Surgical management of proximal articular fracture of the patella in a horse.

This research discusses the surgical treatment of a mature Tennessee Walking Horse with a severe lameness caused by a fracture in the patella or kneecap. The horse returned to training as a show horse 8 months after surgery.

Diagnosis

• The Tennessee Walking Horse stallion was diagnosed with a patellar fracture in the right stifle. This diagnosis was made through radiography, a widely-used imaging technique in veterinary orthopedics.
• The severity of the horse’s lameness was evaluated to be grade IV/V on observing its right hindlimb, indicating a severe level of discomfort.

Surgical Intervention

• Given the articular nature (involvement of a joint) and the small size of the fracture, surgical removal of the fracture fragment was deemed as the most appropriate treatment. This surgical procedure was performed through arthrotomy, a surgical procedure to access the interior of a joint by an incision into it.
• A dorsomedial approach was used to access the femoropatellar joint. This approach refers to the surgical path embarked from the back and inside position of the knee joint, leading to the fractured part of the patella. This technique is typically chosen to achieve successful access to the joint without causing significant soft tissue damage.

Recovery and Prognosis

• The horse responded positively to the surgical intervention and recovered well.
• Eight months after the surgery, the horse was able to resume training as a show horse, suggesting a successful recovery and return to normal function. This also points to a positive prognosis for horses undergoing similar surgical procedures for proximal articular fracture of the patella.