Subchondral Bone Cysts (SBC)

Present therapies for subchondral bone cysts in horses are varied and there is no consensus on the best treatment.

Some SBC’s are of little concern and require no treatment, while others may undermine the structure of the joint and cause collapse of the joint surface, resulting in arthritis and lameness.

Rest (up to six months), and a course of nonsteroidal anti-inflammatory drugs may bring some relief. A more recent approach to treatment has been the injection of steroids into the cyst, or the injection of either PRP or stem cells into the defect. But the cyst doesn’t resolve. It’s always there, ready to flare up when the horse starts to work again. SBC’s causing lameness are treated surgically using a variety of techniques.

There are several surgical treatments for SBCs, all done with arthroscopy.
The traditional and most common surgery is debridement. The surgeon basically digs out the cyst, scraping away the fibrous scar-tissue lining that forms inside it and leaving as much cartilage intact as possible.

Post-op care varies; usually, the horse will need two or more weeks of stall rest after surgery, to allow the inflammation to subside and healing to begin. That’s followed by weeks of hand-walking and then a gradual return to work over several months.