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Topic:Stifle Joint

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.
A comparison of arthroscopy to ultrasonography for identification of pathology of the equine stifle.
Equine veterinary journal    February 25, 2016   Volume 49, Issue 3 314-321 doi: 10.1111/evj.12541
Adrian AM, Barrett MF, Werpy NM, Kawcak CE, Chapman PL, Goodrich LR.To evaluate and compare the diagnostic capability of arthroscopy and ultrasonography for the detection of pathological change in equine stifle joints. Although descriptions of the arthroscopic and ultrasonographic boundaries of the normal femorotibial joint exist, there are few examples in the literature comparing the pathological changes observed with each imaging modality. Objective: To evaluate and compare arthroscopic and ultrasonographic examinations for characterising pathological change in the stifle joint. To describe how the results of arthroscopic and ultrasonographic examinations ma...
Ultrasound Imaging of the Musculoskeletal System.
The Veterinary clinics of North America. Small animal practice    February 2, 2016   Volume 46, Issue 3 355-v doi: 10.1016/j.cvsm.2015.12.001
Cook CR.Musculoskeletal ultrasound is a rapidly growing field within veterinary medicine. Ultrasound for musculoskeletal disorders has been commonly used in equine and human medicine and is becoming more commonly performed in small animal patients due to the increase in the recognition of soft tissue injuries. Ultrasound is widely available, cost-effective, but technically difficult to learn. Advantages of musculoskeletal ultrasound are the opposite limb is commonly used for comparison to evaluate symmetry of the tendinous structures and the ease of repeat examinations to assess healing. The article d...
Ultrasonographic appearance of normal and injured lateral patellar ligaments in the equine stifle.
Equine veterinary journal    May 29, 2015   Volume 48, Issue 3 299-306 doi: 10.1111/evj.12444
Gottlieb R, Whitcomb MB, Vaughan B, Galuppo LD, Spriet M.Ultrasound is widely used in horses with stifle lameness, yet limited information is available regarding the appearance of normal and injured lateral patellar ligaments (LPL). Objective: To map the normal ultrasonographic appearance of the LPL. To describe the clinical and ultrasonographic features of LPL injuries. Methods: Descriptive study of healthy horses and retrospective case series. Methods: Twelve horses without stifle lameness underwent ultrasonographic examination of bilateral LPLs and ultrasonographic features were recorded. Eighteen horses with LPL injury were identified from 1999 ...
Medial patellar ligament splitting in horses with upward fixation of the patella: A long-term follow-up.
Equine veterinary journal    May 26, 2015   Volume 48, Issue 3 312-314 doi: 10.1111/evj.12435
Andersen C, Tnibar A.Medial patellar ligament splitting (MPLS) has been shown to be a highly effective and minimally invasive treatment for upward fixation of the patella (UFP) in horses. However, long-term follow-up results of this procedure have not previously been reported. Objective: To evaluate the long-term resolution of UFP following MPLS and provide information on complications and recurrence. Methods: Retrospective case series. Methods: Data were collected from horses that underwent MPLS between 1999 and 2013. All cases had a confirmed diagnosis of UFP that had not responded to conservative therapy. Data ...
Mechanoreceptors in the Anterior Horn of the Equine Medial Meniscus: an Immunohistochemical Approach.
Anatomia, histologia, embryologia    April 23, 2015   Volume 45, Issue 2 131-139 doi: 10.1111/ahe.12181
Nemery E, Gabriel A, Grulke S, Piret J, Toppets V, Antoine N.Lameness due to stifle and especially meniscal lesions is frequent in equine species. In humans, mechanoreceptors involved in proprioceptive function are well studied. Given the high incidence of meniscal injuries in horses, and the lack of information concerning them in equine menisci, our objective was to study these corpuscles in six healthy anterior horns of the equine medial meniscus, which is the most common localisation reported for equine meniscal injuries. Immunohistochemical stainings were performed using antibodies against high molecular weight neurofilaments and glial fibrillary ac...
Gross and Histopathologic Correlation of Low-Field Magnetic Resonance Imaging Findings in the Stifle of Asymptomatic Horses. 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 ...
Treatment of osteochondrosis dissecans in the stifle and tarsus of juvenile thoroughbred horses.
