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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.
Evaluation of cartilage lesions on the medial femoral condyle as a cause of lameness in horses: 11 cases (1988-1994). 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...
Kinematic comparison of the leading and trailing fore- and hindlimbs at the canter. 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...
Ultrasonographic examination of the femorotibial articulation in horses: imaging of the cranial and caudal aspects. The aim of this study was to determine the normal ultrasonographic features of the cranial and caudal aspects of the femorotibial articulation and, in particular, to establish a method of examining the menisci, cruciate and meniscal ligaments ultrasonographically. Twenty hindlimbs isolated post mortem from 10 horses were used to study the normal ultrasonographic and gross anatomy of the femorotibial joint. Five stifles from 3 normal, live horses were also examined with B-mode, real-time ultrasound imaging. The results of the anatomical study are presented. The joint surfaces, menisci, cruciate...
Estimation of the heritability of lameness in standardbred trotters. The degree of lameness of 265 randomly selected three-year-old standardbred trotters was assessed on a fixed point scale with 0 indicating soundness and 5 indicating that the animals were not weightbearing. Two variables were used to describe the signs of lameness; one was the continuous variable: the sum of the initial lameness score and the lameness scores after separate flexion tests of the carpal, stifle/tarsal and phalangeal joints and the second was the bivariate variable; the ratio of lame/sound horses. The mean (sd) heritability of the continuous variable was estimated to be 0.25 (0.21...
Removal of chip fractures of the femoral trochlear ridges of three horses by arthroscopy. Clinical and radiographic examinations of three horses with histories of trauma and/or wounds to the stifle revealed chip fractures from the medial trochlear ridge of the femur of one of them and from the lateral ridges of the femurs of the others. The joints were evaluated and the fragments of bone were removed by arthroscopy. The results were good in all three horses.
How the horse moves: 2. Significance of graphical representations of equine hind limb kinematics. Kinematic data of the equine hind limb are presented graphically and related to functional aspects of the hind limb in locomotion. The trot of 24 two-year-old Dutch Warmblood horses was recorded at 4 m/s on a high-speed treadmill using kinematic analysis equipment. Joint angle-time, angle-angle, stick and marker diagrams were used to present graphically the data following standardised procedures. As the kinematic data were expressed with reference to the joint angles of the horse standing squarely and were time-standardised to the duration of the stride cycle, mean joint curves for the total g...
Vertical tears of the cranial horn of the meniscus and its cranial ligament in the equine femorotibial joint: 7 cases and their treatment by arthroscopic surgery. Five horses with a vertical tear in the cranial horn and cranial ligament of the medial meniscus and 2 horses with a similar injury in the lateral meniscus were diagnosed from a series of 126 horses which were examined arthroscopically for stifle lameness. All the lesions had similar characteristics. The tear was about 1 cm from the axial border of the meniscus and its ligament and, in all but one case in which it was incomplete, much of the torn tissue was loosely attached in the axial part of the joint from where it was removed. The remaining meniscus, abaxial to the tear, was displaced cran...
Consideration of anatomic and radiographic features of the caudal pouches of the femorotibial joints of horses for the purpose of arthroscopy. Development of an arthroscopic approach to the caudal pouches of the equine stifle has been necessary because cranial approaches do not allow access to articular lesions in the caudal aspect of the joint. Therefore, the anatomy of the caudal region was examined in 52 cadaver limbs by use of gross dissection (29), x-ray-computed tomography (6), fluoroscopy (8), or arthroscopy (9). Additionally, using arthroscopic techniques developed in equine cadaver limbs, 3 stifles from 2 anesthetized horses were arthroscopically explored. Fluoroscopy was used to verify needle placement for joint injection a...
Case report: acute joint destabilization in the equine demonstrating early pathology in osteoarthritis. A case of acute destabilization of the right stifle joint associated with rupture of the anterior cruciate ligament and avulsion fracture of the tibial spine in a horse is reported. The diagnosis was obtained by scintigraphy and radiography. Post mortem investigations 6 weeks after injury demonstrated fibrillation of surface cartilage in regions unprotected by tibial menisci. No pathological change was demonstrated in the subchondral bone of the tibia in regions associated with loss of cartilage integrity.
Comparison of the cranial and a new lateral approach to the femoropatellar joint for aspiration and injection in horses. The genual joint in horses is complex, making synovial fluid aspiration and injection of the femoropatellar joint difficult. Horses commonly have signs of resentment to needle penetration at this site. We compared the safety and efficacy of a new technique, using a lateral approach to the femoropatellar joint, with that of the standard cranial approach in 12 horses. A significantly greater amount of fluid was obtained with the lateral approach (2.0 +/- 0.5 ml, mean +/- SEM) than with the cranial approach (0.9 +/- 0.2 ml). Significant differences were not observed in color, nucleated cell count...
