Equine subchondral lucencies: Knowledge from the medial femoral condyle (stifle)

This article gives continued support for the idea that small lesions not associated with lameness do not require surgery. When to do surgery and which procedure still remains speculative but some reports suggest screw fixation may have the best chance of returning a horse to usable soundness.
DrO

Equine subchondral lucencies: Knowledge from the medial femoral condyle
Vet Surg. 2024 Jan 16. doi: 10.1111/vsu.14062. Online ahead of print.
Author
Elizabeth M Santschi 1
Affiliation

1 Equine Medical Associates, Lexington, Kentucky, USA.

PMID: 38229531
DOI: 10.1111/vsu.14062

Abstract

Equine subchondral lucencies (SCL) have been described since the first availability of suitable radiographic equipment. The initial clinical sign can be lameness, but SCLs are often first found on surveys of juvenile horses and are primarily a radiographic concern for public auctions. When lameness is present, it varies from subtle to obvious and can be intermittent. Some SCLs heal spontaneously, and some remain blemishes, but when the SCL and lameness are persistent, further damage to the joint and limitations to an athletic career are likely. SCLs were initially described in the distal limb followed by the stifle, and the medial femoral condyle (MFC) is now considered the most common location. The aim of this review is to highlight the initial pathology and discuss the clinical and experimental information available on equine SCLs. SCL treatment has evolved from rest alone and has progressed to debridement, grafting, intralesional injection, and most recently, transcondylar screw and absorbable implant placement. Comparison of success rates between techniques is difficult due to variations in follow-up and outcome measures, and no single technique is best for all SCLs. Treatment appears to increase success by 15%-20% over rest alone, but the method chosen depends on many factors. This review emphasizes the need for further work to fully understand SCL formation and all aspects of trabecular bone healing to optimize surgical therapy and improve treatment success.

© 2024 American College of Veterinary Surgeons.