Story M R, Bramlage L R
Rood and Riddle Equine Hospital, PO Box 12070, 2150 Georgetown Road, Lexington, Kentucky 40580, USA.
Equine Vet J. 2004 May;36(4):356-60. doi: 10.2746/0425164044890643.
Historically, there has been a consensus that conservative management of subchondral cystic lesions of the distal phalanx carries a poor prognosis. Surgical management has been advocated; however, there are no reports documenting its routine use and successful surgical treatment.
To describe arthroscopically-guided curettage of distal phalangeal subchondral cystic lesions (SCLs) and report the qualitative and quantitative results in 11 affected horses age 16-33 months.
Medical records of horses with previously treated lameness resulting from SCLs of the third phalanx were reviewed. Arthroscopic debridement of the SCLs was described. Follow-up information was obtained from race records and telephone contact with owners and trainers. The sign-rank test was used to compare performance of operated racehorses to that of unoperated siblings.
Ten of the 11 horses (91%) in the study returned to athletic soundness after surgical treatment and had performance records similar to their siblings.
Data show that arthroscopic debridement of distal phalangeal SCLs is a viable treatment for affected horses age 16-33 months and can result in a successful return to intended athletic performance. No horses younger than 16 months or older than 33 months were treated and results in horses younger or older than this group may vary in success.
The description of treatment and approach used for arthroscopic curettage will increase awareness of this option and increase treatment options for this condition.
从历史上看，人们一直认为对远节指骨软骨下囊性病变进行保守治疗预后不佳。一直有人主张进行手术治疗；然而，尚无报告记录其常规使用情况及成功的手术治疗案例。
描述关节镜引导下对远节指骨软骨下囊性病变（SCLs）进行刮除术，并报告11匹年龄在16 - 33个月的患马的定性和定量结果。
回顾了因第三指骨SCLs导致跛行且先前接受过治疗的马匹的病历。描述了对SCLs进行关节镜下清创术的过程。通过比赛记录以及与马主和驯马师的电话联系获取随访信息。采用符号秩检验比较接受手术的赛马与其未接受手术的同胞的表现。
研究中的11匹马中有10匹（91%）在手术治疗后恢复了运动健康，其表现记录与它们的同胞相似。
数据表明，关节镜下对远节指骨SCLs进行清创术对于年龄在16 - 33个月的患马是一种可行的治疗方法，并且可以成功恢复到预期的运动表现。未对年龄小于16个月或大于33个月的马匹进行治疗，该年龄组以外的马匹治疗结果可能不同。
对关节镜刮除术的治疗方法和途径的描述将提高对该治疗选项的认识，并增加针对这种病症的治疗选择。
