There are two studies in veterinary literature supporting the potential for conservative therapy having a positive outcome. In a second study following 33 cases, the horses were given a six-month rest period followed by pasture turnout. In both of these studies, horses which were younger and horses with smaller lesions had a better prognosis. Although one report in the veterinary literature indicated that continued moderate exercise during the therapeutic period was not detrimental to the eventual outcome, a specific exercise program shown to maximize benefit and minimize risk of detriment has not yet been defined. It also has been observed that when maximal performance training has been resumed, some horses have a recurrence of the lameness.
Surgical management involves the use of arthroscopy.
During the procedure, the joint can be more effectively evaluated for the presence of degenerative joint disease and other factors that might affect the overall prognosis. With respect to the cystic lesion, the procedure involves essentially removing it. The abnormal cartilage over the cystic area is removed as well as all abnormal material within the cavity. Some surgeons prefer to place a bone graft into the remaining cavity in an effort to expedite the healing process. A study presented by Robert Lewis, DVM, in the proceedings of the 1982 meeting of the American Association of Equine Practioners, reported the results of 99 cases of subchondral bone cysts treated by arthroscopic techniques.