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  Discussion on Ocd horse still lame after surgery on fetlock joint
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Member:
Ekeeling

Posted on Friday, Jan 6, 2006 - 10:16 am:

Hi,

My horse had an operation on the fetlock joint after being diagnosed with OCD.

The following is an extract from the vet report:

SURGERY: Under general anaesthesia arthroscopic evaluation of the right metatarsophalangeal joint revealed osteochondral fragmentation of the proximal aspect of the sagittal ridge which is consistent with a diagnosis of a partially healed osteochonDrOsis lesion. The loose osteochondral tissue was removed and debrided back to hard healthy subchondral bone. Evaluation of the right metacapophalangeal joint revealed mild osteochondral fragmentation which was also removed and the parent bone debrided back to hard healthy subchondral tissue. Evaluation of the left metacarpophalangeal joint revealed an area of fibrillated cartilage at the proximal extent of the sagittal ridge but no loose cartilage or subchondral bone. No further treatment was carried out on that joint. All portals were closed in routine fashion (please note there is only one arthroscopic portal on the dorsal aspect of the left fore fetlock where as there are tow on the right fore and right hind limb.

My horse is 4 yrs old. The vet said the ocd was quite mild but the horse was showing up lame behind on a circle to the right, before surgery. She has been rested for 8 weeks after surgery after which she was sound, when she was allowed out (not surprisingly) went ballistic. She was in a restricted area but broke through a fence and had a gallop. Resulting in her being lame again on the same right hind fetlock! She is now back on yard rest. I am waiting for the Orthopedic Surgeon and my vet to decide what to do and as you can imagine am worried sick! Do you think that you could explain the technicalities to me from the vet's report. I am trying to figure out what she might have done. I know that the fetlock would have been weakened after surgery but hope against hope she hasn't gone back to square one. It is just the one hind leg she is lame on and there is a bit of heat in the fetlock joint and some slight swelling just towards the back. Any ideas would be welcome. I have also just put her on Glucosamine Joint supplement.

Regards Eileen
Moderator:
DrO

Posted on Saturday, Jan 7, 2006 - 11:25 am:

Let's see,
osteochondral fragmentation means that he found pieces of the cartilage broken loose from the surrounding tissues, see the first image in the article associated with this forum. The report seems to indicate he found 2 such lesions but does not give us the location of the second. These type lesions cannot heal and will result in chronic arthritis. He removed these pieces and cleaned up the surrounding defects. This leaves behind two holes in the cartilage that will heal over the next few months, but will never be as strong as normal healthy tissue.

Fibrillated cartilage is hyaline (outermost layer) cartilage that has a roughened appearance and represents a chronic low level of damage to the cartilage of the joint. Unfortunately even mild damage like this does not heal well.

Are you not currently giving any phenylbutazone and if not why?
DrO
Member:
Ekeeling

Posted on Monday, Jan 9, 2006 - 7:05 am:

Hi Dr Oglesby,

Thanks very much for that. Yes she is being give one sachet of bute per day.

Do you think that the holes in the cartilage are the reason why she is still lame behind?

I am hoping that with further rest she will improve.

The report says that she had two lesions does this mean places where cartilage has broken loose or where the loose cartilage has damaged other tissue? This is the most confusing bit. It also mentioned partially healed lesions. I am therefore thinking that it is a bit like scarring?

A friend of mine breeds dogs and in the dog world a dog with OCD would not be bred from. I presume it is the same with the horses?

Eileen
Moderator:
DrO

Posted on Monday, Jan 9, 2006 - 8:05 am:

I cannot say without an exam why the horse may still be lame Eileen but there may have been injury to the unhealed debrided areas. I think they mean where they are broke loose but this would be best directed at the person doing the arthroscopy. "Partially healed" refers to the fact that OC lesions that break out into the joint cannot heal properly on their own, which is why you debride them. Unfortunately horses with OCD lesions are bred and their is good work that when parents are selected for a low incidence of OCD there is less incidence of OCD in the progeny, for more on prevention see the article.
DrO
Member:
Ekeeling

Posted on Monday, Jan 9, 2006 - 11:36 am:

many thanks Dr Oglesby,

I appreciate all your help. Will now keep my fingers crossed that she gets sound. I don't think it would help any progeny to breed from her even though she has wonderful conformation. I think it's too big a risk.

Eileen
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