Chondromalacia of the cranial medial femoral condyle; its occurrence and association with clinical outcome in a population of adult horses with stifle lameness.
Authors: Croxford A K, Parker R A, Burford J H, Lloyd D, Boswell J C, Hughes T K, Phillips T J
Journal: Equine veterinary journal
Summary
# Editorial Summary: Chondromalacia of the Cranial Medial Femoral Condyle and Stifle Lameness Chondromalacia affecting the cranial medial femoral condyle (CMFC) has been suspected as a cause of stifle lameness in adult horses, yet its true prevalence and prognostic significance remained largely undocumented in the peer-reviewed literature. Croxford and colleagues conducted a retrospective analysis of 104 horses presenting with unilateral or bilateral stifle lameness that underwent diagnostic arthroscopy of the cranial medial femorotibial joint at a UK referral hospital, reviewing surgical findings and determining outcomes through owner telephone interviews at 12 months post-operatively, with success defined as return to ridden work without ongoing anti-inflammatory medication. CMFC was identified in 76% of cases (79/104 horses): 25 had CMFC as an isolated lesion, whilst 54 had concurrent pathology; notably, horses with CMFC were nearly 10 times more likely (9.9 odds ratio, 95% CI 2.2–45.0) to have an unsatisfactory long-term outcome compared to those without CMFC. These findings establish CMFC as both a common and significantly prognostically unfavourable arthroscopic finding in horses with stifle lameness, suggesting that its presence warrants careful client discussion regarding realistic expectations for return to athletic function, and that treatment decisions should account for this substantially elevated risk of poor outcome at 12 months.
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Practical Takeaways
- •Chondromalacia of the cranial medial femoral condyle is a common arthroscopic finding in horses with stifle lameness and carries a poor long-term prognosis for return to ridden work
- •When CMFC is identified during diagnostic arthroscopy, owners should be counselled regarding reduced likelihood of satisfactory outcome at 12 months post-operatively
- •The presence of CMFC alone (without concurrent pathology) still carries significant prognostic implications and warrants careful case discussion
Key Findings
- •CMFC was found in 79 of 104 horses (76%) undergoing diagnostic arthroscopy for stifle lameness
- •Horses with CMFC were 9.9 times more likely to have unsatisfactory outcome (not in ridden work) at 12-month follow-up compared to those without CMFC (95% CI 2.2-45.0, P<0.01)
- •CMFC as sole finding occurred in 25 horses; 54 horses had CMFC with concurrent pathology; 25 had other pathology without CMFC
- •CMFC is significantly associated with increased likelihood of long-term poor prognosis in equine stifle lameness