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Vet Comp Orthop Traumatol 2007; 20(02): 119-125
DOI: 10.1160/VCOT-06-01-0004
Clinical Communication
Schattauer GmbH

Upward fixation of the patella in the horse

A retrospective study
M. Dumoulin
1   Department of Surgery and Anaesthesiology of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
,
F. Pille
1   Department of Surgery and Anaesthesiology of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
,
P. Desmet
1   Department of Surgery and Anaesthesiology of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
,
J. Dewulf
1   Department of Surgery and Anaesthesiology of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
,
M. Steenhaut
1   Department of Surgery and Anaesthesiology of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
,
F. Gasthuys
1   Department of Surgery and Anaesthesiology of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
,
A. Martens
1   Department of Surgery and Anaesthesiology of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
› Author Affiliations
Further Information

Publication History

Received 18 January 2006

Accepted 04 September 2006

Publication Date:
18 December 2017 (online)

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Summary

The objective of the present study was to assess the incidence of upward fixation of the patella (UFP) in different types of patients and to evaluate the outcome of conservative and surgical treatment for correcting this condition. A particular attempt was made to find out whether corrective trimming and/or shoeing (CTS) is efficient in the conservative treatment of UFP, and whether a longer postoperative resting period reduces the risk of complications after medial patellar desmotomy (MPD). Medical records of 78 horses with intermittent or permanent UFP were analyzed retrospectively. Young animals and ponies were mostly affected, mainly during winter (P<0.05). Seventy-six horses with UFP were treated conservatively, with follow-up being possible in 64 of them. This treatment, in which CTS seemed the most important aspect, was fully successful in 51.6% of these patients; 20.3% of them improved partially. In case of no response to conservative treatment, or in case of a permanent fixation, MPD was performed in 20 horses, which corrected UFP completely in 17 of the 18 followed-up patients. However, gait abnormalities were seen in seven of those 17 horses postsurgically, but with the incidence being lower in horses that had rested for at least three months (25%) compared to horses that had only rested for less than one month (66.6%). Results indicate that conservative treatment, with special attention for CTS, is worth trying before performing more radical procedures to correct UFP, and that a longer convalescence period after MPD is desirable.

Keywords

Upward fixation of the patella - corrective shoeing - medial patellar desmotomy - horse
 