Veterinary surgery : VS    September 22, 2014   Volume 44, Issue 3 297-303 doi: 10.1111/j.1532-950X.2014.12277.x
Clarke KL, Reardon R, Russell T.To determine if arthroscopic surgery performed on weanlings/yearlings with trochlear ridge OCD of the femur (stifle OCD), or intermediate ridge of the tibia (tarsal OCD) detected on routine presale radiographs affects future racing performance. Methods: Retrospective case control study. Methods: Thoroughbred weanlings and yearlings. Methods: Stifle (N = 37; 22 male, 15 female) and tarsal (N = 35; 22 male, 13 female) OCD cases were identified. Outcome measures relating to racing performance (number of race starts, wins, places, and prize money earned, from races in their 2- and 3-year-old racin...
Allogenic mesenchymal stem cells as a treatment for equine degenerative joint disease: a pilot study.
Current stem cell research & therapy    September 2, 2014   Volume 9, Issue 6 497-503 doi: 10.2174/1574888x09666140826110601
Broeckx S, Suls M, Beerts C, Vandenberghe A, Seys B, Wuertz-Kozak K, Duchateau L, Spaas JH.Cell-based therapies, such as treatments with mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP) are thought to have beneficial effects on the clinical outcome of orthopedic injuries, but very few animal studies with large sample size are published so far. Therefore, the aim of this study was to assess the safety and report the clinical outcome of allogenic, immature or chondrogenic induced MSCs in combination with PRP for the treatment of degenerative joint disease (DJD) in 165 horses. MSCs and PRP were isolated from a 6-year-old donor horse and transplanted either in their native s...
Ex vivo equine medial tibial plateau contact pressure with an intact medial femoral condyle, with a medial femoral condylar defect, and after placement of a transcondylar screw through the condylar defect.
Veterinary surgery : VS    August 28, 2014   Volume 44, Issue 3 289-296 doi: 10.1111/j.1532-950X.2014.12242.x
Bonilla AG, Williams JM, Litsky AS, Santschi EM.To determine ex vivo contact data on the equine medial tibial plateau loaded by an intact medial femoral condyle (MFC), by an MFC with an osteochondral defect, and with a screw inserted in lag fashion through the MFC defect. Methods: Ex vivo experiment. Methods: Stifles (n = 6). Horses (n = 4). Methods: Stifle joints were axially loaded to 1800 N at 155°, 145°, and 130°, under 3 conditions: Intact, MFC with a 15 mm circular osteochondral defect, and with a transcondylar screw inserted in lag fashion through the defect. An electronic pressure sensor (Tekscan®) on the medial tibial plateau...
Comparison of equine articular cartilage thickness in various joints.
Connective tissue research    August 26, 2014   Volume 55, Issue 5-6 339-347 doi: 10.3109/03008207.2014.949698
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...
Diagnostic sensitivity of bone scintigraphy for equine stifle disorders. Graham S, Solano M, Sutherland-Smith J, Sato AF, Maranda L.Disorders of the stifle are a common cause of lameness in horses yet the accuracy of scintigraphy for diagnosis of stifle conditions is controversial. The aim of retrospective cross-sectional study was to determine the diagnostic sensitivity (Se) of bone scintigraphy in detecting stifle disease and to determine if two orthogonal scintigraphic images improve diagnostic Se. Horses that underwent scintigraphic examination during a two-year period were included. Horses were divided into two groups: group 1 (N = 23) had lameness that was localized to the stifle by intra-articular analgesia and grou...
Clinical outcome after intra-articular administration of bone marrow derived mesenchymal stem cells in 33 horses with stifle injury.
Veterinary surgery : VS    January 16, 2014   Volume 43, Issue 3 255-265 doi: 10.1111/j.1532-950X.2014.12100.x
Ferris DJ, Frisbie DD, Kisiday JD, McIlwraith CW, Hague BA, Major MD, Schneider RK, Zubrod CJ, Kawcak CE, Goodrich LR.To report outcome of horses with femorotibial lesions (meniscal, cartilage or ligamentous) treated with surgery and intra-articular administration of autologous bone marrow derived mesenchymal stem cells (BMSCs). Methods: Prospective case series. Methods: Horses (n = 33). Methods: Inclusion criteria included horses that had lameness localized to the stifle by diagnostic anesthesia, exploratory stifle arthroscopy and subsequent intra-articular administration of autologous BMSCs. Case details and follow-up were gathered from medical records, owner, trainer or veterinarian. Outcome was defined as...
