Morphological characteristics of subchondral bone cysts in medial femoral condyles of adult horses as determined by computed tomography

Wade T. Walker Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853.

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Jesse L. Silverberg Wyss Institute for Biologically Inspired Engineering, Harvard University, Cambridge, MA 02138.

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Christopher E. Kawcak Gail Holmes Equine Orthopaedic Research Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523.

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Bradley B. Nelson Gail Holmes Equine Orthopaedic Research Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523.

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Lisa A. Fortier Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853.

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Abstract

OBJECTIVE To determine morphological characteristics of subchondral bone cysts (SBCs) in medial femoral condyles (MFCs) of adult horses with orthopedic disease.

SAMPLE CT scans of 7 MFCs with SBCs from 6 adult horses.

PROCEDURES CT was used to determine the volume, surface area, and centers of the articular cyst opening and SBC in each MFC. Cysts were ordered from smallest to largest on the basis of volume. Osseous pathological characteristics of the MFC were assessed in the frontal plane. Three-dimensional distance of displacement between the center of the articular cyst opening and center of the cyst was determined for each SBC. Cyst surface area-to-volume ratio was evaluated and compared with that of a true sphere.

RESULTS All SBCs had a defect in the subchondral bone plate at the cranial 15% to 20% of the MFC. Cyst center was located in a caudal, proximal, and abaxial direction with respect to the center of the articular cyst opening for each horse. Small- and intermediate-volume SBCs were irregular and multilobulated, whereas large-volume SBCs were smooth and discrete with a surface area-to-volume ratio approaching that of a sphere.

CONCLUSIONS AND CLINICAL RELEVANCE Consistency in morphological characteristics suggested a common etiopathogenesis for SBCs in MFCs of adult horses. Cyst enlargement may have been attributable to a biomechanical predisposition to decrease the surface area-to-volume ratio, resulting in a spherical cyst.

Abstract

OBJECTIVE To determine morphological characteristics of subchondral bone cysts (SBCs) in medial femoral condyles (MFCs) of adult horses with orthopedic disease.

SAMPLE CT scans of 7 MFCs with SBCs from 6 adult horses.

PROCEDURES CT was used to determine the volume, surface area, and centers of the articular cyst opening and SBC in each MFC. Cysts were ordered from smallest to largest on the basis of volume. Osseous pathological characteristics of the MFC were assessed in the frontal plane. Three-dimensional distance of displacement between the center of the articular cyst opening and center of the cyst was determined for each SBC. Cyst surface area-to-volume ratio was evaluated and compared with that of a true sphere.

RESULTS All SBCs had a defect in the subchondral bone plate at the cranial 15% to 20% of the MFC. Cyst center was located in a caudal, proximal, and abaxial direction with respect to the center of the articular cyst opening for each horse. Small- and intermediate-volume SBCs were irregular and multilobulated, whereas large-volume SBCs were smooth and discrete with a surface area-to-volume ratio approaching that of a sphere.

CONCLUSIONS AND CLINICAL RELEVANCE Consistency in morphological characteristics suggested a common etiopathogenesis for SBCs in MFCs of adult horses. Cyst enlargement may have been attributable to a biomechanical predisposition to decrease the surface area-to-volume ratio, resulting in a spherical cyst.

  • 1. Ondrouch AS. Cyst formation in osteoarthritis. J Bone Joint Surg Br 1963; 45: 755760.

  • 2. Resnick D, Nixayama G, Coutts RD. Subchondral cysts (geodes) in arthritis disorders: pathologic and radiographic appearance of the hip joint. AJR Am J Roentgenol 1977; 128: 799806.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 3. McErlain DD, Appleton CTG, Litchfield RB, et al. Study of subchondral bone adaptations in a rodent surgical model of OA using in vivo micro-computed tomography. Osteoarthritis Cartilage 2008; 16: 458469.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 4. Ortved KF, Nixon AJ, Mohammed HO, et al. Treatment of subchondral cystic lesions of the medial femoral condyle of mature horses with growth factor enhanced chondrocyte grafts: a retrospective study in 49 cases. Equine Vet J 2012; 44: 606613.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5. Raynauld J, Martel-Pelletier J, Berthiaume MJ, et al. Correlation between bone lesion changes and cartilage volume loss in patients with osteoarthritis of the knee as assessed by quantitative magnetic resonance imaging over a 24-month period. Ann Rheum Dis 2008; 67: 683688.

    • Search Google Scholar
    • Export Citation
  • 6. Tanamas SK, Wluka AE, Pelletier J, et al. The association between subchondral bone cysts and tibial cartilage volume and risk of joint replacement in people with knee osteoarthritis: a longitudinal study. Arthritis Res Ther 2010; 12: R58.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7. Freund E. The pathological significance of intra-articular pressure. Edinburgh Med J 1940; 47: 192203.

