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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.
Radiographic anatomy of the soft tissue attachments of the equine stifle. Radiography is a very important aspect of equine stifle imaging. The precise radiographic anatomy of the soft tissue structures of the equine stifle has not been described previously. Objective: To describe the anatomical relationship between sites of attachment of soft tissue structures of the equine stifle and their locations on standard radiographic views. Methods: The sites of bony attachments of the tendons, ligaments and fibrous portion of the joint capsules of equine stifles were determined by gross dissection. These sites of attachment were transposed onto one set of bones deprived of ...
Cross-sectional anatomy and comparative ultrasonography of the equine medial femorotibial joint and its related structures. Injuries of the equine stifle are frequent causes of hindlimb lameness. Ultrasonography is useful for the diagnosis of many soft tissue lesions but, until recently, its application to the equine stifle has been limited to a description of normal and abnormal structures. A comparative study using gross anatomical sections to identify all structures visible on ultrasonographic images of the equine stifle has not previously been reported. Objective: To provide a comprehensive comparative cross-sectional atlas of the normal equine medial femorotibial (MFT) joint and its related structures using ul...
Evaluation of subchondral bone mineral density associated with articular cartilage structure and integrity in healthy equine joints with different functional demands. To determine and correlate subchondral bone mineral density and overlying cartilage structure and tensile integrity in mature healthy equine stifle (low magnitude loading) and metacarpophalangeal (high magnitude loading) joints. Methods: 8 healthy horses, 2 to 3 years of age. Methods: Osteochondral samples were acquired from the medial femoral condyle (FC) and medial trochlear ridge (TR) of the stifle joint and from the dorsal (MC3D) and palmar (MC3P) aspects of the distal medial third metacarpal condyles of the metacarpophalangeal joint. Articular cartilage surface fibrillation (evaluated via...
Autologous osteochondral grafting (mosaic arthroplasty) for treatment of subchondral cystic lesions in the equine stifle and fetlock joints. To describe treatment of equine subchondral bone cysts (SBCs) by reconstruction of the articular surface with osteochondral grafts. Methods: Case series of horses with SBCs unresponsive to conservative therapy. Methods: Eleven horses (1-12 years). Methods: SBCs were identified in 4 locations: medial femoral condyle (5 horses), lateral femoral condyle (1), distal epiphysis of the metacarpus (4), or metatarsus (1). Osteochondral autograft transplantation (mosaic arthroplasty) was performed, taking grafts from the abaxial border of the medial femoral trochlea of the unaffected limb. Graft implant...
Arthroscopic findings in horses with subtle radiographic evidence of osteochondral lesions of the medial femoral condyle: 15 cases (1995-2002). 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...
Assessment of subchondral bone mineral density in equine metacarpophalangeal and stifle joints. Functional relationships between articular cartilage and underlying subchondral bone have been shown to be associated with the progression of osteoarthritis (OA). However, quantifiable factors substantiating this relationship do not exist. Therefore, the study objective involved quantifying subchondral bone mineral density (BMD) of the equine metacarpophalangeal (MCP) and stifle joints as a step in determining if regional subchondral BMD may be associated with OA changes. BMD was bilaterally quantified using dual energy xray absorptiometry (DEXA) for four subchondral regions: palmer and dorsal...
Effect of lateral heel wedges on sagittal and transverse plane kinematics of trotting Shetland ponies and the influence of feeding and training regimes. Lateral heel wedges are used to treat horses and ponies with patella fixation or bone spavin. However, these therapies are purely empirically based and lack scientific evidence. Objective: Lateral heel wedges would change joint motion in the sagittal, but mainly in the transversal planes, in healthy horses. This effect would be increased by restricted feeding and decreased by extra training. Methods: A group of 24 Shetland ponies age 3 years was used, as foals had been assigned to restricted and ad libitum (ad lib) feeding, and low and high level training groups of 6 animals each. An experienc...
Radiographic changes in Thoroughbred yearlings. Part 1: Prevalence at the time of the yearling sales. Radiography in presale examinations of TB yearlings has become standard practice in recent years. Objective: To describe the prevalence and distribution of radiographic changes in the fetlocks, carpi, tarsi, stifles and fore feet of Thoroughbred yearlings in central Kentucky when these joints were examined as part of routine pre- and post sale evaluations. Methods: Horses subjected to radiographs included the fore (n = 1127) and hind (n = 1102) fetlocks, carpi (n = 1130), tarsi (n = 1101), stifles (n = 660) and fore feet (n = 300). Radiographic changes were categorised by location and type of ...
Radiographic changes in Thoroughbred yearlings. Part 2: Associations with racing performance. Although the radiographic examination of yearlings has become commonplace at some large Thoroughbred sales, there are few data to support the decisions facing veterinarians who are asked to evaluate future racing potential. Objective: To identify radiographic changes in the fetlocks, proximal sesamoid bones, carpi, tarsi, stifles and fore feet of Thoroughbred yearlings associated with future racing performance during ages 2 and 3 years. Methods: Radiographs from routine pre- and post sale examinations of 1162 yearlings were used to identify individual radiographic changes in sale yearlings. St...