Effect of anesthetizing individual compartments of the stifle joint in horses with experimentally induced stifle joint lameness.
American journal of veterinary research    December 29, 2013   Volume 75, Issue 1 19-25 doi: 10.2460/ajvr.75.1.19
Tóth F, Schumacher J, Schramme MC, Hecht S.To evaluate the effects of sequential anesthesia of the individual compartments of the equine stifle joint on lameness induced by intra-articular deposition of interleukin (IL)-1β. Methods: 6 horses. Methods: For each horse, baseline hind limb lameness was first evaluated. A randomly selected compartment of 1 stifle joint was then injected with IL-1β to induce synovitis and lameness; subsequently, the same compartment was anesthetized with 2% mepivacaine hydrochloride, and lameness was reevaluated. Two weeks later, baseline lameness was evaluated, and lameness was similarly induced; thereaft...
Mosaic arthroplasty of the medial femoral condyle in horses – An experimental study.
Acta veterinaria Hungarica    December 18, 2013   Volume 62, Issue 2 155-168 doi: 10.1556/AVet.2013.059
Bodó G, Vásárhelyi G, Hangody L, Módis L.One Arabian and 5 Hungarian half-bred horses were used to study the macroscopic and microscopic survival of autologous osteochondral grafts in the weight-bearing surface of the medial femoral condyle (MFC). Grafts were harvested from the cranial surface of the medial femoral trochlea (MFT) under arthroscopic control. Three of them were transplanted into the weight-bearing surface of the contralateral MFC using an arthrotomy approach. Three months later this transplantation procedure was repeated on the opposite stifle joints in the same animals, but at that time transplantation was performed a...
Diagnostic stifle joint arthroscopy using a needle arthroscope in standing horses.
Veterinary surgery : VS    October 31, 2013   Volume 43, Issue 1 12-18 doi: 10.1111/j.1532-950X.2013.12068.x
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...
Three dimensional, radiosteriometric analysis (RSA) of equine stifle kinematics and articular surface contact: a cadaveric study.
Equine veterinary journal    September 11, 2013   Volume 46, Issue 3 364-369 doi: 10.1111/evj.12127
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...
Use of bovine carpal joints as a training model for cruciate ligament repair.
ANZ journal of surgery    July 15, 2013   Volume 83, Issue 12 933-936 doi: 10.1111/ans.12308
Calvert N, Grainger N, Hurworth M.Currently, there is a lack of cheap and effective training models to allow orthopaedic surgery trainees to learn the basics of anterior cruciate ligament reconstruction. The aim of this paper was to investigate the viability of using various animal joints as models for the training of anterior cruciate ligament reconstruction. Methods: Equine stifles, bovine stifles and carpal joints, sheep stifles and porcine stifles, were sourced from a local abattoir. Each joint was assessed for the following criteria: suitable tendons for harvesting, ease of arthroscopy access, adequacy of arthroscopy view...
Prevalence of osteochondral fragments, osteochondrosis dissecans and palmar/plantar osteochondral fragments in Hanoverian Warmblood horses.
Berliner und Munchener tierarztliche Wochenschrift    June 14, 2013   Volume 126, Issue 5-6 236-244 
Hilla D, Distl O.In this study, the prevalences of osteochondral fragments in the distal (DUI) and proximal interphalangeal joints (PIJ) as well as in the fetlock, hock and stifle joints, of palmar/plantar osteochondral fragments in the fetlock joints (POFs) and of osteochondrosis dissecans (OCD) in fetlock, hock and stifle joints were estimated in a large sample of Hanoverian Warmblood horses. For this purpose, radiographic findings of 9478 Hanoverian Warmblood horses collected from 2005 to 2011 were analyzed. Overall 31.9% of the horses showed one or more osteochondral fragments in at least one joint. The fe...
Medial femoral condyle morphometrics and subchondral bone density patterns in Thoroughbred racehorses.
