Analyze Diet
Veterinary surgery : VS2022; 51(3); 455-463; doi: 10.1111/vsu.13782

Comparative results of 3 treatments for medial femoral condyle subchondral cystic lesions in Thoroughbred racehorses.

Abstract: To compare 3 different methods for treatment of medial femoral condyle (MFC) subchondral cystic lesions in Thoroughbred horses <24 months old based on the criterion of ability to race post-treatment. Methods: Retrospective cohort study. Methods: Thoroughbreds (n = 107, age < 24 months) diagnosed with MFC subchondral cystic lesions. Methods: Medical records between January 2004 and December 2017 were reviewed. Three treatment methods were used in these horses during that time frame: arthroscopic debridement, intralesional autologous mesenchymal stem cell (MSC) injection, and intralesional corticosteroid injection. The outcome evaluated was the ability to compete in a pari-mutuel race. Results: Seventy-eight of 107 Thoroughbreds (73%) raced post-treatment; 41/57 (72%) of horses treated by arthroscopic debridement raced; 16/19 (84%) of horses treated with intralesional MSCs raced; 21/31 (68%) of horses treated with intralesional corticosteroids raced. There was no difference between groups in the ability to start a race. Sex, limb affected, and lesion size also had no effect on the ability to start a race. There was a trend for increasing lesion size reducing the probability of racing. Conclusions: Seventy-three percent of the horses raced, but there was no difference in the ability of unraced Thoroughbreds to race after treatment of MFC subchondral cystic lesions with arthroscopic debridement, intralesional mesenchymal stem cells, or intralesional corticosteroids. Conclusions: The 3 reported treatment options may be considered for treatment of MFC subchondral cystic lesions with a good prognosis for racing post-treatment. Owners should be advised that increasing lesion size decreases the probability of racing.
Publication Date: 2022-02-15 PubMed ID: 35167130DOI: 10.1111/vsu.13782Google 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.
  • Journal Article

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 is a retrospective study that looks at three treatments for a type of knee lesion in young Thoroughbred racehorses, assessing their efficacy based on whether the horses were able to race after treatment. The study found no difference in racing ability post-treatment between the three methods, although it did note a trend that larger lesions might reduce the likelihood of a horse racing again.

Study Background and Methods

  • The study considered a period of data between January 2004 to December 2017, focusing on Thoroughbred horses less than 24 months old with medial femoral condyle (MFC) subchondral cystic lesions. This is a type of knee condition in horses that can influence their capability to race.
  • The primary objective was to compare the effectiveness of three different surgical options: arthroscopic debridement, intralesional autologous mesenchymal stem cell (MSC) injection, and intralesional corticosteroid injection. The workability and success of these treatments were evaluated based on the horse’s ability to compete in a pari-mutuel race post-treatment.

Study Results

  • A total of 107 Thoroughbreds were involved in this study. Of this number, 78 horses (approximately 73%) raced post-treatment.
  • The treatment results were broken down further: 72% of horses treated by arthroscopic debridement raced; 84% of horses treated with intralesional MSCs raced; and 68% of horses treated with intralesional corticosteroids raced.
  • The study found no significant difference across the three treatment groups in terms of their ability to start a race.
  • Additionally, the study noted that factors such as the horse’s sex, the limb affected, and lesion size did not appear to have a meaningful impact on the horse’s ability to start a race.
  • However, the study did indicate a trend which suggested that an increasing lesion size might reduce the horse’s probability of racing.

Study Conclusions

  • Considering the overall success rate of 73% of horses being able to race post-treatment, the study concluded that there was no notable difference in the ability of unraced Thoroughbreds to race after receiving one of the three treatments for MFC subchondral cystic lesions.
  • The study suggests that all three treatments, namely, arthroscopic debridement, intralesional mesenchymal stem cells, and intralesional corticosteroids, could be considered viable treatment options for MFC subchondral cystic lesions due to their good prognosis for racing post-treatment.
  • The study also advises horse owners that larger lesion sizes could possibly reduce the probability of the horse racing again post-treatment.

