Osteomyelitis of the patella in eight foals.
Authors: Kay Alastair T, Hunt Robert J, Rodgerson Dwayne H, Spirito Michael A, Santschi Elizabeth M, Payne Richard J
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Osteomyelitis of the Patella in Foals Patellar osteomyelitis represents a serious but potentially manageable complication in neonatal foals, though published guidance on its treatment and prognosis has been limited. This retrospective review examined eight foals diagnosed with patellar osteomyelitis between 2003 and 2007, analysing their clinical presentations, diagnostic findings, surgical interventions, and long-term outcomes over a minimum follow-up period of 15 months. Six of eight foals (75%) survived with sound limbs, all receiving a combination of intralesional antimicrobial therapy, systemic antibiotics, and surgical joint lavage; these survivors went on to yearling sales or competitive careers in racing and showing. The two fatalities resulted from secondary systemic complications (renal failure and septic peritonitis with cecal perforation) rather than local patellar disease, whilst the single lame survivor—notably the only foal not treated with intralesional antimicrobials—developed suppurative osteonecrosis. Early aggressive surgical management with intralesional drug delivery, alongside broad-spectrum systemic antimicrobial therapy and meticulous joint decontamination, appears essential for achieving functional recovery in affected foals, though prognosis becomes significantly guarded when concurrent septicaemia or other perinatal diseases complicate the clinical picture.
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Practical Takeaways
- •Patellar osteomyelitis in foals requires aggressive combined therapy: intralesional antimicrobials, systemic antibiotics, and synovial lavage—outcomes are good if treated promptly
- •Monitor foals closely for systemic complications during treatment, as concurrent septicemia or perinatal disease significantly prolongs recovery and worsens prognosis
- •Intralesional antimicrobial therapy appears critical to success; foals managed without it had significantly worse outcomes
Key Findings
- •6 of 8 foals (75%) survived long-term (15 months–4 years) with intralesional and systemic antimicrobial therapy plus synovial lavage
- •All 6 surviving foals achieved soundness and returned to athletic use (yearling sales, show, or racing)
- •2 foals died from secondary systemic complications (renal failure and suppurative peritonitis from cecal perforation)
- •The foal with fatal outcome was not treated with intralesional antimicrobial therapy, developing suppurative osteonecrosis at necropsy