American journal of veterinary research    May 1, 2013   Volume 74, Issue 5 691-699 doi: 10.2460/ajvr.74.5.691
Walker WT, Kawcak CE, Hill AE.To characterize medial femoral condyle (MFC) morphometrics and subchondral bone density patterns in Thoroughbred racehorses and to determine whether these variables differ between left and right limbs. Methods: Stifle joints harvested from 6 Thoroughbred racehorses euthanized for reasons other than hind limb lameness. Methods: The distal portion of the left and right femurs of each cadaver was scanned via CT. Hounsfield units were converted to dipotassium phosphate equivalent densities through use of a phantom on each specimen. Medial femoral condyle width, length, height, and curvature; subch...
Genetic parameters of juvenile osteochondral conditions (JOCC) in French Trotters.
Veterinary journal (London, England : 1997)    April 29, 2013   Volume 197, Issue 1 77-82 doi: 10.1016/j.tvjl.2013.03.045
Ricard A, Perrocheau M, Couroucé-Malblanc A, Valette JP, Tourtoulou G, Dufosset JM, Robert C, Chaffaux S, Denoix JM, Guérin G.Juvenile osteochondral conditions (JOCC) have been defined as lesions resulting from biomechanical influences (compressive, tensional or shear forces) on the developing and growing musculoskeletal system. They include different types of osteochondrosis, osteochondral fragmentation of the articular surface or of the periarticular margins, juvenile subchondral bone cysts, osteochondral collapse, avulsion fractures of epiphyseal (or metaphyseal) ossifying bone and 'physitis'. The aim of this study was to estimate heritability of JOCC in a sample of 2106 French Trotters from four different sources...
Prevalence of abnormal radiographic findings in 2-year-old Thoroughbreds at in-training sales and associations with racing performance.
Journal of the American Veterinary Medical Association    March 23, 2013   Volume 242, Issue 7 969-976 doi: 10.2460/javma.242.7.969
Meagher DM, Bromberek JL, Meagher DT, Gardner IA, Puchalski SM, Stover SM.To estimate the prevalence of radiographic abnormalities (lesions) in Thoroughbred racehorses at 2-year-old in-training sales and determine whether these lesions and 1-furlong presale workout times were associated with subsequent racing performance. Methods: Retrospective cohort study. Methods: 953 Thoroughbreds. Methods: Repository radiographs of carpal, metacarpophalangeal and metatarsophalangeal (fetlock), stifle, and tarsal (hock) joints were examined. Horses with lesions were classified by lesion type and location. Race performance variables were compared between horses with and without l...
Diagnostic sensitivity and interobserver agreement of radiography and ultrasonography for detecting trochlear ridge osteochondrosis lesions in the equine stifle. 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...
Outcome after arthroscopic treatment of lateral femoral trochlear ridge osteochondrosis in sport horses. A retrospective study of 37 horses.
Veterinary and comparative orthopaedics and traumatology : V.C.O.T    December 13, 2012   Volume 26, Issue 2 105-109 doi: 10.3415/VCOT-11-12-0182
UpRichard K, Elce YA, Piat P, Beauchamp G, Laverty S.To determine the short- and long-term outcome for sport horses after arthroscopic treatment of osteochondrosis of the lateral trochlear ridge of the femur. Methods: A retrospective study was performed using the medical records of horses intended for use as English sport horses. Outcome was obtained through telephone questionnaire. Results: Thirty-seven horses, mainly Warmbloods, underwent arthroscopic surgery for treatment of lateral femoral trochlear ridge osteochondrosis. Short-term outcome revealed that 27 of 37 horses had no complications. Seven horses had postoperative lameness and effusi...
Computed tomographic arthrography of the equine stifle joint.
The Veterinary clinics of North America. Equine practice    October 15, 2012   Volume 28, Issue 3 583-598 doi: 10.1016/j.cveq.2012.09.002
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.
Evaluation of a positioning method for equine lateral stifle scintigrams.
Acta veterinaria Scandinavica    June 15, 2012   Volume 54, Issue 1 38 doi: 10.1186/1751-0147-54-38
Grapperon Mathis M, Ley C, Berger M, Hansson K.The current lack of a standardized protocol for positioning of the gamma camera relative to the horse limb in a lateral stifle scintigram, and thus the reliance on subjective positioning, may be a cause of diagnostic error and inter-operator variability due to variations of the view angle. The aims of this study were to develop a reliable method to obtain a lateral scintigram of the equine stifle based on fixed anatomical landmarks and measure the resulting foot to gamma camera angle on sequential measurements of the same horse and of different horses Methods: Technetium filled capsules were g...