  • References

  • 1 Wyn-Jones G. Conditions of the upper hind limb. In: Equine Lameness. Oxford: Blackwell Scientific Publications; 1988: 170-174.
    Google Scholar
  • 2 Wright I. Ligaments associated with joints. Vet Clin North Am EquinePract 1995; 11: 249-292.
    PubMedGoogle Scholar
  • 3 Miller Miller, Swanson TD. Upward Fixation of the patella. In: Current Therapy in Equine Medicine. Robinson NE. (ed). Philadelphia: Saunders; 2003: 536-537.
    Google Scholar
  • 4 Schuurman SO, Kersten W, Weijs WA. The equine hind limb is actively stabilized during standing. J Anat 2003; 202: 355-362.
    CrossrefPubMedGoogle Scholar
  • 5 Valentine BA. Mechanical lameness in the hind- limb. In: Diagnosis and Management of Lameness in the Horse. Ross MW, Dyson SJ. (eds). Philadelphia: Saunders; 2003: 475-480.
    Google Scholar
  • 6 Black JB. The western performance horse. In: Diagnosis and Management of Lameness in the Horse. Ross MW, Dyson SJ. (eds). Philadelphia: Saunders; 2003: 1017-1031.
    Google Scholar
  • 7 Stashak TS. The stifle. In: Adam's Lameness in Horses. Stashak T.S.. (ed). Philadelphia: Lea and Febiger; 1987: 737-741.
    Google Scholar
  • 8 Rooney JR. Stifle Lameness. In: The Lame Horse: Causes, Symptoms and Treatment. A.S. Barnes and Co., Inc; 1974: 174-181.
    Google Scholar
  • 9 Back Back. The role of the hoof and shoeing. In: Equine Locomotion. Back W, Clayton H. (eds). Philadelphia: W.B. Saunders Company; 2001: 135-166.
    Google Scholar
  • 10 Walmsley JP. The stifle. In: Diagnosis and Management of Lameness in the Horse. Ross MW, Dyson SJ. (eds). Philadelphia: Saunders; 2003: 455-470.
    Google Scholar
  • 11 Sullins KE. The stifle. In: Adam's Lameness in Horses. Troy D. (ed). Philadelphia: Lea and Febiger; 2002: 999-1027.
    Google Scholar
  • 12 McIlwraith McIlwraith. Osteochondral fragmentation of the distal aspect of the patella in horses. Equine Vet J 1990; 22: 157-163.
    CrossrefPubMedGoogle Scholar
  • 13 McIlwraith CW. Patellar fragmentation secondary to bilateral medial patellar ligament desmotomy. Equine Vet Educ 2005; 17: 205-206.
    PubMedGoogle Scholar
  • 14 Hermans WA. Beengebreken. In: Hoefverzorging en Hoefbeslag. Utrecht: Uitgeverij Terra Zutphen; 1984: 221-225.
    Google Scholar
  • 15 Wheat JD. Conditions of the hind limb and lower back. In: Equine Medicine and Surgery. A Text and Reference Work (71 authors). Catcott EJ, Smithcors JF. (eds). Santa Barbara: American Veterinary Publications Inc.; 1972: 565-566.
    Google Scholar
  • 16 Brown MP, Moon PD, Buergelt CD. The effects of injection of an iodine counterirritant into the pa- tellar ligaments of ponies: application to stifle lameness. J Equine Vet Sci 1984; 4: 82-87.
    CrossrefPubMedGoogle Scholar
  • 17 Van Hoogmoed LM, Agnew DW, Whitcomb M, Hyde DW, MacDonald MH, Snyder JR. Ultrasonographic and histologic evaluation of medial and middle patellar ligaments in exercised horses following injection with ethanolamine oleate and 2% iodine in almond oil. Am J Vet Res 2002; 63: 738-743.
    CrossrefPubMedGoogle Scholar
  • 18 Gibson KT, McIlwraith CW, Park RD. et al. Production of patellar lesions by medial patellar desmotomy in normal horses. Vet Surg 1989; 18: 466-471.
    PubMedGoogle Scholar
  • 19 Wright Wright, Rose RJ. Fracture of the patella as a possible complication of medial patellar desmot- omy. Aust Vet J 1989; 66: 189-190.
    CrossrefPubMedGoogle Scholar
  • 20 Squire KRE, Blevins WE, Frederick M. et al. Radiographic changes in an equine patella following medial patellar desmotomy. Vet Radiol 1990; 31: 208-209.
    CrossrefPubMedGoogle Scholar
  • 21 Riley CB, Yovich JV. Fracture of the apex of the patella after medial patellar desmotomy in a horse. Aust Vet J 1991; 68: 37-39.
    CrossrefPubMedGoogle Scholar
  • 22 Turner Turner, McIlwraith CW. Medial patellar desmotomy. In: Techniques in Large Animal Surgery. Philadelphia: Leaand Febiger; 1982: 115-117.
    Google Scholar
  • 23 Dyson S. Patellar injuries. In: Current Techniques in Equine Surgery and Lameness. White NA, and Moore JN. (eds). Philadelphia: W.B. Saunders Company; 1998: 440-447.
    Google Scholar
  • 24 Walmsley Walmsley. Medial patellar desmotomy for upward fixation of the patella. Equine Vet Educ 1994; 6: 148-150.
    CrossrefPubMedGoogle Scholar
  • 25 Tnibar MA. Medial patellar ligament splitting for the treatment of upward fixation of the patella in 7 equids. Vet Surg 2002; 31: 462-467.
    CrossrefPubMedGoogle Scholar
  • 26 Tnibar MA. Treatment of upward fixation of the patella in the horse: an update. Equine Vet Educ 2003; 15: 236-242.
    PubMedGoogle Scholar
  • 27 Tnibar MA. Experience with medial patellar ligament splitting for the treatment of upward fixation of the patella in the horse. Proceedings of the 14th Annual Scientific Meeting of the European College of Veterinary Surgeons. Lyon, France: 2005: 111-113.
    Google Scholar
  • 28 Mattson S, Boure L, Pearce S. et al. Clinical observation: bilateral upward fixation of the patella following epidural administration of morphine. JVet Med Assoc 2001; 219: 298-299.
    PubMedGoogle Scholar
  • 29 Baird AN, Angel KL, Moll HD. et al. Upward fixation of the patella in cattle: 38 cases (1984-1990). J Am Vet Med Assoc 1993; 202: 434-436.
    PubMedGoogle Scholar
  • 30 Husband JA, Weaver AD. Bilateral upward patellar fixation in two pregnant beef heifers. Vet Rec 1995; 137: 464-465.
    CrossrefPubMedGoogle Scholar
  • 31 Back W, Remmen JLMA, Knaap J. et al. Effect of lateral heel wedges on sagittal and transverse plane kinematics of trotting Shetland ponies and the influence of feeding and training regimes. Equine Vet J 2003; 35: 606-612.
    PubMedGoogle Scholar
  • 32 Wilson AM, Seelig TJ, Shield RA. et al. The effect of foot imbalance on point of force application in the horse. Equine Vet J 1998; 30: 540-545.
    CrossrefPubMedGoogle Scholar
  • 33 Davies HMS. No hoof, no horse! The clinical implications of modelling the hoof capsule. Equine Vet J 2002; 34: 646-647.
    PubMedGoogle Scholar
  • 34 Firth EC, Schamhardt HC, Hartman W. Measurements of bone strain in foals with altered foot balance. Am J Vet Res 1988; 49: 261-265.
    PubMedGoogle Scholar
  • 35 Dyson SJ. Normal ultrasonographic anatomy and injury of the patellar ligaments in the horse. Equine Vet J 2002; 34: 258-264.
    PubMedGoogle Scholar
  • 36 Labens R, Busoni V, Peters F. et al. Ultrasonographic and radiographic diagnosis of patel- lar fragmentation secondary to bilateral medial patellar ligament desmotomy in a Warmblood gelding. Equine Vet Educ 2005; 219: 298-299.
    PubMedGoogle Scholar