INNOVATIVE IMAGING TECHNIQUES TO ENHANCE THE QUALITY OF YOUR PRACTICE
Fig. 6. In cases that cannot be treated standing, the horse is placed in dorsal recumbency following intravenous anesthe- sia. The stifle is flexed through 90° and the needle placed as for the standing patient.
Fig. 5. A, demonstration of needle placement into the medial femoral condyle in the path of the ultrasound beam (left femur, lateral to right of image). B, corresponding ultrasound image from a treated case. The hyperechoic line (arrows) represents the needle as it enters the SBC under ultrasound guidance.
352 2014 Vol. 60 AAEP PROCEEDINGS
the selection criteria for inclusion in this study. Twenty horses were identified from our medical re- cords to comprise a retrospective control group. Controls were Thoroughbred horses of the same age and stage of training as case horses with a known history of lameness resulting from a unilateral MFC SBC. All horses had been subjected to ultrasono- graphic evaluation of the stifle with the SBC con- firmed as the only significant pathological finding. Controls had been treated with intra-articular tri- amcinolone acetonide injection and were, thus, con- sidered to have been treated conservatively. For both groups, treatment was considered a success if the horse returned to training and remained free from stifle lameness for at least 1 year. This was assessed by direct observation by the authors over the first 6 months and then by detailed trainer/ owner follow-up conversations. Long-term fol- low-up was assessed by the ability to start a race. Comparison of outcome variables between groups was performed using Fishers Exact Test (P 0.05). The number of days from treatment to resumption of training was compared using analysis of variance (ANOVA). The number of repeat injections and changes in radiographic SBC appearance were also compared between groups. Eleven (91.7%) cases required only a single ultra- sound-guided injection of the fibrous cyst lining to achieve soundness. Ten (83.3%) resumed training without lameness, and 9 (75%) successfully started a race. Only 11 (55%) conservatively treated control horses became sound following a single intra-artic- ular injection with 14 (70%) returning to training. Eleven (55%) subsequently started a race. Al- though there was no statistically significant differ- ence in likelihood of a positive outcome between the methods, cases treated with ultrasound-guided SBC injection were significantly more likely to require
