Arthroscopic reattachment of osteochondritis dissecans cartilage flaps of the femoropatellar joint: long-term results.
Authors: Sparks H D, Nixon A J, Fortier L A, Mohammed H O
Journal: Equine veterinary journal
Summary
# Editorial Summary: Arthroscopic Reattachment of Femoropatellar OCD When osteochondritis dissecans (OCD) cartilage flaps fragment in the femoropatellar joint, the traditional approach has been simple removal; however, Sparks and colleagues (2011) investigated whether reattachment could preserve articular surface and restore function in young horses. Using arthroscopic polydioxanone pins to reattach viable cartilage flaps—selected on the basis of perimeter continuity, surface integrity and mineralisation status—the team treated 40 of 44 femoropatellar joints across 27 horses (mostly Thoroughbreds, mean age 9.7 months), supplementing the procedure with bone marrow aspirate concentrate to lesion margins; radiographic resolution was significantly improved at 6 months post-operation. Among 20 horses with long-term follow-up data (mean 15.6 months, range 2 months to 12 years), 19 achieved soundness and their intended athletic performance, yielding a 95% success rate based on continued ridden work. This work demonstrates that salvaging OCD cartilage through reattachment—rather than débridement alone—can result in normal subchondral bone healing and durable performance, offering a tissue-preserving alternative that may be particularly valuable for valuable breeding stock or competition prospects where articular cartilage conservation carries prognostic weight.
Read the full abstract on PubMed
Practical Takeaways
- •Arthroscopic OCD cartilage reattachment with pins offers a high success rate (95%) for preserving joint surface and maintaining long-term athletic soundness in young horses
- •Lesion suitability for reattachment includes preserved perimeter continuity, absence of deep fissuring, and minimal mineralization; use bone marrow aspirate concentrate for additional cartilage-denuded areas
- •Expect significant radiographic improvement by 6 months post-surgery; most successfully treated horses return to intended athletic use without lameness
Key Findings
- •Arthroscopic reattachment of OCD cartilage flaps using polydioxanone pins achieved 95% success rate (19/20 horses) for long-term soundness and athletic performance
- •Radiographic resolution of OCD lesions treated with reattachment was significantly improved at 6 months post-surgery
- •Mean follow-up duration was 15.6 months (range 2 months to 12 years) across 26 horses that completed recovery
- •Cartilage flap reattachment resulted in normal radiographic subchondral bone contour in successfully treated cases