Subchondral bone cyst lesions (SBLs) with joint communication are often a cause of
lameness in horses. An essential part of the surgical treatment is the entire debridement
of the fibrovascular layer lined in the cystic cavity. Previous studies have shown
that β-tricalcium phosphate/calcium sulfate bioabsorbable screws promote osteoinduction
and osteoconduction. Additionally, the augmentation of bone marrow aspirate concentrate
contributes to bone regeneration. This retrospective study included 16 adult lame
horses with unilateral SBL. Eleven cysts are located in the medial femoral condyle,
three in the lateral femoral condyle, one in the front distal phalanx, and one in
the distal third metacarpal bone. After transcortical drilling, the cystic cavity
was inspected through a needle arthroscope and the cyst wall was debrided under arthroscopic
guidance. Subsequently, the screw was inserted, and autologous bone marrow concentrate
was injected in SBL and intraarticularly as well. The rehabilitation period lasted
6 months and the radiological follow-up was up to 18 months. No major complications
were observed. Thirteen horses were sound approximately 9 months postsurgery. Inadequate
bony ingrowth was observed in five cysts and adequate bone remodelling in the 11 cysts
radiographically. The main limitations of this report include the lack of a control
group, the possible radiological variations in the technique and position between
presurgery and follow-up as well as the lack of advanced diagnostic imaging. In conclusion,
the combination of a bioabsorbable screw and bone marrow concentrate after thorough
debridement of the cystic cavity may be an alternative treatment option in SBLs.
Acknowledgment
None.
