The stifle joint in horses is a complex synovial joint located in the hind limb, analogous to the human knee. It comprises several components, including the femur, tibia, patella, and associated ligaments and cartilage. The stifle joint facilitates various movements and is integral to the horse's locomotion. Conditions affecting the stifle joint, such as osteochondritis dissecans, ligament injuries, and arthritis, can impact a horse's performance and quality of life. Diagnostic approaches often involve physical examinations, imaging techniques like X-rays and ultrasonography, and sometimes arthroscopy. This page gathers peer-reviewed research studies and scholarly articles that explore the anatomy, function, common disorders, and diagnostic and treatment methodologies related to the stifle joint in horses.
Kajabi AW, Casula V, Sarin JK, Ketola JH, Nykänen O, Te Moller NCR, Mancini IAD, Visser J, Brommer H, René van Weeren P, Malda J, Töyräs J....Chondral lesions lead to degenerative changes in the surrounding cartilage tissue, increasing the risk of developing post-traumatic osteoarthritis (PTOA). This study aimed to investigate the feasibility of quantitative magnetic resonance imaging (qMRI) for evaluation of articular cartilage in PTOA. Articular explants containing surgically induced and repaired chondral lesions were obtained from the stifle joints of seven Shetland ponies (14 samples). Three age-matched nonoperated ponies served as controls (six samples). The samples were imaged at 9.4 T. The measured qMRI parameters included ...
O'Neill HD, Bladon BM.Current arthroscopic approaches to the caudal pouches of the lateral femorotibial joint are challenging and risk iatrogenic nerve and cartilage injury. Objective: Describe an alternative arthroscopic approach to the caudal pouches of the lateral femorotibial joint in the horse and report intra-articular abnormalities observed during diagnostic stifle arthroscopy of these pouches. Methods: Descriptive cadaver anatomical and clinical study. Methods: An approach to the caudal pouches of the lateral femorotibial joint was developed during clinical surgery using an arthroscopic portal in the poplit...
Croxford AK, Parker RA, Burford JH, Lloyd D, Boswell JC, Hughes TK, Phillips TJ.Chondromalacia of the cranial medial femoral condyle (CMFC) is a potential cause of stifle lameness in adult horses. However, there is scant published evidence of either its occurrence or its clinical significance. Objective: To document the occurrence of CMFC seen during diagnostic arthroscopy in adult horses with stifle lameness and to investigate its prognostic significance. Methods: Retrospective cohort study. Methods: The records were reviewed of all horses with unilateral or bilateral lameness localised to the stifle that underwent diagnostic arthroscopy of the cranial medial femorotibia...
Zellmann P, Ribitsch I, Handschuh S, Peham C.We developed a finite element model (FEM) of the equine stifle joint to identify pressure peaks and simulate translocation and deformation of the menisci. A series of sectional magnetic resonance images (1.5 T) of the stifle joint of a 23 year old Shetland pony gelding served as basis for image segmentation. Based on the 3D polygon models of femur, tibia, articular cartilages, menisci, collateral ligaments and the meniscotibial ligaments, an FEM model was generated. Tissue material properties were assigned based on data from human (Open knee(s) project) and bovine femoro-tibial joint available...
Mariani LPR, Sampaio F, Silveira AB, Bastos LF, Weber SH, Michelotto PV.Diseases of the stifle joint remain a challenge for veterinarians. The objective of this study was to achieve a valuable acupuncture suggestive diagnosis to be considered for stifle joint diseases in horses. Thirty-nine nonlame horses involved in different activities were assessed. Acupuncture was independently performed by two evaluators. Reactions of the animal when pressurizing the point suggestive of stifle disease (PSSD), Bladder-20 and/or Bladder-21, were considered as the inclusion criteria for inclusion in the stifle group (SG, n = 31), and the animals with no reactions were assigne...
Nykänen O, Sarin JK, Ketola JH, Leskinen H, Te Moller NCR, Tiitu V, Mancini IAD, Visser J, Brommer H, van Weeren PR, Malda J, Töyräs J, Nissi MJ.To investigate the potential of quantitative susceptibility mapping (QSM) and T2* relaxation time mapping to determine mechanical and structural properties of articular cartilage via univariate and multivariate analysis. Samples were obtained from a cartilage repair study, in which surgically induced full-thickness chondral defects in the stifle joints of seven Shetland ponies caused post-traumatic osteoarthritis (14 samples). Control samples were collected from non-operated joints of three animals (6 samples). Magnetic resonance imaging (MRI) was performed at 9.4 T, using a 3-D multi-echo gr...
