Arthroscopic findings and long-term outcomes in 76 sport horses with meniscal injuries (2008-2018).
Authors: Davis Joseph G, García-López José M
Journal: Veterinary surgery : VS
Summary
# Editorial Summary Meniscal injuries in sport horses present a clinical challenge with uncertain long-term prognoses, prompting Davis and García-López to conduct a retrospective analysis of 76 horses (93 meniscal injuries across 85 stifles) treated arthroscopically between 2008 and 2018, with follow-up obtained via telephone interview at least 1.5 years post-operatively. The medial meniscus was predominantly affected (82.8% of cases), and the majority of injuries were classified as grade 1 (76.3%), though injury severity proved significantly associated with athletic return (P = 0.023). Whilst 85.5% of horses resumed work, only 40% returned to their previous performance level—a distinction critical for setting realistic owner expectations—and notably, the presence of preoperative radiographic changes or concurrent joint pathology did not negatively influence outcomes, nor did intra-articular orthobiologic therapy (autologous conditioned serum, platelet-rich plasma, or stem cells). For equine practitioners, these findings suggest that meniscal grade is the key prognostic indicator for return-to-work decisions, whilst radiographic findings alone should not be used to counsel clients toward conservative management, and that expensive biological therapies warrant careful consideration given their lack of demonstrated benefit in this cohort. This first long-term outcome study provides valuable guidance for prognostication in what remains a guarded prognosis, particularly for higher-grade lesions.
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Practical Takeaways
- •When counseling owners about meniscal injury prognosis, expect 85% to return to some work but only 40% to previous level; severity of injury is the key prognostic factor
- •Presence of additional stifle pathology or radiographic changes should not be used to downgrade prognosis—these don't predict outcome
- •Orthobiologic treatments (PRP, ACS, stem cells) did not improve long-term outcomes in this population, so their use should not be marketed as improving return-to-sport rates
Key Findings
- •85.5% of horses with meniscal injuries returned to some level of athletic performance following arthroscopic surgery, but only 40% returned to their previous level
- •Medial meniscus was involved in 82.8% of cases, with 76.3% classified as grade 1 injuries
- •Meniscal injury grade was significantly associated with long-term outcome (P = 0.023), with more severe injuries having worse prognosis
- •Preoperative radiographic abnormalities, additional joint pathology, and use of orthobiologics (PRP, ACS, MSCs) showed no significant association with long-term athletic performance