In vitro mechanical properties and failure mode of the equine (pony) cranial cruciate ligament. In vitro failure modes and mechanical properties of the equine cranial cruciate ligament (CCL) were evaluated in 15 stifle joints from 10 ponies. Ponies were from 3 to 25 years of age and weighed from 122 to 208 kg. Femur-CCL-tibia specimens were mounted in 48 degrees of flexion, distracted until a 500-g tensile preload was achieved, and then tested by tensile loading to failure. Specimens failed by complete midsubstance CCL rupture (n = 9), combined tibial insertion avulsion fracture and midsubstance CCL rupture (n = 4), and combined femoral origin avulsion fracture and midsubstance CCL ruptu...
Arthroscopic removal of a fragment from an intercondylar eminence fracture of the tibia in a two-year-old horse. A 2-year-old Standardbred colt was admitted because of lameness of the left hind limb. Physical examination revealed marked effusion of the left femoropatellar and femorotibial joints and grade IV/V lameness of the left hind limb. Radiography of the left stifle revealed a complete fracture of the medial tubercle of the intercondylar eminence of the tibia. Arthroscopy was used to provide diagnostic, therapeutic, and prognostic information. A cranial approach to the medial compartment of the femorotibial joint was performed. Manipulation of the medial tubercle revealed it to be unstable, but a d...
Avulsion fracture of the origin of the extensor digitorum longus muscle in a foal. A 9-week-old Thoroughbred x Holsteiner colt was referred for evaluation and treatment of lameness of the right hind limb. Radiography of the stifle revealed multiple bony fragments within the lateral portion of the femorotibial joint and a radiolucency of the distolateral portion of the femur in the area of the extensor fossa, which were consistent with avulsion of the origin of the extensor digitorum longus muscle. Arthroscopy of the lateral portion of the femorotibial joint revealed exposed subchondral bone in the area of the extensor fossa, and the origin of the extensor digitorum longus mu...
Progression of femoropatellar osteochondrosis in nine young horses. Clinical, radiographic and arthroscopic findings. The clinical and radiographic progression, and arthroscopic findings for nine young horses (< 1 year of age) with femoropatellar osteochondrosis (OCD) are presented. Horses had a 2 to 12 week history of bilateral (8 horses) or unilateral (1 horse) hindlimb lameness. The most consistent clinical signs included femoropatellar joint distention and bilateral hindlimb lameness. At the onset of clinical signs, radiographic lesions were not present (4 horses) or subtle (5 horses), but were easily identified on radiographs taken 4 to 24 weeks later. Arthroscopic surgery was delayed until radiograph...
Electroencephalography of detomidine-ketamine-halothane and detomidine-ketamine-isoflurane anesthetized horses during orthopedic surgery. A comparison. 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...
Lateral patellar luxation in miniature horses. Bilateral luxation of the patella in four Miniature Horses was corrected by a lateral release incision and medial imbrication of the parapatellar fascia to the tendon of the sartorius muscle. Before surgery, the four horses had a grade 3 to 4 lateral patellar luxation bilaterally and had difficulty walking. Trochlear ridge hypoplasia was evident on radiographs in each horse. Follow-up information varied from 11 months to 4 years after surgery. Three horses had no patellar luxation or lameness. The other horse had a normal right stifle, but patellar luxation (grade 3) had recurred on the left.
Generalized medullary infarction of the long bones in a horse. Generalized medullary infarction of the long bones was diagnosed in a 12-year-old Tennessee Walking Horse mare. The mare was referred after a 6-week course of shifting weight on her hind limbs, and kicking. Physical examination revealed mild stifle joint distention and withdrawal reactions to digital pressure over the long bones. Radiography revealed patchy areas of medullary sclerosis in the distal portion of each femur and proximal portion of each tibia. A full-thickness cortical and cancellous tibial biopsy revealed infarcted bone marrow, with cortical and periosteal osteonecrosis. The caus...
Communication between the femoropatellar and medial and lateral femorotibial joints in horses. Communications between the femoropatellar, medial femorotibial, and lateral femorotibial joints were studied, using fresh equine cadaver specimens. A total of 90 specimens from 45 horses were used. Horses were randomly assigned to 3 groups with 15 horses/group. Each group was assigned an injection site (femoropatellar joint, medial femorotibial joint, or lateral femorotibial joint), and red latex was injected into the respective location of each joint in each group. Immediately after injection, the joints were flexed and extended 100 times. The stifles were frozen in slight flexion, then cut i...
Clinical and radiographic features, treatment and outcome in 15 horses with fracture of the medial aspect of the patella. A sagittal fracture of the medial aspect of the patella was identified in 15 horses, 2 of which had been kicked and 12 of which had hit a fixed fence while jumping. Eight horses showed concurrent fragmentation of the base of the patella, and 2 had sustained a concurrent fracture of the distal end of the lateral trochlear ridge of the femur. A cranioproximal-craniodistal oblique radiographic view was essential to identify the site of the medial patellar fracture and to determine its configuration. Fourteen horses were treated by surgical removal of the medial patellar fracture fragment(s). Of 1...
