Janicek John C, Cook James L, Wilson David A, Ketzner Karissa M
Comparative Orthopaedic Laboratory, University of Missouri, Columbia, MO, USA.
Vet Surg. 2010 Jan;39(1):95-100. doi: 10.1111/j.1532-950X.2009.00576.x.
To adapt the multiple osteochondral autograft technique for treatment of a subchondral cystic lesion (SCL) of the proximal medial trochlear ridge (MTR) of the equine talus and assess long term outcome.
Case report.
Quarter horse stallion with SCL of the proximal MTR of the talus.
Osteochondral autograft techniques used in dogs and humans were adapted and optimized in equine cadavers. A horse with a SCL of the MTR of the talus was treated by osteochondral autografting. Three osteochondral autografts were harvested from the distal lateral trochlear ridge of the talus in the affected tarsus. No curettage or debridement of the osteochondral lesion was performed. Three recipient beds were predrilled and osteochondral autografts were press-fit into the proximal MTR of the talus. Outcome was assessed by radiography, telephone interview of the owner, and direct observation during training. RESULTS; Postoperative radiographs indicated excellent filling of the osteochondral defect and graft-articular surface congruency. No complications were encountered after surgery. At 10 months after surgery, the horse successfully re-entered reining training, and continued to be sound and performing athletically 2 years after surgery.
Osteochondral autografting deserves consideration and further evaluation as a primary treatment option for SCL of the proximal MTR of the talus in horses.
Based on the outcome of this case, osteochondral autografting appears to be a safe, valuable and realistic option for treating SCL of the proximal MTR of the talus in equine athletes.
采用多块自体骨软骨移植技术治疗马距骨内侧滑车嵴近端的软骨下囊性病变（SCL），并评估长期疗效。
病例报告。
一匹患有距骨内侧滑车嵴近端SCL的四分之一马种公马。
对犬类和人类使用的自体骨软骨移植技术进行了调整并在马尸体上进行优化。对一匹患有距骨内侧滑车嵴SCL的马进行自体骨软骨移植治疗。从患侧跗关节距骨外侧滑车嵴远端采集三块自体骨软骨移植物。未对骨软骨病变进行刮除或清创。预先钻出三个受体床，将自体骨软骨移植物压配入距骨内侧滑车嵴近端。通过放射照相、对马主的电话访谈以及训练期间的直接观察来评估疗效。结果：术后放射照片显示骨软骨缺损填充良好，移植物与关节表面贴合。术后未出现并发症。术后10个月，这匹马成功重新开始绕圈驯马训练，并在术后2年继续保持健康且能进行竞技表现。
自体骨软骨移植作为马距骨内侧滑车嵴近端SCL的主要治疗选择值得考虑和进一步评估。
基于该病例的结果,自体骨软骨移植似乎是治疗马运动员距骨内侧滑车嵴近端SCL的一种安全、有价值且切实可行的选择。
