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Veterinary surgery : VS2023; doi: 10.1111/vsu.13972

Arthroscopically guided lag screw fixation of subchondral bone cysts in the medial femoral condyle in Thoroughbred racehorses: description of technique and comparative results.

Abstract: To describe an arthroscopically guided technique for lag screw placement across subchondral bone cyst (SBC) in the medial femoral condyle (MFC) and to compare postoperative racing performance with corticosteroid injection and cyst debridement. Methods: Retrospective cohort study. Methods: One hundred twenty-three horses with 134 MFC SBCs undergoing treatment at a single referral hospital in the UK between January, 2009, and December, 2020. Methods: Sex, age, limb affected, radiographic cyst dimensions, preoperative and postoperative lameness, surgical technique (lag screw placement, cyst debridement, intralesional corticosteroid injection), and, where applicable, screw positioning were recorded retrospectively. A ratio was calculated using measurements from preoperative and postoperative radiographs. Outcome was assessed by resolution or improvement in lameness, reduction in cyst size, and starting one race after treatment. Outcome data was compared between treatment groups. Results: Twenty-six of 45 (57.8%) horses that underwent transcondylar screw placement raced postoperatively, at a median of 403 days between surgery and first postoperative race. There was no difference between treatment groups with regard to racing or preoperative and postoperative lameness. Cysts treated with transcondylar screw placement had a greater reduction in cyst size and a reduced period of convalescence in comparison with those that underwent debridement; the results were similar to those treated by intralesional corticosteroid injection. Conclusions: Postoperative racing rates were similar for all techniques. Convalescence was reduced for lag screw placement and corticosteroid injection compared to debridement. Conclusions: The arthroscopically guided technique results in radiographically consistent screw placement and cyst engagement and offers a viable alternative to other treatments.
© 2023 American College of Veterinary Surgeons.
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Publication Date: 2023-06-06 PubMed ID: 37280742DOI: 10.1111/vsu.13972Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research paper details an arthroscopically guided technique for treating subchondral bone cysts in thoroughbred racehorses, comparing the postoperative racing performance after this treatment against two standard treatments: corticosteroid injection and cyst debridement.

Study Methodology

  • The study is retrospective in nature and focuses on 123 horses with a total of 134 subchondral bone cysts in the medial femoral condyle (MFC).
  • All the horses underwent treatment at a single referral hospital in the UK from January 2009 to December 2020.
  • Various parameters such as sex, age, the limb affected, dimensions of the cyst in radiographic view, preoperative and postoperative lameness, the surgical technique used, and where applicable, the placement of the screw, were recorded.
  • A ratio based on measurements from preoperative and postoperative radiographs was calculated.

Outcome Evaluation

  • The outcome was assessed based on the resolution or improvement in lameness, the reduction in cyst size, and the subject’s ability to start one race after treatment.
  • The outcome data was then compared between the different treatment groups.

Study Results

  • Of the 45 horses that underwent lag screw placement, 26 (57.8%) raced postoperatively, with a median of 403 days between the surgery and the first postoperative race.
  • No significant difference was observed between treatment groups regarding racing or preoperative and postoperative lameness.
  • Cysts treated with lag screw placement showed more reduction in size and required a shorter convalescence period compared to those treated with cyst debridement. The results for this group were close to those observed for horses treated by intralesional corticosteroid injections.

Conclusions

  • The postoperative racing rates were similar for all techniques. However, the convalescence period was shorter for lag screw placement and corticosteroid injection compared to debridement.
  • The arthroscopically guided lag screw placement technique offers a viable alternative for treating cysts, resulting in radiographically consistent screw placement and cyst engagement.

Cite This Article

APA
Young N, Barker W, Minshall G, Wright I. (2023). Arthroscopically guided lag screw fixation of subchondral bone cysts in the medial femoral condyle in Thoroughbred racehorses: description of technique and comparative results. Vet Surg. https://doi.org/10.1111/vsu.13972

Publication

Veterinary surgery : VS
ISSN: 1532-950X
NlmUniqueID: 8113214
Country: United States
Language: English

Researcher Affiliations

Young, Natalie
  • Department of Clinical Science and Services, The Royal Veterinary College, Hatfield, UK.
  • Newmarket Equine Hospital, Suffolk, UK.
Barker, Will
  • Newmarket Equine Hospital, Suffolk, UK.
Minshall, Gaynor
  • Newmarket Equine Hospital, Suffolk, UK.
Wright, Ian
  • Newmarket Equine Referrals, Suffolk, UK.

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Citations

This article has been cited 3 times.
  1. Pál Z, Tuska P, Vásárhelyi G, Hangody L, Hurtig M, Kaposi AD, Bodó G. Mosaic arthroplasty in equine stifle and fetlock joints: A retrospective study of 31 cases between 1998 and 2023. Vet Surg 2025 Aug;54(6):1196-1207.
    doi: 10.1111/vsu.14296pubmed: 40576056google scholar: lookup
  2. Pérez-Nogués M, Manso-Díaz G, Spirito M, López-Sanromán J. Treatment Comparison for Medial Femoral Condyle Subchondral Cystic Lesions and Prognosis in Yearling Thoroughbred Racehorse Prospects. Animals (Basel) 2024 Apr 6;14(7).
    doi: 10.3390/ani14071122pubmed: 38612360google scholar: lookup
  3. 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, Eggenhöffner R, Scicluna MT, Barbaro K. Arthroscopic Treatment of a Subchondral Bone Cyst via Stem Cells Application: A Case Study in Equine Model and Outcomes. Biomedicines 2023 Dec 14;11(12).
    doi: 10.3390/biomedicines11123307pubmed: 38137527google scholar: lookup
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