Osteochondritis dissecans in the tibio-tarsal joint. Results by surgical treatment

Osteochondrosis is a rapidly growing problem in the horse population and reports are frequent. Osteochondritis dissecans can in most cases be treated surgically, but reports on results are lacking. This paper reports the results of surgery of the tibiotarsal joint in 43 cases.     

Osteochondritis dissecans of the canine stifle joint

In fourteen dogs with osteochondritis dissecans of the stifle joint the lesion was found in the articular cartilage of the medial condyle of the femur in six and the lateral condyle in eight. Both stifle joints were affected in eight dogs and in two of these, both Wolfhounds, the shoulder joints were also affected. Ten dogs were treated surgically and three by conservative means. The results of treatment are discussed.     

Osteochondritis dissecans of the tibio–tarsal joint in the dog

In five dogs with osteochondritis dissecans in the hock joint the primary lesions were on the medial ridges of the trochlea of the tibial tarsal bones. Clinical and radiographic findings, and surgical techniques are described. Possible aetiological factors, and the results of treatment are discussed.     

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

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.     

Osteochondritis dissecans of the tibial tarsal bone in dogs

The clinical histories of nineteen cases of osteochondritis dissecans of the medial ridge of the tibial tarsal bone are described. The clinical signs were lameness and a reduced range of joint flexion. Radiography demonstrated changes over the medial ridge of the tibial tarsal bone. Untreated cases remained lame and the rapid development of degenerative joint changes was noted. Cases treated promptly by arthrotomy, removal of the detached flap of cartilage and curettage made a quick and permanent recovery. Access to the lesion was gained by a postero-medial approach.     

Arthroscopic surgery for osteochondritis dissecans of the femoropatellar joint of the horse.

Arthroscopic surgery for the treatment of osteochondritis dissecans was undertaken on 252 femoropatellar joints in 161 horses (82 Thoroughbreds, 39 Quarter Horses, 16 Arabians, 9 Warmbloods and 15 others of various breeds). There were 53 females and 108 males. Twenty-two horses were 1 year of age at the time of surgery, 68 were yearlings, 36 were 2-year-olds, 21 were 3-year-olds, and 14 were > or = 4 years old. Ninety-one had bilateral involvement and 70 had unilateral disease. Follow-up information was obtained on 134 horses, including 79 racehorses and 55 non-racehorses: 86 (64%) of these 134 horses returned to their intended use, 9 (7%) were in training, 21 (16%) were unsuccessful and 18 (13%) were unsuccessful due to other defined reasons. Horses with Grade I lesions (< 2 cm in length) had a significantly higher success rate (78%) than did horses with Grade 2 (2-4 cm) or Grade 3 (> 4 cm) lesions (63% and 54% success rates respectively). A significantly higher success rate was also noted for horses operated on as 3-year-olds compared with the remainder of the study population. A significantly lower success rate was noted for yearlings than for the remainder of the population. There was no significant difference in outcome as related to sex of animal involved, racehorse versus non-racehorse, lesion location, unilateral versus bilateral involvement, presence or absence of patellar or trochlear groove lesions, or presence or absence of loose bodies.     

Osteochondritis dissecans of the humeral head of a cat

A one-year-neutered male cat was presented for veterinary examination because of a left forlimb lameness. A painful left shoulder joint was found on examination and radiology of this joint revealed an erosive lesion of the humeral head and a detached flap of articular cartilage. The detached cartilage was surgically removed after which the lameness resolved. The lesion in this cat resembled osteochondritis dessicans of other species but whether the pathogenesis of the condition in this cat was 115 similar also was not determined.     

Osteochondritis dissecans of the femoral head of a Pekingese

An 8-month-old male Pekingese was admitted with a 1-month history of right hindlimb lameness and crepitation in the right coxofemoral joint. There was radiographic evidence of a focus of subchondral osteolysis of the right femoral head. The tentative diagnosis was avascular necrosis of the femoral head. The problem was corrected by femoral head ostectomy. Gross and microscopic examination of the femoral head resulted in a diagnosis of osteochondritis dissecans. Osteochondritis dissecans is an uncommon diagnosis both in small breeds of dogs and in the coxofemoral joint.     

Osteochondritis dissecans in the dog: diagnosis and therapy.

Osteochondritis dissecans (OCD) is a manifestation of osteochondrosis. It is thought to be a metabolic disease of cartilage maturation and endochondral ossification. Therefore, any disturbance affecting the differentiation of growth cartilage constitutes osteochondrosis. When this disturbance affects the articular cartilage so that a piece detaches, it is called OCD. Osteochondritis dissecans is well recognized but poorly understood. The etiology remains controversial. Osteochondritis dissecans is most commonly recognized in the shoulder but can occur in other areas which makes it difficult to differentiate from other disease entities. Diagnosis of OCD is based on signalment (age, breed, and sex), history, and physical and radiographic evidence. Therapy must be individualized and based on the patient's clinical signs and not on the severity of the radiographic lesion. Therapy can be effective only when applied correctly.     

Osteochondritis dissecans of the lateral ridge of the talus in a dog

Osteochondral fragments, which originated from the proximolateral ridge of the talus, were discovered in an 8-month-old Rottweiler. A large fragment was reattached, using a lag screw and wire. Microscopic examination of a small fragment suggested the lesion resulted from osteochondritis dissecans. Stabilization of the major fragment resulted in acceptable joint function.     

Osteochondritis dissecans of the femoral head: a case report

The clinical history, radiographic findings, surgery and short term outcome of a case of osteochondritis dissecans of the femoral head is described.     

Osteochondritis dissecans on the lateral femoral trochlear ridge in a dog

A case of osteochondritis dissecans of the lateral femoral trochlear ridge in a young dog is presented. The localisation is rare and diagnosis and treatment are discussed.     

Osteochondritis dissecans of the medial trochlear ridge of the talus in a calf

Osteochondritis dissecans of the proximal aspect of the medial trochlear ridge of the talus was found to be causing lameness and tarsocrural joint effusion in a male Limousin calf. Arthroscopy via a dorsolateral approach was unsuccessful in revealing the lesion in this calf. A caudomedial arthrotomy or medial malleolar osteotomy, which can be used to gain access to lesions of the medial trochlear ridge in dogs, was not attempted. The lameness gradually worsened, and the calf was slaughtered.     

Osteochondritis dissecans of the sagittal ridge of the third metacarpal and metatarsal bones in horses

Osteochondritis dissecans of the sagittal ridge of the third metacarpal and metatarsal bones was diagnosed in 8 horses during an 18-month period. Seven of the horses were less than or equal to 2 1/2 years old. Synovial distention of the affected fetlock joints and a pain response to fetlock flexion were typical findings. Lameness predominated in 1 limb at a trot, although fetlock flexion frequently elicited lameness in other affected limbs. Radiography revealed bony lesions (flattening, erosion, or fragmentation) of the sagittal ridge in at least 2 fetlock joints in all horses. The onset of signs was not correlated with the severity of radiographic changes in all horses.