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.
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.
Comments
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?
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 .