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TheHorse.com THE HORSE September 2016
identifying similar injuries to the knee.
Horses, however, are another story: "Most
(MRI and CT) units are simply not large
enough to accommodate an equine stifle,"
Kawcak says. "That said, large-bore CT
and MRI devices are being introduced
into the human market and used by some
equine practices. In addition, the use of
contrast agents in the joint have helped
to better characterize damaged tissues in
some referral centers."
Treating Stifle Injuries
How caretakers manage a stifle in-
jury depends on the exact nature of the
lesion(s). Femur and tibia fractures, for
instance, are frequently fatal, whereas a
fractured patella can usually be repaired
because the femorotibial joint is non-
weight-bearing.
Veterinarians typically treat damage to
the articular cartilage lining the femoral
condyles arthroscopically by removing
the damaged cartilage (called debride-
ment). The problem with removing areas
of articular cartilage from the condyles
measuring greater than 5 mm is that it
exposes the bony tissue underneath. As
a result the joint provides less cushion
during movement, causing pain and
inflammation.
Over the years, veterinary researchers
have attempted to remedy this problem
using various "resurfacing" techniques
as well as microfracture (punching small
holes in the subchondral bone beneath
the cartilage defect to stimulate cartilage
growth). To date, none has proven over-
whelmingly successful; however, various
research teams refuse to be thwarted.
Most recently, surgeons from the Uni-
versity of Missouri's College of Veterinary
Medicine evaluated the use of a perma-
nent synthetic implant to help repair
cartilage defects located on the medial
lateral condyles. They hypothesized that
the prosthetic implant would serve as
a cartilage substitute, decreasing pain
the horse experiences following surgical
debridement of articular cartilage. In
this study, published in the April 2016
Veterinary Surgery, the authors found
that biocompatible, synthetic cartilage
implants were safe and might be effective
pending additional research and technical
tweaking.
Meniscal tears all too commonly result
in significant injury and disappointing
post-surgical performance, especially at
higher levels of competition. The menisci
heal poorly following injury. Even after
surgery (typically arthroscopy)—which
often includes removing or debriding
the injured area, then rest and physical
therapy—lameness persists. Recently, sev-
eral research groups have studied the use
of stem cell therapy for treating meniscal
injuries.
Goodrich, Kawcak, and Frisbie,
together with lead author Dora J. Fer-
ris, DVM, (also at CSU) and colleagues,
recently described their research on stem
cell therapy for improving outcomes
after surgical correction of various stifle
Stifling THE PAIN
A multimodal treatment approach post-stifle injury might include intra-articular medications.
ALEXANDRA
BECKSTETT