applied by two masked examiners. Intra- and inter-obse...
Ciamillo SA, Wulster KB, Gassert TM, Richardson DW, Brown KA, Stefanovski D, Ortved KF.Catastrophic injuries of the fetlock joints occur in Thoroughbred racehorses and are preceded by stress-induced bone injury. Early detection of subchondral bone injury is essential to prevent irreversible damage or bone failure. Objective: To investigate the use of standing, robotic cone-beam computed tomography (CBCT) for assessing longitudinal changes in subchondral bone morphology and pathology of the fetlock joints associated with race training in young Thoroughbreds. Methods: Observational cohort study. Methods: Forty-one 2-year-old Thoroughbred racehorses were recruited prior to the star...
Antunes J, Salcedo-Jiménez R, Lively S, Potla P, Coté N, Dubois MS, Koenig J, Kapoor M, LaMarre J, Koch TG.Osteoarthritis (OA) is a leading cause of lameness in horses with no effective disease-modifying treatment and challenging early diagnosis. OA is considered a disease of the joint involving the articular cartilage, subchondral bone, synovial membrane, and ligaments. Osteochondritis dissecans (OCD) is a joint disease consisting of focal defects in the osteochondral unit which may progress to OA later in life. MicroRNAs (miRNAs) have been recognized as small non-coding RNAs that regulate a variety of biological processes and have been detected in biological fluids. MiRNAs are currently investiga...
Koshyk A, Pohl AJ, Takahashi Y, Scott WM, Sparks HD, Edwards WB.Fractures of the equine metacarpophalangeal (MCP) joint are among the most common and fatal injuries experienced by racehorses. These bone injuries are a direct result of repetitive, high intensity loading of the skeleton during racing and training and there is consensus that they represent a mechanical fatigue phenomenon. Existing work has found the fatigue life of bone to be strongly determined by bone microarchitecture and the resulting stressed volume (i.e., the volume of bone stressed above assumed yield). The purpose of this study was to quantify the influence of bone microarchitecture o...
Steiner J, Richter H, Kaufmann R, Ohlerth S.Single-source dual energy (SSDECT) and detector-based spectral computed tomography (DBSCT) are emerging technologies allowing the interrogation of materials that have different attenuation properties at different energies. Both technologies enable the calculation of effective atomic number (EAN), an index to determine tissue composition, and electron density (ED), which is assumed to be associated with cellularity in tissues. In the present prospective observational study, EAN and ED values were determined for 16 zones in normal subchondral and trabecular bone of 37 equine cadaver limbs. Using...
Goodrich LR, McIlwraith CW, Grieger J, Kraus VB, Stabler T, Werpy N, Phillips J, Samulski RJ, Frisbie D.To evaluate the effects of a gene transfer approach to IL-1β inhibition in an equine osteochondral chip fragment model of joint injury using a self-complementary adeno-associated virus with interleukin receptor antagonist transgene cassette (scAAVIL-1ra), as posttraumatic osteoarthritis in horses, similar to people, is a significant clinical problem. Methods: 16 horses were utilized for the study. Methods: All horses had an osteochondral chip fragment induced arthroscopically in one middle carpal joint while the contralateral joint was sham operated. Eight horses received either scAAVIL-1ra o...