The equine hind limb is actively stabilized during standing. Horses spend much of their life standing, and they are believed to be able to keep their limbs straight without muscular effort. We tested the hypothesis that the stifle (knee) and hock (tarsal) joints could be stabilized merely with the help of a passive lock mechanism whereby the patella is secured behind a hook, formed by the medial femoral trochlea. In anaesthetized animals and isolated limbs the stifle and hock flex readily under compression. In isolated limbs this collapse was prevented by a small force applied to the patella, mimicking the action of the vastus medialis muscle. In vivo, ...
The influence of exercise on bone morphogenic enzyme activity of immature equine subchondral bone. This study aimed at the determination of the influence of exercise on the levels of a number of bone morphogenic enzymes in subchondral bone and at the comparison of these data with other (subchondral) bone-related parameters that have been investigated in the same experimental population.Forty-three foals were reared until weaning at 5 months of age under similar conditions, except for the type and amount of exercise. Fifteen foals remained at pasture (Pasture group and also control group), 14 foals were kept in box stalls (Box group) and 14 foals were kept in the same box stalls but were sub...
Evaluation of a cranial arthroscopic approach to the stifle joint for the treatment of femorotibial joint disease in horses: 23 cases (1998-1999). To describe a single-portal cranial arthroscopic approach to the stifle joint in horses and to determine the clinical outcome in horses with femorotibial joint disease in which this approach was used. Methods: Retrospective study. Methods: 23 adult horses. Methods: Medical records were reviewed to obtain information on clinical outcome in horses in which the single-portal cranial arthroscopic approach was used. Results: Twenty-nine stifle joints of 23 horses were examined arthroscopically, using the described approach. Subchondral bone cysts were treated in 19 medial femoral condyles of 12 hor...
Comparison of computed radiography and conventional film-screen radiography of the equine stifle. Major advantages of computed radiography are the potential reduction of dose and the possibility of postprocessing. In our study, we compared conventional radiographs to digital radiographs of the equine stifle by subjective evaluation of diagnostic quality when using a decreasing photon flux (mAs). Twelve equine stifle joints from horses of different weight and size were examined. Conventional and digital radiographs were performed identically in a caudocranial projection with the tube angled 15 degrees. A series of four radiographs was performed in each technique with an increasing photon fl...
Characterisation of reconstituted equine cartilage formed in vitro. Lesions in cartilage of equine weightbearing joints commonly result in lameness. Cell-based resurfacing techniques are currently being developed for human and veterinary applications. Biopsies of stifle joint cartilage (1 g) were harvested aseptically and chondrocytes were isolated by sequential enzyme digestion. The cells were grown in vitro on filter inserts. Analysis of cultures 8 weeks later showed that the cells had accumulated extracellular matrix and formed a continuous layer of cartilagenous tissue as determined histologically. The cells maintained their phenotype as they synthesised t...
Epidural morphine and detomidine decreases postoperative hindlimb lameness in horses after bilateral stifle arthroscopy. To determine whether preoperative epidural administration of morphine and detomidine would decrease postoperative lameness after bilateral stifle arthroscopy in horses. Methods: Prospective clinical controlled study. Methods: Eight adult horses that had bilateral arthroscopic procedures, including drilling of cartilage and subchondral bone within the femoropatellar joints. Methods: Horses were randomly separated into 2 groups. Preoperatively, 4 horses were administered a combination of epidural morphine (0.2 mg/kg) and detomidine (30 microg/kg), and 4 horses were administered an equivalent vol...
Effects of equine recombinant interleukin-1alpha and interleukin-1beta on proteoglycan metabolism and prostaglandin E2 synthesis in equine articular cartilage explants. 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...
Diffusion of mepivacaine between adjacent synovial structures in the horse. Part 2: tarsus and stifle. This paper tests the hypothesis that the local analgesic agent mepivacaine diffuses between adjacent equine synovial structures in the hindlimb and with greater frequency than latex, gelatine dye or contrast media. We report the incidence of diffusion of mepivacaine between the tarsometatarsal, centrodistal and tarsocrural joints, and the 3 synovial compartments of the stifle in 33 fresh equine cadavers. The tarsometatarsal joint and one synovial compartment of the stifle in the left limb and the centrodistal joint and a different synovial compartment of the stifle in the right limbs were inje...
Unusual osteochondral lesions of the talus in a horse. A 2-year-old Thoroughbred gelding was evaluated for a grade 3 out of 5 unilateral hind limb lameness. Flexion of the right hock and stifle joints (spavin test) exacerbated the lameness. Response to intra-articular and perineural anaesthesia isolated the source of lameness to the tarsocrural area, despite an absence of tarsocrural joint effusion. Routine radiographic examination of the hock did not reveal any significant abnormalities. Skeletal nuclear scintigraphic evaluation revealed a focal region of increased bone activity in the proximal medial trochlear ridge of the talus. Flexed laterome...
