Cartilage repair after arthroscopy

[Tash88]

My horse had an arthroscopy on both stifles on Tuesday morning and came home yesterday, with instructions for 6 weeks box rest then 6 months paddock rest and an area of 20 x 40m recommended.

I was there to watch the procedure and the vet spoke to me afterwards. He said that my horse has a 70-80% chance of being sound enough to return to work. Before the surgery he was 3/10 lame on the left and 4/10 lame on the right after flexion tests.

The arthroscopy was relatively straightforward, there was some cartilage that had to be removed but the main problem is a 3mm hole in the cartilage on the left side which needs to heal. There was no damage to the miniscus or surrounding muscle tissues on either side. My horse has a diagnosis of chondromalacia; he is 8y/o and has been backed for about 2 years and hasn't done an awful lot (just hacking and basic schooling with a couple of local showing shows), so is relatively 'low mileage'.

Having never experienced this before, I was wondering if any of you had advice for what I could do to help with my horse's rehab, particularly the cartilage repair? Have you tried anything which works, like magnet therapy or similar?

I don't want to speed anything up and my horse will be having all the time off he needs, I just want to give him the best possible chance. My vet mentioned steroid injections once he comes back into work but other than that just said rest was the only thing he needed, as the damage wasn't significant enough for IRAP injections or anything like that.

Any advice much appreciated and thanks in advance.

Tash x

 

[littleshetland]

I'm watching the replies with great interest. My horse has had arthroscopy on his knee about a year ago and had about 20% of his cartilage removed. It's been a bit of struggle. He's had 3 months off with the same rehab program as you described. Then somehow managed to bang his knee again!! inside of the stable door? ) and is now just coming back from 6 months field rest.After his very recent x ray I've just been advised to start walk work for 10 mins a day 2-3 times a week, so I'm looking for the best supplements I can find, frankly its a bit of a nightmare - there's so many, and they all claim to be the best! As far as I know, cartilage has no, or very little blood supply, so getting it to regenerate is very difficult, but trying to find the best product I can is quite a task. As far as I can see collagen,MSM,Boswellia and turmeric are ok......I'm watching with interest.

 

[shortstuff99]

My horse had this in her fetlock, she was given injections by a vet (can't remember the name) which encouraged re-growth of the secondary cartilage. She then had about a two years off and then brought back into work and was fine 😊. I would really recommend giving longer off as I believe that really helped the most.

 

[littleshetland]

Yes, my feeling is to take it very very easy with him, and more time off. If there's any chance you could remember the name of the injections your mare had, that would be great...but I'll mention this to my vet anyway. Thank you.

 

[shortstuff99]

Yes, my feeling is to take it very very easy with him, and more time off. If there's any chance you could remember the name of the injections your mare had, that would be great...but I'll mention this to my vet anyway. Thank you.

It was about 10 years ago now so I can't really remember the name, but your vet should know of it. If it helps this happened 10 years ago my mare is now coming up for 26 years old and is still competing at BE80 so don't lose hope!

 

[gunnergundog]

Cartilage is a bugger to repair due to the lack of blood supply - amongst other things. Stem cell is a viable option - if you can afford it. I looked into it a couple of years ago for a horse I had but ended up making the decision to PTS. This is the latest I could find on-line. At the time we were talking to someone at Warwick University. https://www.hindawi.com/journals/sci/2018/1073705/

 

[Tash88]

Thank you for the replies - I did mention stem cells to the vet but he said the damage (3mm hole) wasn't significant enough to need that just yet, but this will be reviewed if/when he comes back into work. He will probably have a steroid injection when he starts work again. Regarding the cost of stem cell therapy - the insurance claim has run out (they put his ulcers and stifles down as one incident meaning I only had £5k for both and ulcer treatment is £££) but if he needs it the money will be found.

I am thinking of buying an ArcEquine to aid healing - any thoughts on this?

My boy has his six week post-op check on Thursday so fingers crossed he will be allowed out again as he's getting a bit fed up with box rest, overall he's been a saint though.

 

[gunnergundog]

deleted

 

[Red-1]

I am thinking of buying an ArcEquine to aid healing - any thoughts on this?

I thought my vet would scoff when I bought one for a suspensory ligament recovery but he actually said that the science behind them has merit. He said he could not recommend one particular machine, but the idea was not stupid.

 

[littleshetland]

I used one on my boy.....I don't think it made a huge difference, but it made me feel better - I felt I was doing something pro - active to help the healing process. To be fair, it may have helped as he is better than he was, but it could be any number of things as I've been 'showering' him with supplements and treatments......the latest one I'm trying is 4Cyte Epiitalis gel.....I think is helping.

