Preliminary investigation of the treatment of equine medial femoral condylar subchondral cystic lesions with a transcondylar screw.
Authors: Santschi Elizabeth M, Williams Jarred M, Morgan Joseph W, Johnson Christopher R, Bertone Alicia L, Juzwiak James S
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Transcondylar Screw Treatment for Medial Femoral Condylar Cystic Lesions Subchondral cystic lesions (SCLs) of the medial femoral condyle are a significant cause of hindlimb lameness in horses, yet treatment options with reliable outcomes remain limited. Santschi and colleagues conducted a retrospective review of 20 horses (26 limbs) treated with a 4.5 mm transcondylar lag screw, with radiographic assessment and lameness grading performed at regular intervals over 120 days post-operatively, with follow-up data collected at approximately 12 months. The technique proved remarkably effective: 75% of horses (15/20) achieved complete lameness resolution by 120 days whilst simultaneously demonstrating ≥50% radiographic reduction in SCL area, with all returning to work without lameness. Notably, the addition of autologous biologics offered no significant advantage, and age proved a limiting factor, as horses over three years old showed less favourable outcomes. This approach warrants consideration by practitioners seeking a relatively straightforward, equipment-minimal surgical option for SCL-related lameness, though further prospective investigation would help clarify patient selection criteria and long-term durability of the repair.
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Practical Takeaways
- •Transcondylar screw fixation is a simple, effective surgical option for medial femoral condylar cystic lesions causing hindlimb lameness, with ~75% success rate and no specialized equipment required
- •Plan for 120 days of restricted activity before returning horses to work; younger horses (<3 years) may have better prognosis than older animals
- •Adjunctive biologic therapies (autologous cells/products) do not improve outcomes when screw fixation is used, so they are not necessary additions to this procedure
Key Findings
- •Transcondylar screw placement eliminated lameness in 15 of 20 horses (75%) by 120 days post-operatively
- •Radiographic cystic lesion area decreased ≥50% in successfully treated horses by 120 days
- •Lameness was reduced by 1-2 grades in 18 horses by 60 days post-operatively
- •Treatment was less successful in horses >3 years of age; adjunctive biologic therapies showed no additional benefit