Multiple osteochondral autografts for treatment of a medial trochlear ridge subchondral cystic lesion in the equine tarsus.
Authors: Janicek John C, Cook James L, Wilson David A, Ketzner Karissa M
Journal: Veterinary surgery : VS
Summary
# Editorial Summary Subchondral cystic lesions (SCLs) affecting the medial trochlear ridge of the equine talus present a significant therapeutic challenge, as conservative management frequently fails in athletic horses. Rather than relying on traditional curettage and debridement approaches, this case report describes the adaptation of osteochondral autografting—a technique well-established in small animal and human orthopaedics—to address this specific tarsal pathology in a Quarter horse stallion. Three cylindrical osteochondral grafts were harvested from the distal lateral trochlear ridge of the same tarsus and press-fit into predrilled recipient sites at the lesion site, achieving excellent radiographic congruency with the articular surface without requiring debridement of the defect. The treated horse returned to competitive reining at 10 months post-operatively and remained sound and performing athletically at the 2-year follow-up, demonstrating no surgical complications. Whilst this is a single-case outcome, the technique merits further investigation as a viable primary treatment option for tarsal SCLs in performance horses, potentially offering superior cartilage preservation and functional recovery compared with conventional arthroscopic approaches.
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Practical Takeaways
- •Osteochondral autografting offers a new surgical treatment option for tarsal SCLs that may allow return to athletic soundness in performance horses, warranting further clinical evaluation
- •The technique appears safe with no postoperative complications reported and favorable long-term functional outcomes in this case
- •Consider referral for specialist orthopedic surgery evaluation in cases of medial trochlear ridge SCL, especially in valuable athletic horses where conservative management has failed
Key Findings
- •Osteochondral autografting technique successfully adapted from human/canine protocols and applied to treat a medial trochlear ridge SCL in an equine tarsus
- •Postoperative radiographs demonstrated excellent filling of the osteochondral defect with graft-articular surface congruency achieved
- •Horse returned to athletic reining training at 10 months post-surgery and remained sound and performing athletically at 2-year follow-up with no surgical complications