Arthroscopic Treatment of Osteochondral Trauma to the Proximal Medial Trochlear Ridge of the Talus: 21 Cases

Introduction: Trauma to the proximal medial trochlear ridge (PMTR) has been described following external trauma to the medial tarsus. Unidentified and untreated osteochondral trauma in this location may result in persistent or recurrent synovial sepsis. To date, no studies have documented the treatment and outcome following such injuries.

Materials and Methods: Inclusion criteria: horses who underwent arthroscopic surgery for septic or contaminated tarsocrural joint. Exclusion criteria: horses without identified trauma to the proximal medial trochlear ridge. Patient history, preoperative diagnostics, and intraoperative findings were documented. Postoperative performance data was collected.

Results: Twenty-one horses presented over a 16-year period. All horses had wounds on the medial aspect of the hock with concurrent tarsocrural joint sepsis. Weight-bearing radiographs in 18 horses did not identify the pathology of the PMTR. Flexed proximal plantar lateral–distal dorso medial radiographs were beneficial in cases with fracture (n = 11) but not with chondral trauma (3). Fractures of the PMTR were removed in the initial surgery in 15 horses and articular cartilage erosion was debrided in two horses. The remaining horses had fragments removed or cartilage debrided at a second (n = 3) or third (n = 2) arthroscopy due to unresolved sepsis. Of the 18 horses with >6 months follow-up, 17 were sound and in full exercise.

Discussion/Conclusion: Flexed proximal plantar lateral–distal dorso medial radiographs of the PMTR should be obtained for wounds to the medial tarsus. Horses have an excellent prognosis following arthroscopic removal of all fragments; failure to recognize and remove fractures may result in refractory synovial sepsis.

Acknowledgment

Client-owned horses with owner consent for research, not required for retrospective cases series.

 

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Artikel online veröffentlicht:
15. Juli 2025