Radtke A, Fortier LA, Regan S, Kraus S, Delco ML.Equine diagnostic anaesthesia can be a useful tool in challenging lameness examinations. However, anaesthetics diffuse over time leading to nonspecific desensitisation of periarticular structures. Nerves that convey sensation from the distal limb to the central nervous system pass in close proximity to the caudal stifle joint capsule. Therefore, diffusion of intra-articular (IA) anaesthetics could cause inadvertent desensitisation of the distal limb resulting in a false diagnosis of stifle lameness. Objective: To determine if IA stifle anaesthesia can alleviate lameness originating in the dist...
Lee H, Campbell WD, Theis KM, Canning ME, Ennis HY, Jackson RL, Hanson RR.Fresh and frozen cartilage samples of the fetlock, carpus, and stifle were collected from 12 deceased horses. Half were measured immediately following extraction, and half were frozen for seven days and then measured. Seven indentations (various normalized displacements) were implemented with an indention rate of 0.1 mm/s. Solid phase aggregate modulus (Es), hyperelastic material constant (α), and fluid load fraction (F') of equine articular cartilage were assessed using the Ogden hyperelastic model. The properties were statistically compared in various joints (fetlock, carpus, and stifle),...
McCoy AM, Smith RL, Herrera S, Kawcak CE, McIlwraith CW, Goodrich LR.To report the outcome of horses engaged in Western performance disciplines after stifle arthroscopy and identify prognostic factors for return to performance. Methods: Retrospective case series. Methods: Eighty-two Western performance horses undergoing stifle arthroscopy. Methods: Medical records were reviewed for horses involved in athletic performance/training for various Western performance disciplines and undergoing arthroscopy for lameness localized to the stifle. Follow-up was obtained ≥2 years postoperatively by telephone interviews with the owners. Preoperative and intraoperative f...
Frazer LL, Santschi EM, Fischer KJ.To predict the bone formation stimulus of a transcondylar screw across an equine subchondral bone cyst (SBC) in an equine medial femoral condyle (MFC). Methods: Finite element modeling (FEM) of an equine MFC with a 2 cm SBC under several transcondylar screw conditions. Methods: The right stifle of a yearling thoroughbred without stifle disease that had been euthanized for reasons unrelated to this study and donated to the University. Methods: The FEM was derived from computed tomography of a yearling thoroughbred and analyzed in ABAQUS v6.14. The transcondylar screw was modeled as a 4.5-mm s...
Hoaglund EL, Barrett MF, Daglish J, Contino EK.Intermediate patellar ligament (IPL) desmopathy is a relatively uncommon injury previously reported to have a poor prognosis for return to athletic activity. There is little documentation of the clinical and ultrasonographic features, clinical significance, and outcome for return to work following IPL injury in horses. The aim of this retrospective descriptive study was to describe the clinical and ultrasonographic features of IPL desmopathy, its association with other injuries of the stifle, and outcome for return to work following injury. Forty-two stifles with an ultrasound diagnosis of IPL...
Swor TM, Dabareiner RM, Honnas CM, Cohen ND, Black JB.OBJECTIVE To describe the chief complaints by owners and the types and prevalences of musculoskeletal problems associated with lameness or poor performance in cutting horses. DESIGN Retrospective case series. ANIMALS 200 client-owned cutting horses examined at the Texas A&M University Veterinary Medical Teaching Hospital between January 1, 2007, and December 31, 2015, because of lameness or poor performance. PROCEDURES Medical records were reviewed, and data were collected regarding signalment, history, findings on physical and lameness examinations, results of diagnostic procedures performed,...
Aldrich ED, Goodrich LR, Contino EK, Kawcak CE, Barrett MF, King MR, Valdés-Martínez A.CASE DESCRIPTION A 12-year-old mixed-breed mare (horse 1) and 6-year-old Friesian gelding (horse 2) were examined for chronic lameness associated with the stifle joint. CLINICAL FINDINGS Lameness examination revealed effusion of the right (horse 1) or left (horse 2) femoropatellar and medial femorotibial joints and grade 3/5 (horse 1) or 4/5 (horse 2) lameness. A diagnosis of cranial cruciate ligament (CCL) injury with associated mineralization and avulsion (horse 1) or mineralization alone (horse 2) was facilitated in both horses with a caudomedial-craniolateral oblique radiographic view obta...
Frazer LL, Santschi EM, Fischer KJ.To predict bone and medial meniscal stresses and contact pressures in an equine stifle with a medial femoral condyle (MFC) intact or with a 2-cm subchondral bone void, under varying degrees of internal femoral rotation (IFR). Methods: Finite element model (FEM) of a cadaveric equine stifle loaded to 8000 N. Methods: The FEM was constructed from computed tomography (CT) of the right, extended stifle of a yearling. The CT image was segmented into relevant anatomic structures and meshed into 4-node tetrahedrons. Bone material properties were assigned according to Hounsfield units, soft tissue p...
