Catastrophic complication following injection and extracorporeal shock wave therapy of a medial femoral condyle subchondral cystic lesion in a 14 year old Arabian mare

Catastrophic complication following injection and extracorporeal shock wave therapy of a medial femoral condyle subchondral cystic lesion in a 14 year old Arabian mare

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This report describes fibrous cyst lining injection and extracorporeal shock wave therapy (ESWT) of a medial femoral condyle (MFC) subchondral cystic lesion (SCL) resulting in catastrophic MFC fracture in an Arabian mare.The mare was presented for evaluation of a severe hind limb lameness Mushroom Vapes of approximately 4 months duration.On presentation, a non-weight bearing lameness of the left hind limb with severe effusion and soft tissue swelling of the stifle region was noted.Radiographic evaluation of the stifle revealed a large SCL of the MFC with associated osteoarthritis.Arthroscopic guided intra-lesional injection of the SCL with corticosteroids and Multi-Tools autologous bone marrow concentrate was performed followed by ESWT of the MFC.

The mare was discharged walking comfortably 48-hours post-operatively.An acute increase in lameness was noted 14 days post-operatively.Imaging revealed catastrophic fracture of the left MFC.Possible mechanisms leading to failure of the MFC secondary to the described treatment are discussed.