Mosaic arthroplasty in equine stifle and fetlock joints: A retrospective study of 31 cases between 1998 and 2023.
Authors: Pál Zsófia, Tuska Pál, Vásárhelyi Gábor, Hangody László, Hurtig Mark, Kaposi András D, Bodó Gábor
Journal: Veterinary surgery : VS
Summary
# Mosaic Arthroplasty for Equine Joint Lesions: A 25-Year Review Subchondral bone cysts (SBCs) remain a significant cause of lameness in performance horses, particularly affecting the femoral condyles and distal limb joints, yet surgical management options with proven long-term outcomes remain limited. This retrospective analysis examined 31 horses treated with osteochondral graft transplantation (mosaic arthroplasty) between 1998 and 2023, comparing outcomes between femoral condyle cases (22 horses), fetlock lesions (7 horses), and metatarsal involvement (2 horses), with post-operative follow-up lasting a minimum of 12 months. Two-thirds of the cohort (68%, 21/31) achieved complete soundness and returned to pre-injury athletic level or better, whilst a further 22% demonstrated satisfactory improvement; notably, the technique improved lameness in 90% overall, challenging the conventional assumption that such procedures work better in young horses, as age did not significantly influence outcomes in stifle cases. Seven horses required subsequent arthroscopy for complication management, and interestingly, horses receiving fewer graft implants showed a tendency towards superior recovery. These findings suggest mosaic arthroplasty warrants consideration as a surgical alternative for managing SBCs across a broader age range than traditionally assumed, potentially offering farriers' and rehabilitation professionals' clients an additional option when conservative management fails.
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Practical Takeaways
- •Mosaic arthroplasty offers a promising surgical option for managing subchondral bone cysts in both young and mature horses, with two-thirds returning to full athletic function
- •Unlike other SBC techniques, this approach appears equally effective regardless of horse age, providing options for older performance animals previously considered poor surgical candidates
- •Consider fewer implanted grafts as a strategy to optimize recovery outcomes, and be prepared for potential need for follow-up arthroscopy in ~22% of cases
Key Findings
- •68% of horses (21/31) regained soundness and resumed athletic performance at same or higher level post-mosaic arthroplasty
- •90% of horses showed improvement in lameness following surgery, with 22% achieving satisfactory and 10% unsatisfactory results
- •Success rates were comparable between stifle cases (68%, 15/22) and fetlock cases (67%, 6/9)
- •Age ≤3 years versus >3 years did not significantly influence outcomes in stifle cases, suggesting applicability across age groups