Daglish J, Frisbie DD, Selberg KT, Barrett MF.High field magnetic resonance imaging (MRI) is increasingly used for horses with suspected stifle disease, however there is limited available information on normal imaging anatomy and potential incidental findings. The aim of this prospective, anatomic study was to develop an optimized high field MRI protocol for evaluation of the equine stifle and provide detailed descriptions of the normal MRI appearance of the stifle soft tissues, using ultrasound and gross pathological examination as comparison tests. Nine cadaver limbs were acquired from clinically normal horses. Stifles were evaluated ul...
Dias IR, Viegas CA, Carvalho PP.Namely, in the last two decades, large animal models - small ruminants (sheep and goats), pigs, dogs and horses - have been used to study the physiopathology and to develop new therapeutic procedures to treat human clinical osteoarthritis. For that purpose, cartilage and/or osteochondral defects are generally performed in the stifle joint of selected large animal models at the condylar and trochlear femoral areas where spontaneous regeneration should be excluded. Experimental animal care and protection legislation and guideline documents of the US Food and Drug Administration, the American S...
Mirra A, Klopfenstein Bregger MD, Levionnois OL.A 15-year-old Selle Francais gelding was presented to the equine referral hospital for treatment of a left guttural pouch mycosis previously diagnosed. After induction, the horse was shortly hoisted by all four feet, moved on a padded surgical table, and positioned in right lateral recumbency. In order to reduce the risk of bleeding during surgical manipulation of the carotid and maxillary arteries, a mean arterial pressure between 60 and 70 mmHg was targeted. After surgery, the horse was moved in a padded recovery box keeping the same lateral recumbency. Four unsuccessful attempts were perf...
Barrett MF, McIlwraith CW, Contino EK, Park RD, Kawcak CE, Frisbie DD, zumBrunnen JR.OBJECTIVE To investigate potential associations between repository radiographic findings and subsequent performance of Quarter Horses competing in cutting events. DESIGN Retrospective cohort study. SAMPLE Repository radiographs (ie, radiographs obtained at the time of sale) for 343 client-owned horses. PROCEDURES Repository radiographic findings were compared with objective measures of performance, including the likelihood of competing; the likelihood of earning money as a 3-year-old, as a 4-year-old, and as a 3- and 4-year-old combined; and the amount of money earned as a 3-year-old, as a 4-y...
Herdrich MRA, Arrieta SE, Nelson BB, Frisbie DD, Moorman VJ.OBJECTIVE To determine accuracy for a technique of needle redirection at a single craniolateral site for injection of 3 compartments of the equine stifle joint, describe the external needle position, and identify the location of the needle tip within each joint compartment. SAMPLE 24 equine cadaver stifle joints. PROCEDURES Stifle joints were placed in a customized stand. After the needle was placed, external needle position was measured and recorded. Each joint compartment (medial and lateral compartments of the femorotibial joint and the femoropatellar joint) was injected with a solution con...
Frazer LL, Santschi EM, Fischer KJ.Subchondral lucency (SCL), also referred to as subchondral bone cysts, can cause clinical problems in horses and humans. In humans, SCLs occur in youths and adolescents [1] due to mechanical factors (often related to athletics) and in skeletally mature individuals secondary to osteoarthritis (OA). In horses, SCL most commonly occurs in the medial femoral condyle (MFC) of growing horses (without OA), and causes lameness. The cause of equine SCL is debated, but bone trauma due to overload is the likely mechanism. Investigating the biomechanics of the healthy and cystic MFC is important to unders...
Kremer A, Ribitsch I, Reboredo J, Dürr J, Egerbacher M, Jenner F, Walles H.Meniscal injuries are the most frequently encountered soft tissue injuries in the equine stifle joint. Due to the inherent limited repair potential of meniscal tissue, meniscal injuries do not only affect the meniscus itself but also lead to impaired joint homeostasis and secondary osteoarthritis. The presented study compares 3D coculture constructs of primary equine mesenchymal stem cells (MSC) and meniscus cells (MC) seeded on three different scaffolds-a cell-laden collagen type I hydrogel (Col I gel), a tissue-derived small intestinal matrix scaffold (SIS-muc) and a combination thereof-for ...