Concurrent patellar fracture and lateral collateral ligament avulsion as a result of trauma in three horses.
Journal of the American Veterinary Medical Association    May 9, 2012   Volume 240, Issue 10 1218-1222 doi: 10.2460/javma.240.10.1218
McLellan J, Plevin S, Taylor E.3 horses were evaluated because of lameness and swelling of the stifle joint subsequent to trauma. Results: All horses had characteristic clinical signs of stifle joint pain and effusion. A medial patellar fracture and lateral collateral ligament avulsion fracture were visible ultrasonographically in each. Radiography, including standard as well as flexed lateromedial, cranioproximal-craniodistal oblique (skyline patellar), and laterally stressed caudocranial views, revealed similar findings. Results: Arthroscopic surgery to remove the patellar fracture was attempted in 1 horse with severe des...
Comparison of four techniques of arthrocentesis of the lateral compartment of the femorotibial joint of the horse.
Equine veterinary journal    March 15, 2012   Volume 44, Issue 6 664-667 doi: 10.1111/j.2042-3306.2012.00551.x
Schumacher J, Schumacher J, Wilhite R.Clinical experiences indicate that centesis of the lateral compartment of the femorotibial joint is often unsuccessful. Objective: To determine the accuracy of 2 published and 2 unpublished techniques of centesis of the lateral compartment of the femorotibial joint. Objective: It was hypothesised that a drug can be administered into the lateral compartment of the femorotibial joint via a diverticulum of this joint that surrounds the medial aspect of the long digital extensor tendon and that this technique is more accurate than described techniques of centesis of this compartment. Methods: Twen...
Stifle extension results in differential tensile forces developing between abaxial and axial components of the cranial meniscotibial ligament of the equine medial meniscus: a mechanistic explanation for meniscal tear patterns.
Equine veterinary journal    December 14, 2011   Volume 44, Issue 5 554-558 doi: 10.1111/j.2042-3306.2011.00532.x
Fowlie JG, Arnoczky SP, Lavagnino M, Stick JA.To identify potential functional-anatomical characteristics of the cranial horn attachment of the medial meniscus (MM) that may help explain the pathogenesis of the common tear patterns that have been reported. Objective: Full extension of the stifle generates a significant increase in tensile forces within the cranial meniscotibial ligament (CrMTL) of the MM, which may predispose this structure to injury. Methods: The effect of femorotibial angle (160°, 150°, 140° and 130°) on tensile forces in the axial and abaxial components of the CrMTL was examined in 6 mature cadaver stifles using an...
Evaluation of biomechanical effects of four stimulation devices placed on the hind feet of trotting horses.
American journal of veterinary research    October 26, 2011   Volume 72, Issue 11 1489-1495 doi: 10.2460/ajvr.72.11.1489
Clayton HM, Lavagnino M, Kaiser LJ, Stubbs NC.To compare effects of 4 types of stimulation devices attached to the hind feet on hoof flight, joint angles, and net joint powers of trotting horses. Methods: 8 clinically normal horses. Methods: Horses were evaluated under 5 conditions in random order: no stimulators, loose straps (10 g), lightweight tactile stimulators (55 g), limb weights (700 g), and limb weights with tactile stimulators (700 g). Reflective markers on the hind limbs were tracked during the swing phase of 6 trotting trials performed at consistent speed to determine peak hoof heights and flexion angles of the hip, stifle, ta...
Resection of Grade III cranial horn tears of the equine medial meniscus alter the contact forces on medial tibial condyle at full extension: an in-vitro cadaveric study.
Veterinary surgery : VS    September 23, 2011   Volume 40, Issue 8 957-965 doi: 10.1111/j.1532-950X.2011.00899.x
Fowlie J, Arnoczky S, Lavagnino M, Maerz T, Stick J.To evaluate the magnitude and distribution of joint contact pressure on the medial tibial condyle after grade III cranial horn tears of the medial meniscus. Methods: Experimental study. Methods: Cadaveric equine stifles (n = 6). Methods: Cadaveric stifles were mounted in a materials testing system and electronic pressure sensors were placed between the medial tibial condyle and medial meniscus. Specimens were loaded parallel to the longitudinal axis of the tibia to 1800 N at 130°, 140°, 150°, and 160° stifle angle. Peak pressure and contact area were recorded from the contact maps. Testing...