A 7-year-old Warmblood show jumper presents with intermittent right forelimb lameness that worsens after flexion of the distal limb. Radiographs reveal subchondral bone cysts in the medial femoral condyle. Intra-articular analgesia of the femoropatellar joint provides 70% improvement. Which treatment approach has demonstrated the highest long-term success rate for return to athletic function in horses with large (>15 mm) medial femoral condyle cysts?

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