Bonilla AG, Bertone AL, Brokken MT, Santschi EM.CASE DESCRIPTION 4 horses were examined because of signs of chronic hind limb lameness. CLINICAL FINDINGS 3 horses had a history of lameness for > 6 months; specific duration was unknown for 1 horse. On initial evaluation, grade 3 to 4 (on a scale from 1 to 5) hind limb lameness was present in all 4 horses. Radiography of the stifle joint of the affected limb revealed medial femoral condyle subchondral lucencies or subchondral cystic lesions (SCLs) in all 4 horses, medial femorotibial osteoarthritis in 3 horses, and medial tibial condyle SCLs in 3 horses. TREATMENT AND OUTCOME 2 horses were...
Russell J, Matika O, Russell T, Reardon RJ.Osteochondrosis is considered multifactorial in origin, with factors such as nutrition, conformation, body size, trauma and genetics thought to contribute to its pathogenesis. Few studies have investigated the effects of genetic variability of osteochondrosis in Thoroughbreds. Objective: To describe the prevalence and genetic variability of a subset of osteochondrosis lesions in a group of Thoroughbred yearlings. Methods: Retrospective cohort study. Methods: Radiographs of 1962 Thoroughbred yearlings were retrieved from clinical records obtained between 2005 and 2013. Pedigree information was ...
Aldrich ED, Goodrich LR, Monahan MK, Conway JD, Valdés-Martínez A.Injury to the tendons and ligaments of the equine stifle is a common cause of lameness in horses. Individual radiographic localisation of each tendon and ligament of the stifle has not been previously reported or demonstrated in multiple radiographic projections. Objective: To create a series of radiographs identifying the origins and/or insertions of the tendons and ligaments of the equine stifle. Methods: Descriptive study of radiographic anatomy. Methods: The location of all entheses were determined by gross dissection. The proximal tibia and fibula, distal femur, patella and menisci were i...
González-Fernández ML, Pérez-Castrillo S, Sánchez-Lázaro JA, Prieto-Fernández JG, López-González ME, Lobato-Pérez S, Colaço BJ, Olivera ER....OBJECTIVE To assess the ability to regenerate an equine meniscus by use of a collagen repair patch (scaffold) seeded with mesenchymal stem cells (MSCs) derived from bone marrow (BM) or adipose tissue (AT). SAMPLE 6 female Hispano-Breton horses between 4 and 7 years of age; MSCs from BM and AT were obtained for the in vitro experiment, and the horses were subsequently used for the in vivo experiment. PROCEDURES Similarities and differences between MSCs derived from BM or AT were investigated in vitro by use of cell culture. In vivo assessment involved use of a meniscus defect and implantation o...
Tuska P, Tóth B, Vásárhelyi G, Hangody L, Papp M, Bodó G.The purpose of this study was to evaluate changes in biomarker and synovial parameters following autologous osteochondral transplantation (AOT) in the equine stifle joint, to test the hypothesis whether synovial parameters would show significant differences at selected time points following the surgery (at days 3, 14, 60 and 180) compared to baseline level (at day 0). Surgical intervention was performed in both stifles of nine horses (n = 18). The joints were randomly assigned to operated and sham-operated groups. Grafts 8.5 mm in diameter were harvested from the femoropatellar (FP) joint unde...
Nemery E, Gabriel A, Piret J, Antoine N.In athletic horses, diseases leading to lameness are of great importance due to the loss of performance and the resultant economic concerns. Although stifle lesions are frequent in the hindlimb, due to the large size and complexity of the joint, and although meniscal tears have been identified as the most common soft tissue injuries in this joint, little is known about the mechanism that causes the painful sensation and thus the lameness. The aim of our study was to highlight any peripheral fibres involved in meniscal nociception in five macroscopically sound cranial horns of the equine medial...
De Lasalle J, Alexander K, Olive J, Laverty S.A better understanding of imaging characteristics of equine stifle osteoarthritis (OA) may allow earlier detection and improve prognosis. Objectives of this ex vivo, prospective, methods comparison study were to (1) describe the location and severity of naturally acquired OA lesions in the equine stifle using ultrasound (US), radiography (XR), computed tomography (CT), and macroscopic evaluation (ME); (2) compare the diagnostic performance of each imaging modality with ME; and (3) describe subchondral bone mineral density (BMD) in equine stifle joints with OA using CT. Radiographic, CT, and US...
Nelson BB, Kawcak CE, Goodrich LR, Werpy NM, Valdés-Martínez A, McIlwraith CW.The femorotibial joints are a common source of lameness in Western performance horses. The objective of this prospective study was to compare the radiography, ultrasonography, computed tomographic arthrography (CTA), and arthroscopy findings in horses with lameness localized to the femorotibial joints. Twenty-five stifles in 24 horses were included and were evaluated with all four of these diagnostic methods. Defects detected in femorotibial joint structures were compared between diagnostic methods using a McNemar's test to evaluate for disagreement. Cranial medial meniscotibial desmopathy was...
