Metacarpophalangeal joint synovial pad fibrotic proliferation in 63 horses.

The study investigates the effects of a growth condition in horses’ metacarpophalangeal joint, examining its correlation with lameness, joint inflammation, and bone change. The researchers also assess both surgical and non-surgical treatment methods and their outcomes on horses’ performance.

Case Selection and Examination

• The records, radiographs, and ultrasound images of 63 horses diagnosed with metacarpophalangeal joint synovial pad proliferation were studied retrospectively.
• All the horses had symptoms of lameness, joint effusion, or both. These horses showed these symptoms in one or both of their metacarpophalangeal joints.
• By studying radiographs, researchers discovered bony remodeling and concavity in the distodorsal region of the third metacarpal bone in 71 joints (93%).
• Around 32% (24 joints) also displayed evidence of chip fractures at the proximal dorsal aspect of the proximal phalanx.

Ultrasound Examination and Surgical Interventions

• Ultrasound was used for further examination in 71% (54 joints) of cases, and the average sagittal thickness of the synovial pad was found to be 11.3 +/- 2.8 mm.
• About 79% of the horses had the condition in a single joint, with equal distribution occurring between the right and left forelimbs.
• Arthroscopic surgery was performed on 68 joints in 55 horses. This involved debridement of chondral or osteochondral fragmentation and removal of bone chip fractures.
• In 42 joints, complete or partial removal of the medial and lateral synovial pads was carried out, while 26 joints had either the medial or lateral pad removed.

Treatment and Prognosis

• Eights joints belonging to eight separate horses were treated non-surgically. This consisted of stall rest and the administration of intra-articular medication and systemic nonsteroidal anti-inflammatory drugs.
• Follow-up data was obtained for both the surgically treated horses (50) and the medically treated horses (8).
• Majority of the horses that underwent surgery (86%) returned to racing. Among them, 68% raced at an equal or better level than prior to surgery.
• In contrast, only 38% of the medically treated horses were able to return to racing.
• The study found that ages of horses who returned to racing at a similar or equal performance level were significantly younger than those returning at a lower level or not racing at all.
• In conclusion, it was observed that horses with synovial pad proliferation who underwent arthroscopic surgery had a good prognosis for returning to racing at a level equal or better than their pre-injury performance.