Effect of walking velocity on hindlimb kinetics during stance in normal horses. The objectives of this study were to measure the effect of walking velocity on net joint moments and joint powers in the hindlimb during stance and to use the data to predict these variables at different walking velocities. Videographic and force data were collected synchronously from 5 sound horses walking over a force plate at a range of velocities. Force and kinematic data from 56 trials were combined using an inverse dynamic solution to determine net joint moments and joint powers. Analysis by simple regression and correlation (P or = 0.30, r > 0.50) showed that, in early stance, there...
Changes in molecular expression of aggrecan and collagen types I, II, and X, insulin-like growth factor-I, and transforming growth factor-beta1 in articular cartilage obtained from horses with naturally acquired osteochondrosis. To determine molecular changes in the expression of insulin-like growth factor-I (IGF-I) and transforming growth factor-beta1 (TGF-beta1) in horses with osteochondrosis, and to characterize expression of matrix aggrecan and collagen types I, II, and X in articular cartilage of affected joints. Methods: Articular cartilage from affected stifle or shoulder joints of 11 horses with naturally acquired osteochondrosis and corresponding joints of 11 clinically normal horses. Methods: Harvested specimens were snap frozen in liquid nitrogen, and total RNA was isolated. Specimens were fixed in 4% paraf...
The surgical technique and the age of the horse both influence the outcome of mosaicplasty in a cadaver equine stifle model. Six pieces of grafts, 6.5 mm in diameter, 20 mm in length, were taken from each of 170 cadaver hindlimbs, using the cranial surface of the medial femoral trochlea for harvesting. The age of the horses varied between 4 months and 23 years. 30 limbs under the age of 12 years were selected for transplantation. Three of six grafts were transplanted into the medial femoral condyle using different combinations of tunnel depth and dilation. With ageing, a significant decline in transplantability was detected. In general, mosaicplasty cannot be recommended in horses above 11 years. Based on a previous...
The hindlimb in walking horses: 1. Kinematics and ground reaction forces. 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; ...
The hindlimb in walking horses: 2. Net joint moments and joint powers. The objective of the study was to describe net joint moments and joint powers in the equine hindlimb during walking. The subjects were 5 sound horses. Kinematic and force data were collected synchronously and combined with morphometric information to determine net joint moments at each hindlimb joint throughout stance and swing. The results showed that the net joint moment was on the caudal/plantar side of all hindlimb joints at the start of stance when the limb was being actively retracted. It moved to the cranial/dorsal side around 24% stride at the hip and stifle and in terminal stance at t...
Hormones, growth factors and other plasma variables in relation to osteochondrosis. 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...
Radiographic development of osteochondral abnormalities, in the hock and stifle of Dutch Warmblood foals, from age 1 to 11 months. In a longitudinal study the hocks and stifles of Dutch Warmblood foals were radiographed at age 1 month and subsequently at intervals of 4 weeks. Forty-three foals were radiographed until age 5 months and 19 foals until age 11 months. The chance for the development of osteochondrosis was enhanced by using only offspring from diseased sires with radiographically proven OC at either the intermediate ridge of the distal tibia or the lateral ridge of the femoral trochlea. The radiographic appearances of the intermediate ridge of the distal tibia, the distal aspect of the lateral trochlear ridge of...
Arthroscopic removal of patellar fracture fragments in horses: five cases (1989-1998). To evaluate the use of arthroscopy as the primary method for removal of large patellar fracture fragments. Methods: Retrospective study. Methods: 5 performance horses of various breeds with patellar fractures. Methods: Clinical signs of lameness, external evidence of injury, and radiography were used to diagnose and determine fracture orientation. Arthroscopy of the stifle joint was performed on the affected limb with the horse positioned in dorsal recumbency and under general anesthesia. Progress after surgery was determined by evaluating medical records and via telephone conversations with o...
The effect of compacted cancellous bone grafting on the healing of subchondral bone defects of the medial femoral condyle in horses. 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...
Physical examination of horses with back pain. The diagnosis of back pain is often a diagnosis of exclusion of other problems in the face of poor performance. It requires careful observation, thought, an open mind, and experience. The signs of back pain can be extremely variable and range from subtle to obvious. Obvious forelimb or hind limb lameness is not usually a sign of back pain. The most common differential diagnosis may be back pain secondary to degenerative joint disease of the hocks, fetlocks, or stifle. These diseases can mimic signs of back pain including lack of impulsion, shortening of the stride length, and change in the str...
Osteochondritis dessicans and subchondral cystic lesions in draft horses: a retrospective study. The clinical features, radiographic findings, treatment, and outcome in 51 draft horses with osteochondritis dessicans (OCD) or subchondral cystic lesions (SC) are reported. Clydesdale and Percheron were the most commonly affected breeds, and affected animals represented only 5% of the hospital population of draft horses. Horses were most frequently affected in the tibiotarsal joints and 73% (24 of 33 cases) of the horses with tibiotarsal effusion were affected bilaterally. Osteochondritis dessicans of the distal intermediate ridge was the most common lesion found in the tibiotarsal joint. The...