Trencart P, Alexander K, De Lasalle J, Laverty S.To measure the minimal joint space width (mJSW) in caudocranial radiographic views of orthopedically normal femorotibial joints of horses, to compare the accuracy of measurements with those of a software program designed for humans, and to identify the ideal caudocranial radiographic projection angle for mJSW measurement. ANIMALS 12 healthy mares (22 femorotibial joints) and 3 equine cadavers (6 stifle joints). Methods: Caudocranial views of femorotibial joints were acquired in the proximodistal plane at 5°, 10°, and 15° (caudo-5°-proximal-craniodistal oblique, 10°, and 15°) and laterome...
Russell J, Matika O, Russell T, Reardon RJ.Osteochondrosis is considered multifactorial in origin, with factors such as nutrition, conformation, body size, trauma and genetics thought to contribute to its pathogenesis. Few studies have investigated the effects of genetic variability of osteochondrosis in Thoroughbreds. Objective: To describe the prevalence and genetic variability of a subset of osteochondrosis lesions in a group of Thoroughbred yearlings. Methods: Retrospective cohort study. Methods: Radiographs of 1962 Thoroughbred yearlings were retrieved from clinical records obtained between 2005 and 2013. Pedigree information was ...
Sloet van Oldruitenborgh-Ooste , Mol JA, Barneveld A.Osteochondrosis (OC) is a multifactorial disorder with endocrinological dysfunction and mineral imbalance having a role in pathogenesis. The present study focused on a possible relationship between insulin-like growth factor I (IGF-I), insulin-like growth factor II (IGF-II), parathyroid hormone (PTH), 1,25-dihydroxy-vitamin D (1,25(OH)2D), cortisol, copper, zinc, calcium, ionised calcium, magnesium and phosphorus and 5 different postmortem and radiographical osteochondrosis scores of hock and stifle joints in foals age 0-11 months. Osteochondrosis-positive foals showed a significantly lower IG...
Frisbie DD, Barrett MF, McIlwraith CW, Ullmer J.To assess use of an 18 g arthroscope for diagnostic stifle joint examination in the standing horse. Methods: Phase 1 used cadaver limbs and simultaneous ultrasonographic assessment. Phase 2 used 6 normal horses where stifles were assessed in both a standing and flexed position. Phase 3 used horses with suspected stifle injury or disease. Methods: Normal horses (n = 6) to assess ability to perform diagnostic procedure (phase 2) and 3 clinical cases (phase 3). Methods: Five cadaver limbs were used in phase 1 to assess all stifle joints. Phase 2 used standing sedated and locally anesthetized hors...
Lee H, Kirkland WG, Whitmore RN, Theis KM, Young HE, Richardson AJ, Jackson RL, Hanson RR.Thicknesses of fresh equine articular cartilage surfaces from the fetlock, carpal and stifle joints were measured employing a needle probe test. Methods: Eighty-seven samples used in measurement were cultivated from fetlock, carpal and stifle joints of 12 deceased within 4 h of death. After approximately three minutes of exposure to air during dissection, all cartilage samples were preserved in a saline solution to keep the articular cartilage hydrated for testing. The thickness was measured on five different spots on the same sample. The thicknesses of the fetlock, carpus and stifle were co...
Fowlie JG, Arnoczky SP, Stick JA, Pease AP.By study of the translocation and deformation of equine menisci throughout the range of motion, it may be possible to identify potential mechanical factors in the pathogenesis of injury to the cranial horn of the medial meniscus. Objective: To quantitatively document meniscal translocation and deformation using radiographic and MR imaging, and to evaluate for potential variation between the medial and lateral menisci. Methods: Radiographic markers were embedded in the periphery of the menisci in 6 cadaver stifles. Proximal-distal radiographs were taken at 15° intervals ranging from full flexi...
De Lasalle J, Alexander K, Olive J, Laverty S.A better understanding of imaging characteristics of equine stifle osteoarthritis (OA) may allow earlier detection and improve prognosis. Objectives of this ex vivo, prospective, methods comparison study were to (1) describe the location and severity of naturally acquired OA lesions in the equine stifle using ultrasound (US), radiography (XR), computed tomography (CT), and macroscopic evaluation (ME); (2) compare the diagnostic performance of each imaging modality with ME; and (3) describe subchondral bone mineral density (BMD) in equine stifle joints with OA using CT. Radiographic, CT, and US...
