DIAGNOSIS AND TREATMENT OF STIFLE
LAMENESS IN THE SPORT HORSE
Michael Schramme
VetAgro Sup, Campus Vétérinaire de Lyon, Marcy L’Etoile, Rhône-Alpes, France
Introduction
The stifle is not an unusual site of lameness in the Sporthorse. While it is a
common site of developmental conditions such as osteochondritis dissecans
and subchondral cyst-like lesions in the young animal, soft tissue injuries are
a common cause of lameness arising from the stifle in adult Sportshorses.
Clinical examination of stifle lameness
Traumatic injuries to the stifle are commonly seen in association with external
trauma from a kick or a collision with a fixed or moving heavy object. Typically
this occurs in event horses that hit cross-country fences with the stifle region
of one or both hindlimbs. However, stifle injuries have also been observed in
horses turned out at pasture without any history of trauma.
In comparison with other diarthrodial joints, the stifle is characterised by the
poor congruity between the spherical femoral condyles and the flat plateau at
the proximal end of the tibia, and by an intricate support system of extra- and
intra-articular ligaments and two fibrocartilagenous discs (menisci). These
structures are at risk of injury when the loaded stifle is subject to craniocaudal,
lateromedial or twisting forces outside of the normal physiological range.
Careful clinical examination by inspection and palpation of an injured stifle can
be rewarding. The landmarks for palpation are the patella, the tibial crest, the
patellar ligaments, the combined tendon of the peroneus tertius and the long
digital extensor, the collateral ligaments, the proximal medial articular margin
of the tibia, and the medial border of the medial meniscus immediately
proximal to it. The presence of stifle effusion is always significant. Diffuse
swelling over the cranial aspect of the stifle causes loss of the characteristic
cranial silhouette of the stifle region and is commonly associated with
periarticular bruising following acute trauma. Effusion of the femoropatellar
joint is most prominent just distal to the distal border of the patella, proximally
between the patellar ligaments. It causes a characteristic bulge in the cranial
silhouette of the stifle just distal to the patella. Effusion of the medial
femorotibial joint is best appreciated as a medial bulge of the joint capsule
through a window bordered by the medial collateral ligament caudally, the
proximal medial articular margin of the tibia with the medial border of the
medial meniscus distally, the medial patellar ligament cranially and the medial
femoral metaphysis proximally. Distension of this joint is a serious clinical
sign, most commonly associated with traumatic arthritis of the medial
femorotibial joint. Effusion of the lateral femorotibial joint is less easily
identified because of the presence of the broad common tendon of the long
digital extensor and the peroneus tertius in the extensor fossa overlying the
craniolateral aspect of this joint.
15-‐18
February
2016
East
London
Convention
Centre,
East
London,
South
Africa
62