Arthroscopic removal of an osteochondral fragment from the caudal pouch of the lateral femorotibial joint in a colt. An osteochondral fragment was removed from the caudal pouch of the lateral femorotibial joint in a 2-year-old Trakehner colt by use of arthroscopic surgery and a lateral approach. The approach to this aspect of the femorotibial joints was developed in another horse. The fragment was not attached and resembled an osteochondritis dissecans lesion. The intermittent lameness associated with the fragment resolved after surgical removal. A positive response to diagnostic anesthesia of the femorotibial joint in the absence of a confirmed diagnosis (following radiographic and arthroscopic evaluations ...
Incorporation of fresh and cryopreserved bone in osteochondral autografts in the horse. The structural integrity of subchondral bone in fresh and frozen osteochondral autografts was investigated at month 3 in 10 horses. Two osteochondral autografts were harvested from the lateral aspect of the lateral trochlear ridge of the left talus in each of 10 anesthetized horses. Grafts were frozen in 7.5% DMSO. After 14 days, the thawed grafts were press-fitted into drill holes in the trochlear ridges of the right stifles. A fresh graft from the right hock was implanted in each left stifle. To control for the effects of surgery, a fresh graft was transferred from the right stifle to the le...
Heterotopic transfer of fresh and cryopreserved autogenous articular cartilage in the horse. Two 10 mm thick osteochondral grafts were harvested from the lateral aspect of the lateral trochlear ridge of the left talus in each of 10 anesthetized horses. The grafts were frozen in a 7.5% DMSO solution and stored in liquid nitrogen. The horses were anesthetized again on day 14 and the thawed grafts were press-fitted into drill holes in the trochlear ridges of the right stifle. A fresh graft was transferred from the right hock to the left stifle. To control for the effects of surgery, another fresh graft was transferred from the right stifle to the left stifle. The result was two grafts in...
Reciprocal apparatus dysfunction as a cause of severe hind limb lameness in a horse. A 2-year-old Appaloosa mare was admitted because of acute, severe hind limb lameness (grade 4 of 5). The hock could be flexed or extended without influencing the position of the stifle joint, and the fetlock and proximal interphalangeal joints could be extended while the hock was maintained in flexion. The diagnosis was functional loss of the reciprocal apparatus. The differential diagnoses for functional loss of the reciprocal apparatus include disruption of the common calcaneal tendon, the gastrocnemius muscle, the peroneus tertius, or the superficial digital flexor muscle. In this horse, th...
Diagnosis of equine stifle joint disorders: three cases. The clinical, radiographic, arthrographic, arthroscopic, and pathological findings of three horses with femorotibial joint injuries are presented. Overall diagnostic accuracy is improved when clinical signs, arthrography, and arthroscopy are combined. Treatment of these injuries remains limited. One horse was euthanized, and two were treated by stall rest after diagnosis. Of the two surviving horses, one became a successful breeding animal, and the other was unable to perform as a pleasure horse.
Anatomical and functional communications between the synovial sacs of the equine stifle joint. The anatomical and functional communications of the synovial sacs of the equine stifle joint were evaluated in 50 stifle joints of 25 horses. Femoropatellar joint (FPJ) sacs were injected with 50 ml of gelatin-based dye and horses were then walked for 50 m. Horses were subsequently killed, the stifle joints dissected and the location of the dye recorded. Twenty-three horses (46 joints) had clinically normal stifle joints and in this group, anatomical communications of the stifle joints were bilaterally symmetrical in each horse. In 15 of these 23 horses (65 per cent), direct anatomical communi...
Disruption of the caudal component of the reciprocal apparatus in two horses. Two horses became acutely lame following a fall during strenuous exercise and were diagnosed as having disruption of the caudal component of the reciprocal apparatus. Clinical signs consisted of lameness of the right pelvic limb, characterized by flexion of the hock and simultaneous extension of the stifle. Radiography revealed an avulsion fracture from the supracondylar tuberosity and fossa of the distal portion of the femur in one horse. Clinical and radiographic findings indicated avulsion of the lateral origin of the gastrocnemius and superficial digital flexor muscles. Treatment consisted...
The role of the reciprocal apparatus in the hind limb of the horse investigated by a modified CODA-3 opto-electronic kinematic analysis system. The function of the reciprocal apparatus in the hind limb of the horse was studied by kinematic gait analysis. For recording purposes a modified opto-electronic CODA-3 kinematic analysis system was used. The raw kinematic data were corrected for skin displacement artifacts by use of recently developed correction models. It was concluded that contradictory findings about the coupling of tarsal and stifle joints by the reciprocal apparatus, when comparing in vitro and in vivo studies, can be fully attributed to artifacts due to the movement of the skin markers over the underlying bony structures...
Osteochondral fragmentation of the distal aspect of the patella in horses. A condition characterised by osteochondral fragmentation of the distal aspect of the patella in 15 horses is described. The problem was unilateral in six horses and bilateral in nine. There were eight Quarterhorses, three Thoroughbreds, two American Saddlebreds, one American Paint and one Warmblood-Thoroughbred cross. A previous medial patellar desmotomy had been performed on 12 of the 15 horses. The condition manifested as hindlimb lameness and stiffness ranging from mild to severe. There was fibrous thickening in the stifle area in the 12 cases with a previous medial patellar desmotomy, and ...