Back W, Schamhardt HC, Barneveld A.The canter is a 3 beat asymmetrical gait with a difference in timing between left and right limbs. To evaluate intralimb asymmetry at the canter, a group of 24 Dutch Warmbloods was evaluated on a treadmill (7 m/s) using a modified CODA-3 optoelectronic gait analysis system. Thirteen horses cantered in the left lead ('leading limb' group) and 11 in the right lead ('trailing limb' group) during left forelimb recordings, while 11 horses were at the left and 13 were at the right lead during left hindlimb recordings. Kinematic differences between horses from the 'leading limb' and 'trailing limb' g...
Hodson E, Clayton HM, Lanovaz JL.The objective was to study associations between kinematics and ground reaction forces in the hindlimb of walking horses. Video (60 Hz) and force (2000 Hz) data were gathered for 8 strides from each of 5 sound horses during the walk. Sagittal plane kinematics were measured concurrently with the vertical and longitudinal ground reaction forces. The hindlimb showed rapid loading and braking in the initial 10% stride. The stifle, tarsal and coffin joints flexed and the fetlock joint extended during this period of rapid loading. The vertical ground reaction force showed 2 peaks separated by a dip; ...
Ekström PM, Short CE, Geimer TR.This study was done to compare the electroencephalographic (EEG) response evoked by orthopedic surgery in halothane- and isoflurane-anesthetized horses. Eight horses scheduled for bilateral arthroscopic surgery of the stifle were premedicated with detomidine (20 micrograms/kg) intravenously and five minutes later induced to anesthesia with ketamine (2.2 mg/kg) intravenously. Anesthesia was maintained with either halothane or isoflurane. Assignment of inhalation anesthetic was done randomly. The multiple of minimal alveolar concentration (MAC) of halothane required for anesthesia was significan...
Changoor A, Hurtig MB, Runciman RJ, Quesnel AJ, Dickey JP, Lowerison M.To improve osteochondral graft reconstruction of subchondral cystic lesions in the medial and lateral femoral condyles by matching the material properties of donor and recipient sites. Objective: To measure biomechanical and biochemical parameters that influence the function and healing of osteochondral grafts used to reconstruct subchondral cystic lesions. Objective: Suitable donor sites are available within the stifle joint for reconstructing the femoral condyles, despite considerable regional property variation. Methods: Fifty-six osteochondral cores were harvested from 6 distal femurs for ...
Vekens EV, Bergman EH, Vanderperren K, Raes EV, Puchalski SM, Bree HJ, Saunders JH.To provide a detailed computed tomography (CT) reference of the anatomically normal equine stifle joint. Sample-16 hind limbs from 8 equine cadavers; no horses had evidence of orthopedic disease of the stifle joints. Methods: CT of the stifle joint was performed on 8 hind limbs. In all limbs, CT was also performed after intra-articular injection of 60 mL of contrast material (150 mg of iodine/mL) in the lateral and medial compartments of the femorotibial joint and 80 mL of contrast material in the femoropatellar joint (CT arthrography). Reformatted CT images in the transverse, parasagittal, an...
Barrett MF, Frisbie DD, McIlwraith CW, Werpy NM.While descriptions of the visible soft tissues of the femorotibial joints exist for both arthroscopy and ultrasonography, there are few examples in the literature that discuss in detail the combined findings of these modalities. Objective: To further elucidate the ultrasonographic and arthroscopic boundaries of the normal equine femorotibial joints and improve the understanding of the benefits and limitations of each individual modality. Methods: Simultaneous arthroscopy and ultrasonography were performed in 10 equine cadaver stifles as well as bilateral stifles on a horse that underwent nonre...
Jackson WA, Stick JA, Arnoczky SP, Nickels FA.To compare the quality of second-intention healing and that of compacting sternally harvested cancellous bone into subchondral bone defects of the medial femoral condyle in horses. Methods: A controlled experiment using a surgical technique that minimizes soft tissue trauma, customized for consistency among horses. Methods: Ten horses, aged 2 to 5 years, free of hindlimb lameness and with radiographically normal stifles. Methods: After a 12.7-mm-diameter x 19-mm-deep defect was created into randomly selected medial femoral condyles, bone and cartilage healing was evaluated over a 6-month perio...
Takafuji VA, McIlwraith CW, Howard RD.To evaluate the effects of equine recombinant interleukin-1alpha (rEqIL-1alpha) and recombinant interleukin-1beta (rEqIL-1beta) on proteoglycan metabolism and prostaglandin E2 (PGE2) synthesis by equine articular chondrocytes in explant culture. Methods: Near full-thickness articular cartilage explants (approx 50 mg) harvested from stifle joints of a 3-year-old and a 5-year-old horse. Methods: Expression constructs containing cDNA sequences encoding EqIL-1alpha and EqIL-1beta were generated, prokaryotically expressed, and the recombinant protein purified. Near full-thickness articular cartilag...
