Fracture of the medial intercondylar eminence of the tibia in horses treated by arthroscopic fragment removal (21 horses)

Rubio-Martínez LM, Redding R, Bladon B, Wilderjans H, Payne RJ, Tessier C, Geffroy O, Parker R, Bell C, Collingwood FA. Equine Vet J. 2017 Jul 15. [Epub ahead of print]

BACKGROUND: Fractures of the medial intercondylar eminence of the tibia (MICET) are scarcely reported in horses.

OBJECTIVES: To report the clinical and diagnostic findings, surgical treatment and outcome in a series of horses presented with MICET fracture and treated with arthroscopic fragment removal.

STUDY DESIGN: Multi-centre retrospective case series.

METHODS: Case records of horses diagnosed with MICET fractures that had undergone surgical treatment were reviewed. Follow-up information was obtained from re-examination visits and/or owners.

RESULTS: Twenty-one cases were identified at 9 equine hospitals between 2004-2016. A history of trauma and acute onset of lameness was reported in 12 horses. All cases underwent fracture removal via arthroscopy of the medial femorotibial joint. The cranial cruciate ligament was intact in 6 horses and damaged in 15 horses (damage was ≤25% [n = 9], 25-50% [n = 4] or ≥50% [n = 2] of the cross-sectional area). The cranial ligament of the medial meniscus was damaged in 11 horses (≤25% [n = 8], 25-50% [n = 3]). The medial meniscus was damaged in 5 horses and articular cartilage damage was identified in 14 horses (mild [n = 8], moderate [n = 6]). Follow-up information (median 14 months; 4 months-6 years) was available for 20 cases; 2 horses were sound but convalescing; thirteen horses were sound and returned to their previous or expected use. Of the 4 horses with the most severe changes to the articular soft tissue structures, 2 remained lame and 2 were euthanised because of persistent lameness.

MAIN LIMITATIONS: The retrospective, multi-centre nature of this study and the limited number of horses are the main limitations.

CONCLUSIONS: Fractures of the MICET are commonly associated with a traumatic event. Prompt diagnosis and early arthroscopic removal of the fracture are recommended.