A 12-year-old Warmblood sport horse presents with a 6-month history of intermittent right forelimb lameness that worsens after collected work. Radiographs reveal subchondral cystic lesions in the medial femoral condyle. Intra-articular anesthesia of the femoropatellar joint abolishes 70% of the lameness, but the stifle shows no significant synovial effusion. Which surgical treatment has demonstrated the best long-term outcomes for large (>15 mm diameter) subchondral cystic lesions of the medial femoral condyle in sport horses?

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