Fugazzola M, Nissinen MT, Jäntti J, Tuppurainen J, Plomp S, Te Moller N, Mäkelä JTA, van Weeren R.Strategies for articular cartilage repair need to take into account topographical differences in tissue composition and architecture to achieve durable functional outcome. These have not yet been investigated in the equine stifle. Objective: To analyse the biochemical composition and architecture of three differently loaded areas of the equine stifle. We hypothesise that site differences correlate with the biomechanical characteristics of the cartilage. Methods: Ex vivo study. Methods: Thirty osteochondral plugs per location were harvested from the lateral trochlear ridge (LTR), the distal int...
Valdés-Martínez A.Computed tomographic arthrography is an imaging technique used for the evaluation of the internal structures of a joint, especially the soft tissues and subchondral bone defects that may communicate with the joint space. Clinical indications, technical aspects, principles of image interpretation, and advantages and disadvantages of this imaging technique for the evaluation of the equine stifle joint are discussed in this article.
Beccati F, Chalmers HJ, Dante S, Lotto E, Pepe M.Osteochondrosis lesions commonly occur on the femoral trochlear ridges in horses and radiography and ultrasonography are routinely used to diagnose these lesions. However, poor correlation has been found between radiographic and arthroscopic findings of affected trochlear ridges. Interobserver agreement for ultrasonographic diagnoses and correlation between ultrasonographic and arthroscopic findings have not been previously described. Objectives of this study were to describe diagnostic sensitivity and interobserver agreement of radiography and ultrasonography for detecting and grading osteoch...
McCoy AM, Smith RL, Herrera S, Kawcak CE, McIlwraith CW, Goodrich LR.To report the outcome of horses engaged in Western performance disciplines after stifle arthroscopy and identify prognostic factors for return to performance. Methods: Retrospective case series. Methods: Eighty-two Western performance horses undergoing stifle arthroscopy. Methods: Medical records were reviewed for horses involved in athletic performance/training for various Western performance disciplines and undergoing arthroscopy for lameness localized to the stifle. Follow-up was obtained ≥2 years postoperatively by telephone interviews with the owners. Preoperative and intraoperative f...
Halley SE, Bey MJ, Haladik JA, Lavagnino M, Arnoczky SP.Studies examining the effect of stifle joint angle on tibial rotation, adduction-abduction angle and articular contact area are lacking. Objective: To test the hypothesis that tibial rotation, adduction-abduction angle and articular contact area change with stifle joint angle. Methods: Descriptive study of normal kinematics and articular contact patterns of the equine stifle through the functional range of motion using 3 dimensional (3D) radiosteriometric analysis (RSA) and equine cadaver stifles. Methods: Multiple, radiopaque markers were embedded in the distal femur and proximal tibia and se...
Schneider RK, Jenson P, Moore RM.To evaluate clinical findings and response to treatment in horses in which cartilage lesions on the medial femoral condyle were a cause of lameness. Methods: Retrospective case series. Methods: Medical records of 11 horses that had cartilage lesions on the medial femoral condyle detected during arthroscopy of the stifle. Methods: Signalment, history, lameness examination, response to intra-articular anesthesia, radiographs of the stifle, observations during diagnostic arthroscopy, and treatment were extracted from the medical record of each horse. Follow-up examinations and outcome were availa...
Santos MP, Gutierrez-Nibeyro SD, McKnight AL, Singh K.With the recent introduction of a 0.25T rotating MRI system, clinical evaluation of the equine stifle joint is now possible in the average equine athlete. A recent publication described common abnormalities of horses with stifle lameness detected with a low-field MRI system; however, postmortem corroboration of the lesions detected was not possible. Therefore, our objective was to compare postmortem findings with low-field MRI findings in equine cadaver stifle joints. Ten fresh cadaver stifle joints from horses without clinical signs of stifle disease were evaluated using low-field MRI, gross ...
White JL, Salinas EY, Link JM, Hu JC, Athanasiou KA.A significant portion of equine lameness is localized to the stifle joint. Effective cartilage repair strategies are largely lacking, however, recent advances in surgical techniques, biomaterials, and cellular therapeutics have broadened the clinical strategies of cartilage repair. To date, no studies have been performed directly comparing neonatal and adult articular cartilage from the stifle across multiple sites. An understanding of the differences in properties between the therapeutic target cartilage (i.e., adult cartilage) as well as potential donor cartilage (i.e., neonatal cartilage) c...
