Arthroscopic Surgery for the Treatment of Osteochondritis Dissecans in the Equine Femoropatellar Joint

Abstract

Forty limbs with femoropatellar osteochondritis dissecans in 24 horses were treated with arthroscopic surgery. Lesions were bilateral in 16 horses and unilateral in eight horses. Diagnostic examination and surgical treatment were performed through a single arthroscopic portal; five different instrument portal locations and six instrument approaches were used. Lesions were localized to the lateral trochlear ridge of the femur in 31 affected joints, medial trochlear ridge in two joints, lateral and medial trochlear ridges together in two joints, lateral trochlear ridge plus patella in four joints, and patella alone in one joint. The lesions consisted of subchondral defects containing chondral or osteochondral flaps or fragments, or were seen as dimpling, cracking, fibrillation, or erosion of articular cartilage, or intact cartilage over a subchondral defect. Loose bodies were found in three joints. There was a poor correlation between radiologic and arthroscopic findings. Surgical manipulations included removal of flaps, fragments, and undermined articular cartilage, and debridement of the subchondral defect. Three horses were euthanized: one electively to assess the joint grossly, one because of complications following surgery and salmonellosis, and one because of unrelated forelimb abnormalities. Immediate clinical improvement after surgery was seen in the 22 horses permitted to survive. Long‐term follow‐up on seven of 10 racehorses revealed that two have raced successfully, two are “ready to race,” three are training sound, two are sound at pasture (still in convalescence), and one has been reoperated. Of six horses used for show or pleasure, three are being shown sound, one is sound for pleasure, and two are training sound. The remaining horses are convalescing.

Enhanced concentration of COMP (cartilage oligomeric matrix protein) in osteochondral fractures from racing Thoroughbreds

“…Arthroscopic surgery with removal of the osteochondral fragments gives immediate relief of pain and is thought to prevent the development of chronic OA [23]. Studies of performance after surgery in 445 horses with carpal fractures show that 68% of the horses raced at a level equal to or better than preinjury levels [24]. One indicator of improved prognosis of these fractures could be the use of 162 Research 23 (2005) [156][157][158][159][160][161][162][163] sf-COMP measurements to determine synthetic or degradative activities.…”

“…Surgery was performed under general anaesthesia with standard arthroscopic techniques [24]. Synovial fluid (sf) samples were taken after anaesthesia, prior to surgery.…”

Concentration of the CS-846 Epitope in Serum and Synovial Fluid of Horses with Different Grades of Osteochondral Fragments in the Carpal Joints

“…Osteochondral fragments are pieces of osteochondral tissue (cartilage or subchondral bone) that detach from the edges of the bones in a synovial joint. This condition occurs with high incidence in the carpal joint, and it seems most prevalent in young racehorses from 2 to 4 years of age who are undergoing rigorous athletic training [3][4][5]. The distolateral aspect of the radius bone, distal aspect of the radial carpal bone and proximal aspects of the intermediate and third carpal bones are common sites of OF; biomechanical loading during hyperextension of highly mobile joints explains the predominance of lesions on the dorsal articular surfaces [3,4,[6][7][8][9][10][11][12][13].…”

“…This condition occurs with high incidence in the carpal joint, and it seems most prevalent in young racehorses from 2 to 4 years of age who are undergoing rigorous athletic training [3][4][5]. The distolateral aspect of the radius bone, distal aspect of the radial carpal bone and proximal aspects of the intermediate and third carpal bones are common sites of OF; biomechanical loading during hyperextension of highly mobile joints explains the predominance of lesions on the dorsal articular surfaces [3,4,[6][7][8][9][10][11][12][13]. Repetitive cyclic loading on the subchondral bone eventually leads to bone sclerosis and focal areas of microfracture, leading to collapse of the weakened tissue and fragmentation of cartilage and bone [14,15].…”

Influence of culture conditions on expansion and re-differentiation of chondrocytes from horses of different ages

“…Ultimately, defects can lead to osteoarthritis. Cartilage defects represent a challenge in equine orthopaedics, in particular for the treatment of racing and sport horses (McIlwraith et al 1987). Furthermore, the horse is considered as an important and relevant large animal model for cartilage repair studies due to the cartilage thickness and naturally occurring osteoarthritis, which are similar to human (Reinholz et al 2004, Frisbie et al 2006).…”