A 10-year study of arthroscopic surgery in racing Thoroughbreds and Quarter Horses with osteochondral fragmentation of the carpus

Background: Osteochondral fragmentation of the carpus is a common cause of lameness in racehorses. Prognosis following arthroscopic removal of the fragments was reported in 1987, but little is known of recent success rates.

Objective: To identify associations between the severity and location of osteochondral fragments in the carpus, and to describe the racing performance of horses pre- and post-surgery in Thoroughbreds and Quarter Horses. To identify factors associated with a horse racing post-surgery.

Study design: Retrospective study of clinical records (2006-2016).

Methods: Surgical and racing records for racehorses undergoing arthroscopic surgery of the carpus were collated during the 10-year study period. Signalment, location of osteochondral fragmentation and grade of defect left after removal and debridement identified and racing performance pre- and post-surgery were described, stratified by breed. Logistic regression analysis was used to identify factors associated with unsuccessful return to racing.

Results: In total, 828 horses (n = 416 Quarter Horses; n = 412 Thoroughbreds) underwent 880 carpal arthroscopies after fragments were found on radiography. Sixty-five percent (n = 289) and 27% (n = 118) of the lesions were bilateral in Quarter Horses and Thoroughbreds respectively (P<0.001). In both breeds, the most commonly affected bone was the dorsodistal radial carpal bone (n = 320/659; 48.6%). Overall, 82% (n = 686; n = 358 Quarter Horses, n = 328 Thoroughbreds) of horses raced post-surgery, with 69.5% (n = 476; n = 228 Quarter Horses, n = 248 Thoroughbreds) racing at the same or a higher level of competition. Factors associated with horses not returning to racing post-surgery were increasing horse age, female horses, and a lesion grade of 4, while racing pre-surgery was protective.

Main limitations: This study does not include a control population for comparison.

Conclusions: There were significant differences between the location and severity of lesions in Quarter Horses, when compared to Thoroughbreds. The majority of horses return to racing following surgery, although performance was influenced by lesion severity. The Summary is available in Portuguese - see Supporting information.