Watts AE, Nixon AJ.To (1) describe a caudal approach to equine medial and lateral femorotibial (FT) joints and (2) illustrate the complex anatomic detail of the caudal compartments of the lateral FT joint. Methods: Prospective experimental study. Methods: Cadaveric equine hindlimbs (n = 36; 26 horses) and 6 horses (11 hind limbs). Methods: Stifles (n = 8) were dissected and 10 FT joints were injected with silicone. Arthroscopic exploration (n = 29) was performed, followed by dissection to determine sites and structures penetrated during entry. Results: A more caudal approach to the caudal pouch of the medial FT ...
Frazer LL, Santschi EM, Fischer KJ.To predict the bone formation stimulus of a transcondylar screw across an equine subchondral bone cyst (SBC) in an equine medial femoral condyle (MFC). Methods: Finite element modeling (FEM) of an equine MFC with a 2 cm SBC under several transcondylar screw conditions. Methods: The right stifle of a yearling thoroughbred without stifle disease that had been euthanized for reasons unrelated to this study and donated to the University. Methods: The FEM was derived from computed tomography of a yearling thoroughbred and analyzed in ABAQUS v6.14. The transcondylar screw was modeled as a 4.5-mm s...
Scott GS, Crawford WH, Colahan PT.To determine arthroscopic findings in lame horses with subtle radiographic lesions of the medial femoral condyle. Methods: Retrospective study. Methods: 15 horses examined because of lameness that had subtle radiographic evidence of osteochondral lesions involving the medial femoral condyle in at least 1 joint. Methods: Medical records were reviewed, and results of physical examination, radiography, and arthroscopy were recorded. Follow-up information was obtained through reexamination of the horses or telephone conversations with the referring veterinarians, owners, or trainers. Results: Lame...
Oliver LJ, Baird DK, Baird AN, Moore GE.To characterise the prevalence and distribution of radiographic changes in the hocks and stifles of Thoroughbred yearling colts and fillies in New Zealand and compare them with other populations of young horses. Methods: Repository radiographs taken in New Zealand for the 2003-2006 Thoroughbred national yearling sales were evaluated by two individual readers. The distribution of radiographic changes was classified as left side only, right side only, or bilateral. Lesions were categorised by type, location, and sex of the yearling. Complete sets of hock and stifle radiographs of 1,505 yearlings...
Rankin JS, Diesem CD.The hindlimbs of 3 ponies and 3 horses were dissected. The hip joint capsule was found to receive articular nerve fibers from the femoral, obturator, cranial gluteal, and sciatic nerves. The nerve fibers were distributed to the fibrous joint capsule and associated capsular ligaments. The stifle joint capsule was found to receive articular branches from the femoral, saphenous, obturator, common peroneal, and tibial nerves. The fibers terminated in the joint capsule, fat pad, patellar and collateral ligaments, and the internally situated meniscal and cruciate ligaments.
Frazer LL, Santschi EM, Fischer KJ.To predict bone and medial meniscal stresses and contact pressures in an equine stifle with a medial femoral condyle (MFC) intact or with a 2-cm subchondral bone void, under varying degrees of internal femoral rotation (IFR). Methods: Finite element model (FEM) of a cadaveric equine stifle loaded to 8000 N. Methods: The FEM was constructed from computed tomography (CT) of the right, extended stifle of a yearling. The CT image was segmented into relevant anatomic structures and meshed into 4-node tetrahedrons. Bone material properties were assigned according to Hounsfield units, soft tissue p...
Jeffcott LB, Kold SE.The clinical and radiological characteristics of stifle lameness in 86 horses are described. The majority of these cases had been lame for some weeks before referral. The most frequent diagnoses made were osteochondrosis dissecans (13 per cent) and subchondral bone cyst (38 per cent). Both of these conditions were seen principally in Thoroughbreds at or before the onset of training. The other bone lesions encountered were osteoarthritis (3 per cent), fractures (4 per cent) and "epiphysitis" (1 per cent). The commonest soft tissue condition was an atypical or partial upward fixation of the pate...
Peat FJ, Kawcak CE, McIlwraith CW, Keenan DP, Berk JT, Mork DS.Subchondral lucencies (SCLs) in the distal aspect of the medial femoral condyle (MFC) of young Thoroughbred horses are a source of controversy on presale radiographs. There is limited scientific evidence regarding the risk of progression and impact on future racing performance. Objective: To (1) identify the prevalence of MFC SCLs on sales repository radiographs in yearling and 2-year-old Thoroughbreds; (2) identify any association between grade of MFC SCL and future racing performance and (3) monitor changes in MFC SCL grades between yearling and 2-year-old sales. Methods: Prospective cohort ...
