Use of an aiming device and computed tomography for assisted debridement of subchondral cystic lesions in the limbs of horses.

This study investigates the effectiveness of using a combination of computed tomography (CT) and an aiming device (AD) to guide the surgical cleanup (debridement) of cyst-like lesions in horse limbs. The research concludes that using these technologies for preoperative planning and during surgery can precisely target and remove the diseased tissue while preserving neighbouring healthy bone.

Research Methods

• The study was a prospective case series involving twelve horses referred for lameness caused by subchondral cystic lesions (SCLs) – either one or two (totaling 14 SCLs).
• All horses underwent CT-guided debridement of the SCL, a surgical procedure involving the removal of damaged, infected or dead tissue to promote healing.
• The entry point of the drill used in the debridement and the direction of the drilling were planned using CT images and controlled using the aiming device (AD).
• The SCLs were scraped out (curetted) and then filled with recombinant human bone morphogenetic protein-2, a bone growth stimulating substance.
• Surgery times were noted for each horse and the outcomes of the procedure were evaluated 12 months post surgery.

Key Results

• Using a combination of AD and CT made the drilling into the SCLs precise and straightforward.
• The drill’s entry point into the SCL was noted as optimal in 11 SCLs and satisfactory in the remaining 3.
• All lesions were accurately debrided with preservation of the adjacent healthy bone in all cases.
• There were no accompanying complications reported with the surgical procedure.
• The average surgery time was 75 minutes, varying between 45 and 115 minutes.
• Outcomes 12 months after the surgery were favorable in 10 out of 11 horses. One horse sadly died due to reasons unrelated to the procedure.

Research Conclusions

• The use of CT images and an aiming device (AD) was found to be effective in allowing precise debridement of all SCLs in the limbs of the twelve horses participating in the study.
• CT-guided surgical debridement of SCLs in horse limbs appears to show favorable outcomes. However, the study does not discuss whether this is an overall improvement compared to other debridement methods not using CT and AD technology.