Cite This Article

APA
Klein CE, Bramlage LR, Stefanovski D, Ruggles AJ, Embertson RM, Hopper SA. (2022). Comparative results of 3 treatments for medial femoral condyle subchondral cystic lesions in Thoroughbred racehorses. Vet Surg, 51(3), 455-463. https://doi.org/10.1111/vsu.13782

Publication

ISSN: 1532-950X
NlmUniqueID: 8113214
Country: United States
Language: English
Volume: 51
Issue: 3
Pages: 455-463

Researcher Affiliations

Klein, Chelsea E
  • Rood and Riddle Equine Hospital, Lexington, Kentucky, USA.
Bramlage, Lawrence R
  • Rood and Riddle Equine Hospital, Lexington, Kentucky, USA.
Stefanovski, Darko
  • New Bolton Center, Department of Clinical Sciences, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Ruggles, Alan J
  • Rood and Riddle Equine Hospital, Lexington, Kentucky, USA.
Embertson, Rolf M
  • Rood and Riddle Equine Hospital, Lexington, Kentucky, USA.
Hopper, Scott A
  • Rood and Riddle Equine Hospital, Lexington, Kentucky, USA.

MeSH Terms

  • Animals
  • Bone Cysts / veterinary
  • Epiphyses
  • Femur
  • Horse Diseases / drug therapy
  • Horse Diseases / surgery
  • Horses
  • Humans
  • Retrospective Studies

