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.
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...
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 ...
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...
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...
Wadbled L, Finck C, Santschi EM, Morehead JP, Fogarty U, Lemirre T, Beauchamp G, Richard H, Laverty S.Assess femorotibial features in foals with and without medial femoral condyle (MFC) subchondral radiolucencies (SR+ and SR-). Methods: 3 independent, sequential radiographic studies were performed. Study 1 retrospectively measured femorotibial morphological parameters in repository radiographs (SR- and SR+). Study 2 qualitatively compared drawings of intercondylar notch shape in postmortem radiographs (SR-). Study 3 prospectively measured femorotibial parameters in 1-month-old foals (SR-). In studies 1 and 3, 13 morphologic parameters were measured. Limb directional asymmetry was assessed in 2...
Lin ST, Foote AK, Bolas NM, Sargan DR, Murray RC.Information regarding the histopathology of the proximal phalanx (P1) sagittal groove in racehorses is limited. Twenty-nine cadaver limbs from nine Thoroughbred racehorses in racing/race-training underwent histological examination. Histological specimens of the third metacarpal/metatarsal (MC3/MT3) parasagittal grooves and P1 sagittal grooves were graded for histopathological findings in hyaline cartilage (HC), calcified cartilage (CC), and subchondral plate and trabecular bone (SCB/TB) regions. Histopathological grades were compared between (1) fissure and non-fissure locations observed in a ...
Solum G, Acutt E, Johnson SA, Zhou T, Contino EK, Donnell JR, Donnell A, Frisbie DD.Pathological changes of the fetlock joint are well documented in Thoroughbreds, but little information is available describing the common radiographic findings in western performance horses with fetlock lameness. Objective: To describe radiographic findings in western performance horses with fetlock lameness. It was hypothesised that the degree of lameness would correlate with the severity of radiographic findings. Methods: Retrospective case series. Methods: Retrospective review (2012-2022) of horses with lameness isolated to the fetlock joint via intra-articular analgesia and corresponding r...
Pál Z, Tuska P, Vásárhelyi G, Hangody L, Hurtig M, Kaposi AD, Bodó G.To evaluate the clinical application of equine mosaic arthroplasty for joint surface repair, including outcomes and complications. Methods: Retrospective clinical study. Methods: A total of 31 horses diagnosed with subchondral bone cysts (SBCs) in the femoral condyle (22/31), distal metacarpus (7/31), or metatarsus (2/31). Methods: Medical records of horses that underwent autologous or allogeneic osteochondral graft transplantation were reviewed. Follow-up lasted at least 12 months. Success was determined in terms of improvements in lameness and post-surgical athletic performance, classified...
Northwood A, Berner D.Radiographic protocols for the metacarpo-/tarsophalangeal joint during pre-purchase examinations (PPE) vary internationally, but their impact on pathology detection remains unclear. Optimising imaging protocols is essential to balance diagnostic accuracy with workflow efficiency and radiation exposure. Objective: To evaluate the effect of different radiographic view combinations on fetlock pathology detection and observer agreement in a PPE context; hypothesising that detection rates vary with view selection. Methods: Retrospective observational study. Methods: Two observers reviewed fetlock r...
Keller LE, Kelly TN, Chevalier JM, Jung HJ, Pearson GB, Begum L, Beane OS, Bhumiratana S, Fortier LA.Fresh osteochondral allograft (OCA) transplantation effectively repairs cartilage and subchondral bone; however, the persisting shortage of available donor OCAs and their short shelf-life make scheduling surgeries and meeting patient demand challenging. Attempts have been made to develop tissue-engineered solutions to address the limitations of OCA; nonetheless, these have failed to progress beyond the preclinical stage. Objective: To assess the safety and efficacy of a tissue-engineered osteochondral allograft (TE-OCA) as compared with equine OCA in an equine osteochondral defect model. Metho...
Pan M, Malekipour F, Pivonka P, Morrice-West AV, Flegg JA, Whitton RC, Hitchens PL.Fractures of the distal limb in Thoroughbred racehorses primarily occur because of accumulation of bone microdamage from high-intensity training. Mathematical models of subchondral bone adaptation of the third metacarpal lateral condyles are capable of approximating existing data for Thoroughbred racehorses in training or at rest. To improve upon previous models, we added a dynamic resorption rate and microdamage accumulation and repair processes. Our ordinary differential equation model simulates the coupled processes of bone adaptation and microdamage accumulation, and is calibrated to data ...
Beck C, Hitchens PL, Muir P, Whitton RC.Computed tomography (CT) is increasingly used for metacarpo/tarsophalangeal or fetlock joint (MC/TPJ) evaluation in Thoroughbred racehorses. CT features and lesion prevalence in competing Thoroughbreds are unknown. Objective: To identify standing CT features within the MC/TPJ of elite Thoroughbred staying racehorses. Methods: Retrospective cohort study. Methods: Computed tomography scans of the MC/TPJ were performed as part of pre-race screening for fracture risk and graded for CT features. Descriptive statistics and univariable logistic regression models were generated to investigate associat...
Marković L, Vićić I, Lazarević Macanović M, Francuski Andrić J, Kovačević Filipović M, Radaković M.Working horses often develop distinct patterns of joint degeneration, yet research in this population remains limited. This study aimed to characterize degenerative changes in the metacarpophalangeal (MCP) and metatarsophalangeal (MTP) joints of Serbian Mountain Horses using computed tomography (CT) and to explore their associations with synovial fluid (SF) biomarkers. A cross-sectional analysis was conducted on 32 MCP/MTP joints from eight clinically sound horses. Postmortem, joints underwent CT imaging, and SF samples were analyzed for viscosity, protein content, total nucleated cell count (...
De Zani D, Rabbogliatti V, Rabba S, Auletta L, Longo M, Zani DD.Damage to the osteochondral unit is a common cause of lameness in horses. Published descriptions of MRI findings of osteochondral unit and subchondral damage are currently lacking, and only a few reports describe outcomes in sport horses. The aims of this case series retrospective study were to describe different MRI patterns of osteochondral/subchondral pathology in the fetlock joint using low-field MRI and to provide outcome information. A total of 35 sport horses were included. Data regarding detailed clinical history, treatment and outcome were evaluated. MRI identified a total of 39 bone ...
Malekipour F, Whitton RC, Muir P, Lee PV.Stress fractures are common in racehorses, with the metacarpophalangeal (MCP) joint being the most frequently affected site as it is subjected to high-magnitude and high-rate cyclic loads during training and racing. These loads lead to repeated compressive stresses, resulting in subchondral bone (SCB) sclerosis, fatigue microcracks, and matrix damage that can progress to parasagittal fractures or palmar osteochondral disease (POD). The present study developed joint-specific 3D FE models and slice-based FE models using standing CT images for three trained racehorses, each presenting distinct SC...
