Concurrent or sequential tibial subchondral cystic lesions in 4 horses with medial femoral condyle subchondral cystic lesions.

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.