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.
Kold SE, Hickman J.The results of surgical treatment of 10 subchondral bone cysts, all located in the medial femoral condyle, are presented. A cancellous bone graft was used in nine cases and a two component acrylic bone cement was used in the case of an extremely large cyst. Eight out of the 10 cases made a satisfactory clinical recovery.
Lindsell CE, Hilbert BJ, McGill CA.Osteochondrosis dissecans was diagnosed clinically and radiographically in 31 joints of 21 horses. The horses ranged in age from 8 months to 5 years at the time of presentation. The usual age of onset of clinical signs was 18 to 24 months. Presenting complaints included joint effusion and lameness of either gradual or sudden onset. In Thoroughbred horses, the stifle joint was the most common site of lesions and in Standardbred horses lesions occurred more commonly in the hock. In 16 of the 21 horses, the contralateral joint was radiographed and 9 of these horses had bilateral lesions. Thorough...
Jeffcott LB, Kold SE, Melsen F.The gross and histological appearance of subchondral bone cysts in six Thoroughbred or partbred horses is described. The lesions were all situated in the centre of the medial femoral condyle and were not associated with any other damage to the articular surface of the femorotibial or femoropatellar joints. In three cases the cysts were unilateral but had an early non-cystic lesion present in the opposite stifle. All the cysts had a narrow channel at their distal extremity which communicated with the femorotibial joint. The more recently developed ones were fluid filled and contained fibrous st...
Nickels FA, Sande R.The radiographic and arthroscopic findings in the equine stifle were compared. Survey radiography, contrast arthrography, and arthroscopy were performed on both stifles of 10 horses. Nine of the horses were euthanatized to evaluate the effects of the techniques on the joints. Techniques for double-contrast arthrography and arthroscopy were developed, and the findings were compared. Survey radiography identified only osseous structures. Double-contrast arthrography of the femoropatellar joint demonstrated articular surfaces of the trochlea, patella, and joint capsule. Those of the femorotibial ...
Stewart B, Reid CF.Osseous cyst-like lesions of the medial femoral condyle were found in 32 horses admitted to the University of Pennsylvania between 1971 and 1978. Sex or breed predilection was not found. In 12 horses, osseous cysts were found in both hindlimbs. Of the 25 horses on which follow-up information was obtained, 16 became sound and useful between 4 months and 1 year after diagnosis. Horses that became lame before 3 years of age had a better chance for later soundness. Horses that became sound had significantly smaller cysts than those that remained lame.
Jeffcott LB, Kold SE.A radiographic technique is described for the equine stifle joint with the horse in the standing position or under general anaesthesia. The method with the animal anaesthetised in the dorsal recumbency and the leg extended was preferred because it gave greater flexibility with a better range of views and greatly reduced the safety hazards. In the standing position a useful practical tip for the lateral view was to raise and extent the limb caudally. This provides some flexion and ventral movement of the stifle allowing improved access for the cassette, a more accurate lateral view of the joint...
Verschooten F, De Moor A.Twenty-nine horses were examined over a period of 8 years and found to have cystic lesions in the stifle (14 cases) or pedal bone (15 cases). The lesions are described and illustrated with radiographs. In the stifle 12 lesions were found on the femoral condyles (11 medially and one laterally) and 10 were typical subchondral cysts. One lesion was observed in the tibia and 3 in the patella. Bone cysts wee found unilaterally in the pedal bone (14 in the forelimbs and one in the hindlimb). All but 2 of the horses with lesions in the stifle or pedal bone were lame. The only treatment was rest. For ...
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...
Jeffcott LB, Kold SE.Thirty-three cases with subchondral bone cysts in the stifle are reported. The condition was most commonly seen in young Thoroughbreds and produced intermittent lameness of varying degree. Radiographically distinct areas of radiolucency were found in the distal femur or proximal tibia adjacent to the femorotibial joint. Lesions were usually unilateral but 5 horses had cysts in both stifles. The cases could be divided into 2 distinct groups. Horses in Group A (28 cases) had a large circular or dome-shaped cyst in the medial femoral condyle with a distinct communication with the femorotibial joi...
Rooney JR.Sacroiliac arthrosis is a major cause of "hiking" lameness (often, so-called "stifle lameness") in Standardbred horses. The cause of this arthrosis is found in the moment forces generated as horses negotiate unbanked and underbanked turns and in the forces generated on cambered racing surfaces. The prediction is that such lameness could be virtually eliminated if racetrack and training track turns were properly banked and camber held to a minimum.
Updike SJ, Diesem CD.The vascular supply of the equine stifle joint was investigated, using latex vascular injections of pelvic limbs from 3 adult horses and 6 ponies. Vessels were grossly dissected to the small arteriole level. The primary source of blood supply was the femoral artery and its branches which entered the joint on the caudal and medial surfaces. The superficial vasculature arose from the caudal branch of the deep circumflex iliac artery cranially and laterally, and from the saphenous and descending genicular arteries medially. The deep vasculature arose from the popliteal artery and its branches on ...
Bennett D, Campbell JR, Rawlinson JR.Two cases of coxofemoral luxation complicated by upward fixation of the patella are described in the pony. Clinical signs included outward rotation of the stifle and foot and inward rotation of the hock with the stifle and hock joints fixed in extension. One case was treated by performing a medial patellar desmotomy with a resultant significant improvement in locomotion. Other cases of hip luxation reported in the literature, some complicated by upward patellar fixation, are reviewed. Hip luxation is principally seen in ponies and it is suggested that upward fixation of the patella occurring i...