  • 8. Landells JW. The bone cysts of osteoarthritis. J Bone Joint Surg Br 1953; 35: 643649.

  • 9. Jeffcott LB, Kold SE. Clinical and radiological aspects of stifle bone cysts in the horse. Equine Vet J 1982; 14: 4046.

  • 10. Jeffcott LB, Kold SE. Aspects of the pathology of stifle bone cysts in the horse. Equine Vet J 1983; 15: 304311.

  • 11. Reilingh ML, Blankevoort L, van Eekeren ICM, et al. Morphological analysis of subchondral talar cysts on microCT. Knee Surg Sports Traumatol Arthrosc 2013; 21: 14091417.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12. McErlain DD, Ulici V, Darling M, et al. An in vivo investigation of the initiation and progression of subchondral cysts in a rodent model of secondary osteoarthritis. Arthritis Res Ther 2012; 14: R26.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13. Rhaney K, Lamb DW. The cysts of osteoarthritis of the hip; a radiological and pathological study. J Bone Joint Surg Br 1955; 37: 663675.

    • Search Google Scholar
    • Export Citation
  • 14. Marra MD, Crema MD, Chung MR. et al. MRI features of cystic lesions around the knee. Knee 2008; 15: 423438.

  • 15. Durr HR, Martin H, Pellengahr C, et al. The cause of subchondral bone cysts in osteoarthrosis: a finite element analysis. Acta Orthop Scand 2004; 75: 554558.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16. McIlwraith CW. Subchondral cystic lesions (osteochondrosis) in the horse. Compend Contin Educ Pract Vet 1982; 4: S394S404.

  • 17. Baxter GM. Subchondral cystic lesions in horses. In: McIlwraith CW, Trotter GW, eds. Joint disease in the horse. Philadelphia: WB Saunders Co, 1996;384397.

    • Search Google Scholar
    • Export Citation
  • 18. Verschooten F, De Moor A. Subchondral cystic and related lesions affecting the equine pedal bone and stifle. Equine Vet J 1982; 14: 4754.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19. Cox LGE, Lagemaat MW, van Donkelaar CC, et al. The role of pressurized fluid in subchondral bone cyst growth. Bone 2011; 49: 762768.

  • 20. Ray CS, Baxter GM, McIlwraith CW, et al. Development of subchondral cystic lesions after articular cartilage and subchondral bone damage in young horses. Equine Vet J 1996; 28: 225232.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21. Robinson DE, Winson IG, Harries WJ, et al. Arthroscopic treatment of osteochondral lesions of the talus. J Bone Joint Surg Br 2003; 85: 989993.

    • Search Google Scholar
    • Export Citation
  • 22. Kolker D, Murray M, Wilson M. Osteochondral defects of the talus treated with autologous bone grafting. J Bone Joint Surg Br 2004; 86: 521526.

    • Search Google Scholar
    • Export Citation
  • 23. Smith MA, Walmsley JP, Phillips TJ, et al. Effect of age at presentation on outcome following arthroscopic debridement of subchondral cystic lesions of the medial femoral condyle: 85 horses (1993–2003). Equine Vet J 2005; 37: 175180.

    • Search Google Scholar
    • Export Citation
  • 24. Wallis TW, Goodrich LR, McIlwraith CW, et al. Arthroscopic injection of corticosteroids into the fibrous tissue of subchondral cystic lesions of the medial femoral condyle in horses: a retrospective study of 52 cases (2001–2006). Equine Vet J 2008; 40: 461467.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25. Hendrix SM, Baxter GM, McIlwraith CW, et al. Concurrent or sequential development of medial meniscal and subchondral cystic lesions within the medial femorotibial joint in horses (1996–2006). Equine Vet J 2010; 42: 59.

    • Search Google Scholar
    • Export Citation
  • 26. Frisbie DD, Cross MW, McIlwraith CW. A comparative study of articular cartilage thickness in the stifle of animal species used in human pre-clinical studies, compared with articular cartilage thickness in the human knee. Vet Comp Orthop Traumatol 2006; 19: 142146.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 27. Chevrier A, Kouao ASM, Picard G, et al. Interspecies comparison of subchondral bone properties important for cartilage repair. J Orthop Res 2015; 33: 6370.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 28. Nixon AJ, Fortier LA, Williams J, et al. Enhanced repair of extensive articular defects by insulin-like growth factor-I-laden fibrin composites. J Orthop Res 1999; 17: 475487.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 29. Fortier LA, Balkman CE, Sandell LJ, et al. Insulin-like growth factor-I gene expression patterns during spontaneous repair of acute articular cartilage injury. J Orthop Res 2001; 19: 720728.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 30. Frisbie DD, Kisiday JD, Kawcak CE, et al. Evaluation of adipose-derived stromal vascular fraction or bone marrow-derived mesenchymal stem cells for treatment of osteoarthritis. J Orthop Res 2009; 27: 16751680.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 31. von Rechenberg B, McIlwraith CW, Auer JA. Cystic bone lesions in horses and humans: a comparative review. Vet Comp Orthop Traumatol 1998; 11: 818.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 32. Jefcott LB, Kold SE. Stifle lameness in the horse: a survey of 86 referred cases. Equine Vet J 1982; 14: 3139.

