Concurrent or sequential tibial subchondral cystic lesions in 4 horses with medial femoral condyle subchondral cystic lesions.
Abstract: CASE DESCRIPTION 4 horses were examined because of signs of chronic hind limb lameness. CLINICAL FINDINGS 3 horses had a history of lameness for > 6 months; specific duration was unknown for 1 horse. On initial evaluation, grade 3 to 4 (on a scale from 1 to 5) hind limb lameness was present in all 4 horses. Radiography of the stifle joint of the affected limb revealed medial femoral condyle subchondral lucencies or subchondral cystic lesions (SCLs) in all 4 horses, medial femorotibial osteoarthritis in 3 horses, and medial tibial condyle SCLs in 3 horses. TREATMENT AND OUTCOME 2 horses were treated medically (stall rest and oral NSAID administration), and 2 horses were treated surgically by means of medial femoral transcondylar lag screw placement through the medial femoral condyle SCLs. The 2 horses treated medically did not improve and were euthanized. Necropsy confirmed the presence of medial femoral condyle and medial tibial condyle SCLs. Surgical treatment did not resolve the lameness in 1 horse with SCLs in the medial tibial condyle and medial femoral condyle, and euthanasia was performed 150 days after surgery. In the second horse, a medial tibial condyle SCL was evident on radiographs obtained 3 months after surgery; however, this was not addressed surgically, and signs of lameness resolved 11 months after surgery. CLINICAL RELEVANCE Results of this small case series suggested that SCLs in the medial tibial condyle can occur in association with SCLs of the medial femoral condyle, with a poor prognosis for return to athletic function in affected horses. Further investigation is indicated.
Publication Date: 2016-11-23 PubMed ID: 27875085DOI: 10.2460/javma.249.11.1313Google Scholar: Lookup
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Summary
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The research article examines four cases of horses dealing with chronic hind limb lameness and investigates the concurrent or sequential occurrence of subchondral cystic lesions in the tibial and femoral condyles with medial femorotibial osteoarthritis. The study found a poor prognosis for affected horses returning to athletic activities, calling for more research in this area.
Case Description
- The research took into consideration four horses exhibiting chronic hind limb lameness.
- Three horses had a history of lameness for over six months, while the exact condition duration for the fourth horse remained unknown.
- Initial evaluations revealed grade 3 to 4 hind limb lameness (on a scale from 1 to 5) in all four horses.
- Radiographic examinations displayed the presence of subchondral cystic lesions (SCLs) in the medial femoral condyles in all horses, medial femorotibial osteoarthritis in three horses, and medial tibial condyle SCLs in three horses.
Treatment and Outcome
- Two horses underwent medical treatments involving stall rest and oral NSAID administration, while the other two were surgically treated using medial femoral transcondylar lag-screw placement through the medial femoral condyle SCLs.
- The two medically treated horses showed no improvement and were ultimately euthanized. The presence of SCLs in the medial femoral and tibial condyles was subsequently confirmed through necropsy.
- One horse that underwent surgery did not show improved lameness and was euthanized 150 days post-operation.
- The other surgically treated horse displayed a medial tibial condyle SCL three months post-surgery, which was left untreated. Interestingly, signs of lameness resolved in this horse 11 months after surgery.
Clinical Relevance
- The exploration of these four individual cases led to a hypothesis that SCLs in medial tibial condyle could surface in conjunction with SCLs of the medial femoral condyle, impacting the horses’ healing and return to athletic work.
- The study demonstrated a high degree of unpredictability regarding these specific cases’ prognosis and treatment success, underscoring the need for further investigations.
Cite This Article
APA
Bonilla AG, Bertone AL, Brokken MT, Santschi EM.
(2016).
Concurrent or sequential tibial subchondral cystic lesions in 4 horses with medial femoral condyle subchondral cystic lesions.
J Am Vet Med Assoc, 249(11), 1313-1318.
https://doi.org/10.2460/javma.249.11.1313 Publication
Researcher Affiliations
MeSH Terms
- Animals
- Anti-Inflammatory Agents, Non-Steroidal
- Bone Cysts / pathology
- Bone Cysts / surgery
- Bone Cysts / veterinary
- Femur / pathology
- Horse Diseases / pathology
- Horse Diseases / surgery
- Horses
- Male
- Tibia / pathology
Citations
This article has been cited 2 times.- Lemirre T, Santschi E, Girard C, Fogarty U, Chapuis L, Richard H, Beauchamp G, Laverty S. Maturation of the equine medial femoral condyle osteochondral unit. Osteoarthr Cartil Open 2020 Mar;2(1):100029.
- 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).
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