Category of research
Number and type of study designs reviewed
Two relevant publications were found, both were retrospective case series.
Strength of evidence
The success rate of horses returning to previous level of competition following arthroscopic debridement varies widely in the literature available, from 25–86%. While a study reports 64% return to soundness following rest, it is not clear which horses received strict box rest or paddock rest, the duration of the rest period, and whether non-steroidal anti-inflammatory drugs were also prescribed. It is also worth noting that all horses which undergo surgery will also undergo a period of box rest – which makes the two treatment options difficult to compare.
Newer techniques with better success rates are now available and should be considered in lieu of box rest or arthroscopic debridement. Across all treatments available, age remains an important factor with regards to return to soundness, with older horses having a poorer prognosis. Thorough examinations should therefore be performed to rule out concurrent conditions before deciding upon treatment options.
The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.
Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.
Bonilla, A.G., Bertone, A.L., Brokken, M.T. & Santschi, E.M. (2016). Concurrent or sequential tibial subchondral cystic lesions in 4 horses with medial femoral condyle subchondral cystic lesions. Journal of the American Veterinary Medical Association. 249(11), 1313–1318. DOI: https://doi.org/10.2460/javma.249.11.1313
Hendrix, S.M., Baxter, G.M., Mc Ilwraith, C.W., Hendrickson, D.A., Goodrich, L.R., Frisbie, D.D. & Trotter, G.W. (2009). Concurrent or sequential development of medial meniscal and subchondral cystic lesions within the medial femorotibial joint in horses (1996–2006). Equine Veterinary Journal. 42(1), 5–9. DOI: https://doi.org/10.2746/042516409x454556
Howard, R., McIlwraith, C. and Trotter, G. (1995). Arthroscopic surgery for subchondral cystic lesions of the medial femoral condyle in horses: 41 cases (1988–1991). Journal of the American Veterinary Medical Association. 206(6), 842–850.
Jeffcott, L.B. & Kold, S.E. (1982). Clinical and radiological aspects of stifle bone cysts in the horse. Equine Veterinary Journal. 14(1), 40–46. DOI: https://doi.org/10.1111/j.2042-3306.1982.tb02333.x
Klein, C.E, Bramlage L.R, Stefanovski D., Ruggles A.J., Embertson R.M. & Hopper S.A. (2022). Comparative results of 3 treatments for medial femoral condyle subchondral cystic lesions in Thoroughbred racehorses. Veterinary Surgery. 51(3), 455–463. DOI: https://doi.org/10.1111/vsu.13782
Lemirre, T., Santschi, E.M., Girard, C.A., Fogarty, U., Janes, J.G., Richard, H. & Laverty, S. (2021). Microstructural features of subchondral radiolucent lesions in the medial femoral condyle of juvenile Thoroughbreds: A microcomputed tomography and histological analysis. Equine Veterinary Journal. 00(1–13). DOI: https://doi.org/10.1111/evj.13486
Lewis, R. (1987). A retrospective study of diagnostic and surgical arthroscopy of the equine femorotibial joint. In: Proceedings of the American Association of Equine Practitioners.
