Fracture of the medial intercondylar eminence of the tibia in horses treated by arthroscopic fragment removal (21 horses)

Abstract

SummaryBackgroundFractures of the medial intercondylar eminence of the tibia (MICET) are scarcely reported in horses.ObjectivesTo report the clinical and diagnostic findings, surgical treatment and outcome in a series of horses presented with MICET fracture and treated with arthroscopic fragment removal.Study designMulticentre retrospective case series.MethodsCase records of horses diagnosed with MICET fractures that had undergone surgical treatment were reviewed. Follow‐up information was obtained from re‐examination visits and/or owners.ResultsTwenty‐one cases were identified at 9 equine hospitals between 2004 and 2016. A history of trauma and acute onset of lameness was reported in 12 horses. All cases underwent fracture removal via arthroscopy of the medial femorotibial joint. The cranial cruciate ligament was intact in 6 horses and damaged in 15 horses (damage was ≤25% [n = 9], 25–50% [n = 4] or ≥50% [n = 2] of the cross‐sectional area). The cranial ligament of the medial meniscus was damaged in 11 horses (≤25% [n = 8], 25–50% [n = 3]). The medial meniscus was damaged in 5 horses and articular cartilage damage was identified in 14 horses (mild [n = 8], moderate [n = 6]). Follow‐up information (median 14 months; 4 months–6 years) was available for 20 cases; 2 horses were sound but convalescing; 13 horses were sound and returned to their previous or expected use. Of the 4 horses with the most severe changes to the articular soft tissue structures, 2 remained lame and 2 were subjected to euthanasia because of persistent lameness.Main limitationsThe retrospective, multicentre nature of this study and the limited number of horses are the main limitations.ConclusionsFractures of the MICET are commonly associated with a traumatic event. Prompt diagnosis and early arthroscopic removal of the fracture are recommended.

Clinical insights: Advances in diagnostic imaging: Fractures

“…In another study, fractures of the medial intercondylar eminence of the tibia were also considered to most likely relate to a traumatic event; and lateral motion of the medial condyle was the proposed cause for the fracture. The potential pathogenesis involving avulsion fracture of the cranial cruciate ligament insertion was excluded as the ligament was intact or only mildly damaged in most cases . In contrast, the most common stress‐related fractures in Thoroughbred racehorses were located in the humerus, tibia and ilium .…”

Clinical insights: Recent developments in equine articular disease (2016–2018)

“…In orthopaedics, this is frequently done through retrospective case series, which are often multi-centred in nature to obtain sufficient case numbers. An example of this is the description of fractures of the medial intercondylar eminence of the tibia, and documentation of the treatment of this fracture by arthroscopic surgery [3]. In the series of 21 cases, which were treated by arthroscopic removal of the fracture fragment, it was found that the injury was commonly associated with a traumatic event.…”