stifle | Horse Racing Free Tips

Snap, Crackle, Pop: What Creaky Joints Mean

It's not unusual for equine caretakers to hear their steed's joints pop and crack when they move. Though alarming, these noises are generally nothing to worry about. Joints make noise when the joint capsule is stretched and releases gas from the joint fluid very quickly. This is the same process that allows people to “crack” their knuckles; after a bit of time, the same joint can be cracked again.

The most-mobile joints tend to be the loudest: knees, hocks and stifles. Joints in the neck or back may also pop, especially when the horse is stretching.

Cracking doesn't mean that a joint is tight, loose or out of alignment. If the horse is sound and comfortable, clicking joints is nothing to worry about.

AAEP Convention: Standing Arthroscopy Can Be Used On More Than Stifles

When traditional diagnostic tools such as X-ray and ultrasound provide no definitive diagnosis for an equine lameness, a vet may perform an arthroscopy. While this procedure typically requires putting the horse under general anesthesia, a needle arthroscopy can be done while the horse is under standing sedation, Dr. Alvaro Bonilla said at the virtual 2020 American Association of Equine Practitioners Convention and Trade Show.

A safe, reliable procedure, needle arthroscopy is less risky and less costly to the owner; putting a horse under general anesthesia for surgery has its own risks, including recovery. While typically used for diagnostics, a standing arthroscopy can also be used therapeutically for septic joints and small osteochondral fragments, specifically for dorsal fragments of the first phalanx in the fetlock, Alvaro says. However, the procedure does still have limitations.

Previously, needle arthroscopy was used only in the stifle joint; Alvaro reports that now it can be used successfully to evaluate multiple synovial structures, including shoulders, fetlocks, hocks, radiocarpal and middle carpal joints, and carpal sheaths.

When using this diagnostic tool, it's important that the horse is sedated, but not overly so, which could make him unsteady and make the procedure not only difficult, but dangerous. Additionally, the surgical site must be sterile, which can be difficult as debris can fall onto the joint or the horse can urinate. Potential for both complications can be decreased by using blankets and inserting a urinary catheter.

An adjustable, lightweight splint made from stainless steel and aluminum is used during the procedure; to ensure as successful an outcome as possible, horses should be acclimated to wearing the brace before being sedated for the surgery.

The surgical area should be bandaged for four to five days following the procedure; horses that had the procedure for diagnostic reasons can go back to work as soon as the bandages are removed.

Can Foals With Septic Arthritis Go On To Successful Racing Careers?

Drs. Thomas O'Brien, Sarah Rosanowski, Keith Mitchell, Joan Carrick, Troy Butt and Angus Adkins completed a retrospective study of 114 Thoroughbred foals that had septic arthritis and compared them to their maternal siblings.

Foals involved with the study had undergone treatments for septic arthritis over a 6-year period. These treatments included arthroscopic, cannulae or through-and-through needle lavage. The stifle joint was the most affected (35 percent of foals), with hocks (20 percent affected) not far behind.

In total, 130 synovial fluid samples were cultured; bacterial growth was detected in 80 percent of samples. Thirty-nine of the foals needed repeat lavage of the synovial joint structure to clear the infection.

Overall, 90 foals were discharged alive (78 percent). Foals that were less than 26 days old when they were admitted were five times less likely to be discharged alive. Foals that were also afflicted with multisystemic disease were six times less likely to be discharged alive.

The researchers found that 67 percent of foals discharged alive started in one or more races; there was no difference in the proportion of foals that started or in racing performance between foals that had been treated for septic arthritis and their maternal siblings.

The scientists conclude that the prognosis for the survival of foals with septic arthritis is good and that future racing performance does not seem to be affected by this infection.

Read the published piece here.

New Research Makes Stifle Arthroscopy Easier

Arthroscopic surgery on a horse's stifle is challenging: Current approaches risk both nerve and cartilage damage. However, new research by Drs. H.D. O'Neill and B.M. Bladon offer an alternative arthroscopic entry point for access to the stifle.

In cadaver and clinical studies, the scientists found that the caudal pouches of the lateral femorotibial joint can be accessed arthroscopically in a way that did not threaten damage. The entry point is immediately cranial (toward the head) to the lateral collateral ligament.

Using cadaver limbs held in place to mimic dorsal recumbency with the stifle held in 90-degree flexion, the scientists entered the leg just cranial to the lateral collateral ligament. The arthroscope was then fed along the popliteal tunnel toward the horse's head and then down. Once they had become comfortable with the technique, the scientists completed 38 arthroscopic inspections of caudal lateral femorotibial joints using the new entry point. The doctors were able to see both pouches using the new technique, and no horses experienced complications.