 

[Tash88]

I used one on my boy.....I don't think it made a huge difference, but it made me feel better - I felt I was doing something pro - active to help the healing process. To be fair, it may have helped as he is better than he was, but it could be any number of things as I've been 'showering' him with supplements and treatments......the latest one I'm trying is 4Cyte Epiitalis gel.....I think is helping.

How is your horse getting on and what stage of rehab are you at? What was his original diagnosis?

I have the vet coming out to mine tomorrow, fingers crossed she will be pleased with his progress!

I will have a look into the 4Cyte gel.

Tash x

 

[littleshetland]

After the arthroscopy he had 3 months off and then very gradually bought back into work (walking for 10 -15 mins, and gradually increasing) all was well, and then he started to become lame again (banging his knee on the stable door?) so he's just come through 6 months field rest and is back to very light work - 10 mins walking 2 - 4 times a week. Not quite sound in trot, but has improved a bit. This all started when I caught him in from the field lame with a swollen knee about a year ago now...he'd obviously given it a bang. He had some cartilage trimmed off and bone chips removed in the arthroscopy.....and here we are - improving very very slowly. I'm honestly thinking of leaving him until the spring....I'll see how he goes, but somedays I do feel that I'm never going to get him right. I'm keeping steroid injections and bute as something for the future. He's only 9 so I must give him every chance. Good luck with your vet tomorrow and keep us updated please.

 

[littleshetland]

I must add....he's wearing a pair of Equ StreamZ bands atm....someone recommended them to me - I'll let you know if I think they're working.

 

[Tash88]

Thank you - it's a long process isn't it. Sounds like yours is slightly different to mine in that it was acute onset, but the diagnosis/treatment is similar.

Mixed results this morning - vet checked him and he has healed well from the surgery but he was still lame on the left side when I (conservatively) trotted him up, whereas before his right side was worse. The right side looked okay apparently. He's okay to go out though, so he's having half a day in a 20 x 40 all weather pen (no grass at this time of year in case he slips) for the next week then a day for the next six months. The field rest period was always going to be six months and so there is no change there.

The vet doesn't seem too concerned about the lameness as he is still in the early days of a long rehab process, and I guess they wouldn't have been expecting a miracle in six weeks box rest if that was going to be followed by six months field rest. I don't know whether to email her and the surgeon to ask about IRAP stem cell injections or whether to just give him more time? She did say that he would probably need a steroid injection into the joint when he comes back into work.

My vet didn't scoff at the ArcEquine either, said that as a vet she couldn't recommend it but at the same time it wouldn't do him any harm. So I think I will go for it. I have also had a special herbal tincture made up for him by a medical herbalist that's meant to aid blood supply. It isn't cheap but I've had great results with her other remedies, for inflammation, immunity and colic so though it was worth a try. He's already on the anti-inflammation one.

Good luck with your boy. I do have some Equ Streamz that I bought off a friend, just need to get replacement velcro for them, so I'll be doing that too.

Tash x

 

[littleshetland]

Hi Tash - thanks for the update...I've got my fingers crossed for you. I was thinking about the stem cell injections..but I think I'll 'potter' along carefully through the winter, and see what happens a bit further into the new year. I've got my boy on a collagen supplement 'Suppleaze Progen' from Aviform. The collagens' supposed to help cartilage regeneration. I like the idea of a herbalist for some anti inflammatory help.....could you recommend your herbalist to me? I took my lad out for a very short walk yesterday (10 mins)...it was so nice to be on board again, but he did feel like a coiled spring! I may have to get a blob of sedolin down him to keep things calm. I tentatively ask for a trot step - a little better, but still lame, but the walk felt very good and positive - so that cheered me up. He's obviously feeling better as he was very disappointed when we stopped after 10 mins and I untacked him! it's these small positive things that'll keep us going. Lets keep going with the updates...... LS x

 

[littleshetland]

Definite improvement in movement this last week or so....it's either the 4Cyte Epittalis, or the Equstreamz bands. I'm seriously thinking of stem cell treatment to encourage cartilage regeneration - I'll let you know.

 

[Tash88]

Pleased to heat that LS - I have emailed the surgeon who did the arthroscopy and my vet this afternoon to ask about the Epitalis gel (which looks fantastic but would it still help all this time after surgery?) and the ArcEquine, as well as stem cell injections. I can get £95 off an arc equine at the moment (until tomorrow) so if I'm going to buy one it needs to be now, but I don't want to spend money unnecessarily.

Has your vet said anything about stem cell injections or anything else and has your boy had steroid injections since the arthroscopy?

I will PM you re the herbalist.

Tx

 

[Sandstone1]

I know this is a old thread but just incase anyone wants to try the Equ streamz bands the human version appears to be exactly the same except they are cheaper!
I cant say if they work or not.