Tuesday, September 27, 2005

Stifle issues-upward fixation or locking patella.

I want everyone to know that I read what you read...and a wee bit more. Much of what is available is fairly factual, but some is not. I was reading the current issue of Western Horseman
which has an article on "Unlocking Stifle Problems" by Michelle Anderson. This article deals with
UFP / upward fixation of the patella and for the most part is sound advice. The problem we frequently see in our practice is the unfit (I thought it was fit) horse. This problem (UFP)
arises from a laxity of the Medial patellar ligament which is part of the horses reciprocal apporatus
or locking mechanism which allows the horse to rest standing up. With UFP the ligament is lax or longer and hangs up on the medial side of the femur which causes pain and a stiff leg which drags
the toe behind. Frequently this leg "pops" as the limb comes forward. The old treatment was to
"clip" or "cut" the stifle. This is a surgical procedure where the medial patellar ligament is severed to prevent it form locking. The downside to this is a BIG one.....fracture of the patella. In 15-20% of the cases this occurs and can do so at anytime after the surgery leaving you with an expensive pasture orniment. The only time we do the procedure anymore is in cases where the limb is locked and we are unable to reduce it by backing up the horse. The best treatment is exercise, either straight line or long line lungeing. This builds up the quadricep muscles and thereby pulls the patella into place eliminating the problem. This can require significant amounts of time to properly condition the horse. The article also mentions injecting the joint with counter irritants. This is a NO-NO. No irritating substance should ever be put into a joint,
you can however, inject these substances into and around the medial patella ligament to try and cause local inflammation and scar tissue making the ligament wider and hopefully stop the UFP.
This is frequently helpful but doesn't take the place of a good exercise program.
If you notice this happening to your horse have a thorough lameness exam done to rule out other potential cause and when thats done ......start working your horse.

11 comments:

Anonymous said...

I have a pony (stud) that is too small to ride. He is 2 1/2 yrs old. He has an increasing problem with his right stifle locking. He used to run around and play but now all he does is lie around or stand still. The vet here suggests clipping the stifle but I worry that should I do that it might intefere with his ability to breed. Is this heredity? Maybe I should geld him, if so. He basically is just a pet. Any advice? Thanks!!

Anonymous said...

UFD is a congentital problem. Do not breed.

Anonymous said...

Yeah, geld him. Teach him to pull a cart...you can excercise him and have fun doing it. Pulling a cart is excellent excercise for this problem.

dawn said...

Ok question, I've been reading on this a little bit.... I myself have bad knees and they lock up occasionally... My question is this, with my knees they sometimes " give out" I have arthritis in my knees, my question is can this also happen to horses if they have locking stiffles???

dawn said...

Question, I have bad knees, I have arthritis and my knees sometimes "give out". My question is if a horse has locking stiffles can they also "give out" occationally?

Dr. Alan Weldon said...

Dawn. What frequently happens in people is that the upper leg muscles become weak from decreased use because of the arthritis pain leading to the " giving out" scenario. This can happen as well with horses that become weak or atrophied . Strengthening the upper leg with straight line exersize can be helpful as can swimming or extended rides in a couple of feet of water.

Kathryn Hubbard said...

Hi,
I have been given a horse off the track who has this particular stifle issue. His hindquarters are too straight and as a result one of his tendons has slipped over the patella and the leg locks up. During his race career he bowed the tendon of the right front leg (the same side as the stifle issue) and so is quite at risk for reunjury as it is under much more stress due to the locking stifle. I've been advised to get it cut, should I? I don't know much about the procedure, what it costs, the after effects etc but the chiropractor has assured me that it will fix the problem. Of course I then researched it and found a lot of people who had problems after their horse's stifle was cut. What do you think?

Dr. Alan Weldon said...

Kathryn
I typically only cut the patellar ligament on those cases that are in a virtual permanent state of upward fixation. The odds of a patellar fracture after transection is about 15-20% which will leave you with an unusable horse. It may be that way now if the upward fixation is not controlled.If possible it might be better to try ultrasound guided tendon splitting or prolonged straight line exercise to increase quadriceps strength . Proceed with caution .

Chaska said...

My cob had her locking patellas snipped back in september, she was put into a stable for 2weeks and then out on flat grass only, she seems to be back to herself but we noticed that she is now dragging one leg would this be stifle?? Also what do you reccommend to help ease this problem?

Dr. Alan Weldon said...

Chaska, it could be stifle pain causing a reluctance to advance the limb. It would be good to know if there is ny swelling associated with the stifle. Sometimes pain from the surgery can be persistent or it could be something different all together. I would definitely have your vet take a look as it shouldn't be dragging it at this point....keep me posted if you can .

Ashley said...

Is it true that UPF can be passed to a baby? My Vet says that isn't true but I saw someone on here said it is. What is your opinion Dr Weldon?