This is one of the most common problems in the performance horse. The vast majority of stifle problems involve inflammation of the patellar ligaments or cords. These are three ligament bands which join the patella bone or knee cap to the tibia bone or gaskin. These cords can easily be felt as three distinct bands on the front of the stifle arranged vertically. It is primarily the inside cord or medial ligament which becomes inflamed.
The condition, medically called 'medial patellar desmitis' occurs all year round. However, it is most common in the late fall and winter when the racetrack becomes slippery. Therefore an animal without proper grab on their shoes starts slipping behind, is most susceptible to the ailment.
These horses severely affected will be easy to diagnose as they can be very lame. Typically, a horse with right sided stifle lameness will show the following signs. On the track the horse will be on the right line and bearing in towards the rail. The animal will tend to carry his hindquarters on the left shaft of the sulky. The right hind leg will tend to swing in an outward are giving the impression that the horse is traveling wide. The animal may have a stabbing action behind or even knuckling over with the right hind foot. As well the animal will seem lamer on the turns than the straights resulting in the remark that 'he's losing ground on the turns.'
A palpation exam of the animal will reveal pain on the upper portion of the inside ligament where it attaches to the knee cap. Remember that some horses are naturally ticklish in this area and will react to any manipulation. It is important therefore to be objective. One of the best ways to substantiate the diagnosis is to carefully palpate the hip muscles. Many animals with stifle problems will have a good deal of soreness in this area. The shoe should also be examined closely. Horses with cord problems will tend to wear the toe and inside of the shoe.
The most common method of treatment is to locally inject iodine in oil around the cords. The iodine as an irritating substance, causes the blood supply to increase and therefore help the animal to heal itself. Basically all your doing, is helping nature by speeding up the healing process. The animal should be exercised immediately following the treatment so that the iodine solution can move throughout the inflamed area.
Horses have a great deal of heat and swelling in the area of the stifle pose a different problem. Injecting iodine into those animals which are already red hot will only make the swelling worse and the horse, lamer. In these cases the animal should have complete stall rest until the inflammation subsides. If the swelling refuses to come down, then injecting the area between the ligaments with cortisone will cause the swelling to subside.
There are numerous other problems that occur in the stifle of the horse, almost all of which are fairly rare. Most of these conditions involve arthritis of the three joints of the stifle. Those animals affected, will present themselves rather severe lameness. Typically the horse will continuously short step with the affected limb at all speeds of movement. Injecting the stifle joints with hyaluronic acid may allow some relief in the younger animal. In the older horse, cortisone treatment may be necessary. This will give some pain relief, but only temporarily. If any changes are seen on x-ray, then the prognosis for future racing is very poor indeed.
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