Combined Endoscopic Curettage and Bioabsorbable Screw Augmented by Bone Marrow Concentrate in Subchondral Bone Cyst Lesions with Joint Communication. A Case Series of 16 Horses

Subchondral bone cyst lesions (SBLs) with joint communication are often a cause of lameness in horses. An essential part of the surgical treatment is the entire debridement of the fibrovascular layer lined in the cystic cavity. Previous studies have shown that β-tricalcium phosphate/calcium sulfate bioabsorbable screws promote osteoinduction and osteoconduction. Additionally, the augmentation of bone marrow aspirate concentrate contributes to bone regeneration. This retrospective study included 16 adult lame horses with unilateral SBL. Eleven cysts are located in the medial femoral condyle, three in the lateral femoral condyle, one in the front distal phalanx, and one in the distal third metacarpal bone. After transcortical drilling, the cystic cavity was inspected through a needle arthroscope and the cyst wall was debrided under arthroscopic guidance. Subsequently, the screw was inserted, and autologous bone marrow concentrate was injected in SBL and intraarticularly as well. The rehabilitation period lasted 6 months and the radiological follow-up was up to 18 months. No major complications were observed. Thirteen horses were sound approximately 9 months postsurgery. Inadequate bony ingrowth was observed in five cysts and adequate bone remodelling in the 11 cysts radiographically. The main limitations of this report include the lack of a control group, the possible radiological variations in the technique and position between presurgery and follow-up as well as the lack of advanced diagnostic imaging. In conclusion, the combination of a bioabsorbable screw and bone marrow concentrate after thorough debridement of the cystic cavity may be an alternative treatment option in SBLs.

Acknowledgment

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Publication History

Article published online:
15 July 2025