Osteomyelitis of the patella in eight foals.

This research article presents a case-series study conducted over the course of four years (2003-2007), investigating the characteristics of osteomyelitis, a form of bone infection, in the kneecap (patella) of young horses (foals), and the effects of the treatment used for this condition. The study monitored the short and long term outcomes in eight foals, six of which survived and recovered fully following intensive medical and surgical therapy, while two foals died due to related complications.

Study Design and Methods

• Eight foals diagnosed with osteomyelitis of the patella were the subjects of this retrospective study. The condition was confirmed through clinical, radiographic, and surgical findings in these foals.
• Medical records spanning four years were meticulously reviewed. Data collected included the details of the foals (known as signalment), their blood and biochemical profile, clinical and radiographic signs, and surgical techniques and treatments provided during the perioperative period.
• Follow-ups were conducted over a minimum period of 15 months. Outcome evaluation incorporated the use of radiographs, veterinary examinations, analysis of racing records, and telephone questionnaires.

Results Observed

• Of the eight foals, six survived for periods ranging from 15 months to 4 years. These surviving foals underwent systemic and intralesional antimicrobial therapy coupled with synovial lavage (a procedure for cleaning the joints) and more antimicrobial medication. The treatment resulted in all six of these foals achieving sound health and developing the potential for an athletic career – three went on to yearling sales, and two for show hunter or racing.
• Unfortunately, two of the foals died due to severe complications such as renal failure and suppurative peritonitis (inflammation of the lining of the abdomen) caused by a cecal perforation (rupture of a part of the large intestine). One of these foals developed persistent lameness due to suppurative osteonecrosis (a severe form of bone infection) confirmed at necropsy (the equivalent of autopsy in animals). This foal didn’t undergo the intralesional antimicrobial therapy.

Conclusion

• The study highlighted that immediate medical and surgical intervention for osteomyelitis of the patella may lead to positive outcomes, translating into good prognosis for soundness and possibly an athletic career for the foals.
• It brought attention to the fact that concurrent septicemia (blood infection) or other perinatal systemic diseases (infections around the time of birth) could lead to drawn-out therapy and a delay in the recovery period.