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Catastrophic complication following injection and extracorporeal shock wave therapy of a medial femoral condyle subchondral cystic lesion in a 14 year old Arabian mare.
Abstract: This report describes fibrous cyst lining injection and extracorporeal shock wave therapy (ESWT) of a medial femoral condyle (MFC) subchondral cystic lesion (SCL) resulting in catastrophic MFC fracture in an Arabian mare. The mare was presented for evaluation of a severe hind limb lameness of approximately 4 months duration. On presentation, a non-weight bearing lameness of the left hind limb with severe effusion and soft tissue swelling of the stifle region was noted. Radiographic evaluation of the stifle revealed a large SCL of the MFC with associated osteoarthritis. Arthroscopic guided intra-lesional injection of the SCL with corticosteroids and autologous bone marrow concentrate was performed followed by ESWT of the MFC. The mare was discharged walking comfortably 48-hours post-operatively. An acute increase in lameness was noted 14 days post-operatively. Imaging revealed catastrophic fracture of the left MFC. Possible mechanisms leading to failure of the MFC secondary to the described treatment are discussed.
Publication Date: 2017-05-11 PubMed ID: 28616392PubMed Central: PMC5440609DOI: 10.4314/ovj.v7i2.6Google Scholar: Lookup The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
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Summary
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The research article details a case of a severe complication in a horse after it underwent injection therapy and extracorporeal shock wave therapy for a cyst in its leg.
Introduction
- The study is centered around a 14-year-old Arabian mare which was presented for examination due to severe hind limb lameness that had persisted for around 4 months. The lameness was severe enough to significantly limit the mare’s ability to bear weight on its left hind limb. Additional symptoms included severe soft tissue swelling and stifle region effusion (a collection of fluid).
Initial Diagnosis and Treatment
- A radiographic examination of the stifle, or knee joint in horses, revealed a large subchondral cystic lesion (SCL), which is a type of cyst below the cartilage, on the medial femoral condyle (MFC), a common site for such lesions, with accompanying osteoarthritis.
- Having identified the problem, the mare underwent arthroscopic guided intra-lesional injection into the SCL. This procedure involved injecting corticosteroids and autologous bone marrow concentrate, prepared from the mare’s own bone marrow, into the cyst.
- Following this, the mare underwent extracorporeal shock wave therapy (ESWT) on its MFC – a non-invasive treatment which uses pressure waves to promote healing.
- The initial response to the treatment was positive, as the mare was reported to be walking comfortably 48 hours after the operations.
Post-Treatment Complications
- However, an acute increase in lameness was noticed 14 days after the operations. Further imaging revealed a severe, or “catastrophic”, fracture of the left MFC.
- The study thus discusses the potential reasons and mechanisms that led to the failure of the MFC due to the treatment. These could provide valuable insights for handling similar cases in the future to prevent such devastating complications.
Cite This Article
APA
Moser DK, Schoonover MJ, Sippel KM, Dieterly AM, Ritchey JW, Wall CR.
(2017).
Catastrophic complication following injection and extracorporeal shock wave therapy of a medial femoral condyle subchondral cystic lesion in a 14 year old Arabian mare.
Open Vet J, 7(2), 111-116.
https://doi.org/10.4314/ovj.v7i2.6 Publication
Researcher Affiliations
- Desert Pines Equine Medical and Surgical Center, Las Vegas, Nevada, USA.
- Oklahoma State University, Center for Veterinary Health Sciences, Department of Veterinary Clinical Sciences, Stillwater Oklahoma, USA.
- Gulf Coast Veterinary Specialists, Houston, Texas, USA.
- Oklahoma State University, Center for Veterinary Health Sciences, Department of Veterinary Pathobiology, Stillwater Oklahoma, USA.
- Oklahoma State University, Center for Veterinary Health Sciences, Department of Veterinary Pathobiology, Stillwater Oklahoma, USA.
- Oklahoma State University, Center for Veterinary Health Sciences, Department of Veterinary Clinical Sciences, Stillwater Oklahoma, USA.
References
This article includes 12 references
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- Sandler EA, Bramlage LR, Embertson RM, Ruggles AJ, Frisbie DD. Correlation of lesion size with racing performance in thoroughbreds after arthroscopic surgical treatment of subchondral cystic lesions of the medial femoral condyle:150 cases. In the proceedings of the 2002. Annual Convention of the American Association of Equine Practitioners 2002:255–256.
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- Wallis TW, Goodrich LR, McIlwraith CW, Frisbie DD, Hendrickson DA, Trotter GW, Baxter GM, Kawcak CE. Arthroscopic injection of corticosteroids into the fibrous tissue of subchondral cystic lesions of the medial femoral condyle in horses: a retrospective study of 52 cases (2001-2006).. Equine Vet J 2008 Jul;40(5):461-7.
Citations
This article has been cited 1 times.- Qiu Z, Wang J, Zhang Y, Liu X, Wei C, Ma T. Extracorporeal shock wave therapy for equine musculoskeletal disorders: from biological mechanisms to clinical applications. Front Vet Sci 2025;12:1719123.
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