Ortved, K.F. (2017). Surgical Management of Osteochondrosis in Foals. Veterinary Clinics of North America: Equine Practice. 33(2), 379–396. DOI: https://doi.org/10.1016/j.cveq.2017.03.010
Pérez-Nogués, M., Derham, A., Marmion, J. & Baker W.T. (2021). Progression of shallow medial femoral condyle radiographic lucencies in Thoroughbred repository radiographs and their influence on future racing careers. Equine Veterinary Journal. 53(2), 287–293. DOI: https://doi.org/10.1111/evj.13298
Ravanetti, P., Lechartier, A., Hamon, M. & Zucca, E. (2021). A composite absorbable implant used to treat subchondral bone cysts in 38 horses. Equine Veterinary Journal. 54(1), 97–105. DOI: https://doi.org/10.1111/evj.13428
Ray, C.S., Baxter, G.M., Mcilwraith, C.W., Trotter, G.W., Powers, B.E., Park, R.D. & Steyn, P.F. (1996). Development of subchondral cystic lesions after articular cartilage and subchondral bone damage in young horses. Equine Veterinary Journal. 28(3), 225–232. DOI: https://doi.org/10.1111/j.2042-3306.1996.tb03777.x
Rechenberg, B., Guenther, H., McIlwraith, C.W., Leutenegger, C., Frisbie, D.D., Akens, M.K. & Auer, J.A. (2004). Fibrous Tissue of Subchondral Cystic Lesions in Horses Produce Local Mediators and Neutral Metalloproteinases and Cause Bone Resorption in Vitro. Veterinary Surgery. 29(5), 420–429. DOI: https://doi.org/10.1053/jvet.2000.7538
Santschi, E.M., Williams, J.M., Morgan, J.W., Johnson, C.R., Bertone, A.L. & Juzwiak, J.S. (2015). Preliminary investigation of the treatment of equine medial femoral condylar subchondral cystic lesions with a transcondylar screw. Veterinary Surgery. 44(3), 281–288. DOI: https://doi.org/10.1111/j.1532-950X.2014.12199.x
Santschi, E.M. (2021). Treatment options and long-term outcomes of horses with subchondral lucencies of the medial femoral condyle. Equine Veterinary Education. 33(7), 386–388. DOI: https://doi.org/10.1111/eve.13338
Santschi, E.M., Whitman, J.L., Prichard, M.A., Lopes, M.A.F., Pigott, J.H., Brokken, M.T., Jenson, P.W., Johnson, C.R., Morrow, C., Brusie, R.W., Juzwiak, J.S. & Morehead, J.P. (2020). Subchondral lucencies of the proximal tibia in 17 horses. Veterinary Surgery. 49(4), 778–786. DOI: https://doi.org/10.1111/vsu.13387
Schneider, R., Jenson, P. & Moore, R. (1997). Evaluation of cartilage lesions on the medial femoral condyle as a cause of lameness in horses: 11 cases (1988–1994). Journal of the American Veterinary Medical Association. 210(11), 1649–1652.
Smith, M.A., Walmsley, J.P., Phillips, T.J., Pinchbeck, G.L., Booth, T.M., Greet, T.R.C., Richardson, D.W., Ross, M.W., Schramme, M.C., Singer, E.R., Smith, R.K. & Clegg, P.D. (2005). Effect of age at presentation on outcome following arthroscopic debridement of subchondral cystic lesions of the medial femoral condyle: 85 horses (1993–2003). Equine Veterinary Journal. 37(2), 175–180. DOI: https://doi.org/10.2746/0425164054223741
Stewart, B. & Reid, C. (1982). Osseous cystlike lesions of the medial femoral condyle in the horse. Journal of the American Veterinary Medical Association. 180(3), 254–257.
Textor, J.A., Nixon, A.J., Lumsden, J. & Ducharme, N.G. (2001). Subchondral cystic lesions of the proximal extremity of the tibia in horses: 12 cases (1983–2000). Journal of the American Veterinary Medical Association. 218(3), 408–413. DOI: https://doi.org/10.2460/javma.2001.218.408
Verschooten, F. & de Moor, A. (1982). Subchondral cystic and related lesions affecting the equine pedal bone and stifle. Equine Veterinary Journal. 14(1), 47–54. DOI: https://doi.org/10.1111/j.2042-3306.1982.tb02334.x
Wallis, T.W., Goodrich, L.R., Mcilwraith, C.W., Frisbie, D.D., Hendrickson, D.A., Trotter, G.W., Baxter, G.M. & Kawcak, C.E. (2008). Arthroscopic injection of corticosteroids into the fibrous tissue of subchondral cystic lesions of the medial femoral condyle in horses: A retrospective study of 52 cases (2001–2006). Equine Veterinary Journal. 40(5), 461–467. DOI: https://doi.org/10.2746/042516408X258843
Walmsley, J.P., Phillips, T.J. & Townsend, H.G.G. (2003). Meniscal tears in horses: an evaluation of clinical signs and arthroscopic treatment of 80 cases. Equine Veterinary Journal. 35(4), 402–406. DOI: https://doi.org/10.2746/042516403776014163
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