BACKGROUND
Osteochondral fragment removal is commonly performed but there are little scientific data supporting this procedure in the absence of clinical signs. More information is needed to facilitate clinical decision-making regarding fragment removal of the metacarpo-/metatarsophalangeal joint.
OBJECTIVES
To assess prevalence of cartilage injury in the equine metacarpo-/metatarsophalangeal joint and its association to fragment size, location, age and lameness.
STUDY DESIGN
Retrospective observational study.
METHODS
Clinical records, including radiographs of 823 metacarpo-/metatarsophalangeal joints (640 horses) that underwent arthroscopic fragment removal, were reviewed. Fragment size, intra-articular fragment location and cartilage injury score were recorded. Presence of synovitis was retrospectively evaluated in 157 joints. Kruskal-Wallis and Mann-Whitney tests were used for group comparisons, and Dunn's post hoc test was applied for multiple comparisons. Linear regression analysis was used to assess strength of association between age and mean cartilage score. Univariable regression analysis was performed and variables with p<0.2 were used in the final mixed-effects multivariable model to which backwards stepwise selection was applied. Significance level was p<0.05.
RESULTS
Cartilage injury was present in 28.8% (95% CI=25.8-32.0) of joints. Lameness was not associated with fragment location or fragment size. Fragment size was not associated with cartilage injury. Age (OR=1.35, 95% CI=1.22-1.48, p<0.001) and lameness (OR=5.03, 95% CI=2.27-11.68, p<0.001) were associated with cartilage injury as well as fragment location (palmar/plantar, OR=0.22, 95% CI=0.13-0.38, p<0.001), with dorsal fragments being more likely to be associated with cartilage lesions than palmar/plantar fragments. There was a significant association between age and mean cartilage score (b=0.18, 95% CI=0.14-0.22, p<0.001).
MAIN LIMITATIONS
The series included a heterogenous group of horses of different breed, sex, age and use. Data was collected retrospectively and could, in parts, not be fully evaluated.
CONCLUSIONS
Early fragment removal, especially in joints with dorsal fragmentation, can be beneficial to avoid future cartilage injuries in equine athletes. This article is protected by copyright. All rights reserved.