  • 33. Kold SE, Hickman J. An experimental study of the healing process of equine chondral and osteochondral defects. Equine Vet J 1986; 18: 1824.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 34. White NA, McIlwraith CW, Allen D. Curettage of subchondral bone cysts in medial femoral condyles of the horse. Equine Vet J Suppl 1988; 6: 120124.

    • Search Google Scholar
    • Export Citation
  • 35. Howard RD, McIlwraith CW, Trotter GW. Arthroscopic surgery for subchondral cystic lesions of the medial femoral condyle in horses: 41 cases (1988–1991). J Am Vet Med Assoc 1995; 206: 842850.

    • Search Google Scholar
    • Export Citation
  • 36. Santschi EM, Williams JM, Morgan JW, et al. Preliminary investigation of the treatment of equine medial femoral condylar subchondral cystic lesions with a transcondylar screw. Vet Surg 2015; 44: 281288.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 37. Walker WT, Kawcak CE, Hill AE. Medial femoral condyle morphometrics and subchondral bone density patterns in Thoroughbred racehorses. Am J Vet Res 2013; 74: 691699.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 38. Valdes-Martinez A. Computed tomographic arthrography of the equine stifle. Vet Clin Equine 2012; 28: 583598.

  • 39. Ulanovsky A, Pröhl G. A practical method for assessment of dose conversion coefficients for aquatic biota. Radiat Environ Biophys 2006; 45: 203214.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 40. Korta M, Murua H, Quinococes I, et al. Three-dimensional reconstruction of postovulatory follicles from histological sections. Fish Res 2010; 104: 3844.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 41. Huang YH, Chang YC, Huang CS, et al. Computer-aided diagnosis of mass-like lesion in breast MRI: differential analysis of the 3-D morphology between benign and malignant tumors. Comput Methods Programs Biomed 2013; 112: 508517.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 42. Sternberg RA, Pondenis HC, Yang X, et al. Association between absolute tumor burden and serum bond-specific alkaline phosphatase in canine appendicular osteosarcoma. J Vet Intern Med 2013; 27: 955963.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 43. Halley SE, Bey MJ, Haladik JA, et al. Three dimensional, radiosteriometric analysis (RSA) of equine stifle kinematics and articular surface contact: a cadaveric study. Equine Vet J 2014; 46: 364369.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 44. Fowlie JG, Arnoczky SP, Stick JA, et al. Meniscal translocation and deformation throughout the range of motion of the equine stifle joint: an in vitro cadaveric study. Equine Vet J 2011; 43: 259264.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 45. Fowlie J, Arnoczky S, Lavagnino M, et al. Resection of grade 3 cranial horn tears of the equine medial meniscus alter the contact forces on medial tibial condyle at full extension: an in vitro cadaveric study. Vet Surg 2011; 40: 957965.

    • Search Google Scholar
    • Export Citation
  • 46. Bonilla AG, Williams JM, Litsky AS, et al. Ex vivo equine medial tibial plateau contact pressure with an intact medial femoral condyle, with a medial femoral condylar defect, and after placement of a transcondylar screw through the condylar defect. Vet Surg 2015; 44: 289296.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 47. Back W, Schamhardt HC, Savelberg HHC, et al. How the horse moves: 2. Significance of graphical representations of equine hind limb kinematics. Equine Vet J 1995; 27: 3945.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 48. Israelachvili JN. Intermolecular and surface forces. 3rd ed. Waltham, Mass: Elsevier, 2011.

  • 49. Valdes-Martinez A, Park RD. Diagnostic procedures: radiology. In: Baxter GM, ed. Adams and Stashak's lameness in horses. 6th ed. Ames, Iowa: Blackwell Publishing, 2011; 207337.

    • Search Google Scholar
    • Export Citation
  • 50. Link TM, Steinbach LS, Ghosh S, et al. Osteoarthritis: MR imaging findings in different stages of disease and correlation with clinical findings. Radiology 2003; 226: 373381.

    • Crossref
    • Search Google Scholar
    • Export Citation

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