Multiple osteochondral autografts for treatment of a medial trochlear ridge subchondral cystic lesion in the equine tarsus.

This research explores a new method of treating a specific type of bone and cartilage lesion in horses using a technique adapted from human and canine medicine. The new approach, called multiple osteochondral autografting, was successful in treating the lesion and allowing the patient to fully recover and return to athletic activity within 10 months, with no complications.

Overview of Osteochondral Autograft Technique

The existing technique used for osteochondral autografting in dogs and humans was adapted for application in horses. In this method, an autograft (a graft taken from the patient’s own body) was used to fill the subchondral cystic lesion.

• In particular, three autografts were carefully extracted from the distal lateral trochlear ridge (the lower side ridge) of the talus (ankle bone) in the tarsus (lower leg) of the same horse.
• These autografts were then inserted into the lesion present in the proximal medial trochlear ridge of the talus (upper, inner ridge of the ankle bone).
• This procedure was performed without performing curettage or debridement (cleaning or scraping out diseased or damaged tissue) of the lesion.

Assessment and Outcome of the Procedure

The outcome of the new treatment method was determined through a combination of radiographic imaging, phone interviews with the owner, and direct observation during training exercises.

• Radiographs taken after the surgery indicated that the lesion had been successfully filled by the autografts, which remained congruent with the articular surface (the surface of the bone that interacts with other bones to form a joint).
• No complications or adverse events were encountered following the surgical application of this method.
• The horse was able to enter back into reining training around 10 months after the procedure and has remained sound, indicating successful recovery.
• Two years following the surgery, the horse is still performing athletically with no signs of relapse or further lesion development.

Conclusion

Given the effective and complication-free recovery of the horse following this surgical treatment, the researchers suggest that multiple osteochondral autografting can be considered as a potential primary treatment option for subchondral cystic lesions in the proximal medial trochlear ridge of the talus in equine athletes. However, further evaluation and testing are needed.