References

This article includes 33 references
  1. Bramlage LR. Osteochondrosis related bone cysts.. Proc Am Assoc Equine Pract 1993;39:83-85.
  2. Kold SE, Hickman J, Melsen F. An experimental study of the healing process of equine chondral and osteochondral defects.. Equine Vet J 1986;18(1):18-24.
  3. Ravanetti P, Lechartier A, Hamon M, Zucca E. A composite absorbable implant used to treat subchondral bone cysts in 38 horses.. Equine Vet J 2021;00:1-9.
  4. Santschi EM. Equine subchondral bone cysts.. Proc Am Coll Vet Surg 2011;35-38.
  5. Ray CS, Baxter GM, McIlwraith CW. Development of subchondral cystic lesions after articular cartilage and subchondral bone damage in young horses.. Equine Vet J 1996;28(3):225-232.
  6. Von Rechenberg B, Guenther H, McIlwraith CW. Fibrous tissue of subchondral cystic lesions in horses produce local mediators and neutral metalloproteinases and cause bone resorption in vitro.. Vet Surg 2000;29:420-429.
  7. Olstad K, Ekman S, Carlson CS. An update on the pathogenesis of osteochondrosis.. Vet Pathol 2015;52(5):785-802.
  8. Santschi EM, Wiliams JM, Morgan JW, Johnson CR, Bertone AL, Juzwiak JS. Preliminary investigation of the treatment of equine medial femoral condylar subchondral cystic lesions with a transcondylar screw.. Vet Surg 2015;44(3):281-288.
  9. Howard RD, McIlwraith CW, Trotter GW. Arthroscopic surgery for subchondral cystic lesions of the medial femoral condyle in horses: 41 cases (1988-1991).. J Am Vet Med Assoc 1995;206(6):842-849.
  10. White NA, McIlwraith CW, Allen D. Curettage of subchondral bone cysts in medial femoral condyles of the horse.. Equine Vet J Suppl 1988;6:120-124.
  11. Smith MA, Walmsley JP, Phillips TJ. Effect of age at presentation on outcome following arthroscopic debridement of subchondral cystic lesions of the medial femoral: 85 horses (1993-2003).. Equine Vet J 2005;37(2):175-180.
  12. Foerner JJ, Rick MC, Juzwiak JS. Injection of equine subchondral bone cysts with triamcinolone.. Proc Am Assoc Equine Pract San Antonio 2006;52:412-413.
  13. Wallis TW, Goodrich LR, McIlwraith CW. 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;40(5):461-467.
  14. Ferris DJ, Frisbie DD, Kisiday JD. Clinical outcome after intra-articular administration of bone marrow derived mesenchymal stem cells in 33 horses with stifle injury.. Vet Surg 2014;43:255-265.
  15. Golonka P, Szklarz M, Kusz M, Maredziak M, Houston JI, Marycz K. Subchondral bone cyst surgical treatment using the application of stem progenitor cells combined with alginate hydrogel in small joints in horses.. Pol J Vet Sci 2018;21(2):307-316.
  16. Bodo G, Hangody L, Szabo Z. Arthroscopic autologous osteochondral mosaicplasty for the treatment of subchondral cystic lesion in the medial femoral condyle in a horse.. Acta Vet Hung 2000;48(3):343-354.
  17. Bodo G, Hangody L, Modis L, Hurtig M. Autologous osteochondral grafting (mosaic arthroplasty) for treatment of subchondral cystic lesions in the equine stifle and fetlock joints.. Vet Surg 2004;33(6):588-596.
  18. Ortved KF, Nixon AJ, Mohammed HO, Fortier LA. Treatment of subchondral cystic lesions of the medial femoral condyle of mature horses with growth factor enhanced chondrocyte grafts: a retrospective study of 49 cases.. Equine Vet J 2012;44(5):606-613.
  19. 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 bone cystic lesions of the medial femoral condyle.. Proc Am Assoc Equine Pract Orlando 2002;48:255-256.
  20. Peroni JF, Stick JA. Evaluation of a cranial arthroscopic approach to the stifle joint for the treatment of femorotibial joint disease in horses: 23 cases (1998-1999).. J Am Vet Med Assoc 2002;220(7):1046-1052.
  21. Seo J, Kambayashi Y, Itho M. Effects of a synovial flap and gelatin/β-tricalcium phosphate sponges loaded with mesenchymal stem cells, bone morphogenetic protein-2, and platelet rich plasma on equine osteochondral defects.. Res Vet Sci 2015;101:140-143.
  22. Stewart B, Reid CF. Osseous cyst-like lesions of the medial femoral condyle in the horse.. J Am Vet Med Assoc 1982;180(3):254-257.
  23. Auer JA, von Rechenberg B. Subchondral bone cysts.. Equine Surgery 2012:1255-1263.
  24. Jeffcott LB, Kold SE. Clinical and radiological aspects of stifle bone cysts in the horse.. Equine Vet J 1982;14(1):40-46.
  25. Wylie CE, Newton JR. A systematic literature search to identify performance measure outcomes used in clinical studies of racehorses.. Equine Vet J 2018;50:304-311.
  26. Story MR, Bramlage LR. Arthroscopic debridement of subchondral bone cysts in the distal phalanx of 11 horses (1994-2000).. Equine Vet J 2010;36(4):356-360.
  27. Bramlage LR. Part I: operative orthopedics of the fetlock joint of the horse: traumatic and developmental diseases of the equine fetlock joint.. Proc Am Assoc Equine Pract Las Vegas 2009;55:96-143.
  28. Hogan PM, McIlwraith CW, Honnas CM, Watkins JP, Bramlage LR. Surgical treatment of subchondral cystic lesions of the third metacarpal bone: results in 15 horses (1986-1994).. Equine Vet J 1997;29(6):477-482.
  29. Hubbell JAE. Moving equine anesthesia from an art toward a science.. Proc Am Assoc Equine Pract Virtual 2020;66:153-165.
  30. Wilke MM, Nydam DV, Nixon AJ. Enhanced early chondrogenesis in articular defects following arthroscopic mesenchymal stem cell implantation in an equine model.. J Orthop Res 2007;25(7):913-925.
  31. Rosenthal D, Frank JD. Psychotherapy and the placebo effect.. Psychol Bull 1956;53(4):294-302.
  32. Perez-Nogues M, Derham A, Marmion J, Baker WT. Progression of shallow medial femoral condyle radiographic lucencies in thoroughbred repository radiographs and their influence on future racing careers.. Equine Vet J 2020;53:287-293.
  33. Oliver LJ, Baird DK, Baird AN, Moore GE. Prevalence and distribution of radiographically evident lesions on repository films in the hock and stifle joints of yearling thoroughbred horses in New Zealand.. N Z Vet J 2008;56(5):202-209.

Citations

This article has been cited 0 times.