Osteochondritis dissecans of the tarsocrural joint: results of treatment with arthroscopic surgery

Abstract

The technique and results of arthroscopic surgery for the treatment of osteochondritis dissecans in 318 tarsocrural joints in 225 horses are reported. Of the 225 horses, 154 were racehorses or intended for racing. Arthroscopic surgery was an effective technique for treating osteochondritis dissecans of the tarsocrural joint. The overall functional ability and cosmetic appearance of the limbs were excellent. Post surgical follow-up information was obtained for 183 horses, of which 140 (76.5 per cent) raced successfully or performed their intended use following surgery. Of the remaining 43, 11 were considered to still have a tarsocrural joint problem, 19 developed other problems precluding successful performance, eight were considered poor racehorses without any lameness problems identified, three were killed because of septic arthritis and two died from other causes. There was no significant effect of age, sex or limb involvement on the outcome. The size of the intermediate ridge lesions had no effect on prognosis but the presence of degenerative or erosive changes in the articular cartilage significantly decreased the prognosis. The synovial effusion resolved in 117/131 racehorse joints (89.3 per cent) and 64 of 86 non-racehorse joints (74.4 per cent) with follow-up. The outcome for synovial fluid resolution was significantly inferior for lesions of the lateral trochlear ridge of the talus or medial malleolus of the tibia compared to distal intermediate ridge lesions. There was no significant relationship between resolution of effusion and successful performance outcome.