Moore JN, Mcilwraith CW.Two cases of osteochondrosis are presented. Lesions involving the lateral trochlear ridge of the femur are demonstrated on conventional radiographs and double-contrast arthrograms. A radiographic suggestion of osteochondrosis lesions in the patella is noted. Post mortem examination of one case confirmed the presence of partially free cartilaginous flaps. Reference is made to familial tendency to osteochondrosis in man, dog, pig and horse. The significance of rapid growth rate in the pathogenesis of the condition is also discussed.
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.
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...
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...
Dyson S, Wright I, Kold S, Vatistas N.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...
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...
Schneider N, Heimann M, Lejeune JP, Verwilghen DR, Deby-Dupont GP, Serteyn DA.In the human and equine species, different kinds of free floating intra-articular particles are related to certain disorders. Osteochondral fragments formed during osteochondrosis dissecans are the most common finding in the equine species, whereas in humans rice bodies due to rheumatoid arthritis are more frequent. Herein we report a third type of floating body inside the stifle of an adult draught horse stallion, in macroscopic appearance similar to articular rice bodies known in humans. As revealed by histologic examination, the two particles consist of polypoid degenerated structures deriv...
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...
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...
Davis JG, García-López JM.To report the findings and long-term outcome of 76 sport horses with meniscal injury. Methods: Retrospective case series. Methods: Seventy-six horses with 93 meniscal injuries in 85 stifles. Methods: Medical records of sport horses diagnosed with meniscal injury during arthroscopy were reviewed. Owner follow up was obtained via telephone interview ≥1.5 years postoperatively. Preoperative and intraoperative findings, and postoperative treatments, were analyzed for potential association with return to athletic performance. Results: The medial meniscus was involved in 82.8% of cases, with gra...
Hendrickson DA, Nixon AJ.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...
Fenger CK, Bertone JJ, Biller D, Merryman J.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...
Preston SA, Zimmel DN, Chmielewski TL, Trumble TN, Brown MP, Boneau JC, Hernandez JA.To estimate prevalences of various presale radiographic findings and of presale arthroscopy in horses offered for sale at the 2006 Keeneland September yearling sale and to compare sales prices between yearlings with and without various presale radiographic findings or a history of arthroscopy. Methods: 397 Thoroughbred yearlings. Methods: Cross-sectional study. Methods: Presale radiographs and health records were examined to estimate prevalences of various radiographic findings and presale arthroscopy. Sales price records were used to compare sales prices between yearlings with and without var...
He H, Banks SA, Biedrzycki AH.The objective of this study was to provide an overarching description of the inter-subject variability of the equine femur and tibia morphology using statistical shape modeling. Fifteen femora and fourteen tibiae were used for building the femur and tibia statistical shape models, respectively. Geometric variations in each mode were explained by biometrics measured on ±3 standard deviation instances generated by the shape models. Approximately 95% of shape variations within the population were described by 6 and 3 modes in the femur and tibia shape models, respectively. In the femur shape mod...
Koneberg DG, Edinger J.The purpose of this in vitro study was to evaluate the value of three-dimensional (3D) ultrasonography for the diagnosis of equine meniscal and trochlear ridge lesions under in vitro conditions. Lesions were created in the isolated meniscus and femoral trochlea of 25 cadaver stifle joints. Cylindric, conic, and cuboid lesions were created on the trochlear ridge. Five different meniscal tear configurations were created. A total of 107 lesions of the trochlear ridge and 103 lesions of the meniscus were created. 3D ultrasonography was performed in a waterbath, using a 7.5 MHz 3D scanner. Trochlea...
Ramos S, Pinto A, Cardoso M, Alexandre N, Bettencourt E, Monteiro S, Gama LT.Radiographic prevalence and correlation of radiographic findings has not been performed in Lusitano Purebred horses. The aim of this study was to (1) evaluate the prevalence of primary osteoarthritis radiographic findings in Lusitano Purebred horses; (2) to assess correlations between radiographic findings in different joints of the same limb and different limbs; and (3) elucidate the effect of age in the radiographic findings. A radiographic protocol of the stifle, tarsi, fetlocks and distal limbs was done in 98 Lusitanos and the classification of the radiographs was performed using a 0-4 sc...
Sun Y, Chen H, Kandel R, Hurtig M.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...
Marble GP, Sullins KE.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...
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...
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...
Engelbert TA, Tate LP, Richardson DC, Honore EK, Little ED.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.
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 ...
Simpson CM, Lumsden JM.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...
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...
Norton NM, Santschi E, Fischer KJ.The etiology of subchondral bone cysts (SBCs) is not fully understood. Mechanical trauma and fluid pressure are two mechanisms believed to cause their formation and growth. The equine stifle joint provides a natural animal model for studying SBCs. Computed tomography images of an extended yearling cadaveric stifle joint were segmented using ScanIP to isolate bones and relevant soft tissues. Three model geometries were created to simulate cyst sizes of approximately 0.03 cm (C1), 0.5 cm (C2), and 1 cm (C3). A uniform pressure resulting in 3000 N force was applied at the proximal end of the fem...
Gough MR, Munroe GA, Mayhew G.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...
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,...
Bolz NM, Ehrle A, Mählmann K, Lischer CJ.To describe cases with caudal cruciate ligament (CdCL) avulsion fragments diagnosed based on computed tomography (CT) examination and report on arthroscopic fragment removal. Methods: Four Warmblood horses with hindlimb lameness and osseous fragments located in the caudal medial femorotibial joint (mFTJ). Methods: Short case series. Methods: CT and arthroscopic evaluation of the caudal mFTJ were performed. The caudal mFTJ and the insertion of the CdCL on the tibia were assessed and removal of the avulsion fragments was attempted in three horses using a cranial intercondylar approach. Results: ...
