Meniscus stifle injuries?

Mariposa

Mariposa

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Has anyone had any experience of torn meniscus injuries to the stifle? One of our ponies possibly has this, and the suggesting is investigative surgery, but from what I've read online there is still only a 50% chance of return to athletic ability.

The mare has been sound but a little stiff in the mornings and then some days just not quite right, but then fine the next day. We had her xrayed and scanned a few months ago and there was nothing to report and she was again sound for a while - but on rescanning last week the vet spotted this possible injury.

I'd be really interested to hear of anyone who has experience of this injury, and whether surgery has helped them come good?
 
Friend had a 5 year old ISH with it who I would have had put down. She turned him away for a year and he came back sound but with severe bucking problems. She sold him for a pittance to a dealer who bullied him into shape and sold him on for five times what he paid for him a year later, when he passed a vet. That was three years ago and I have no idea if he is still sound, sorry.
 
How many of the meniscii are torn and what grade tears are they? How old is the pony? Also, any idea what caused the tear/s? Answers to the above will determine likelihood of full athletic recovery.

Arthroscopy is normally needed to fully diagnose as the stifle is so difficult to image and is impossible to MRI. Arthroscopy is then also the route to debride and tidy up and will reveal if any cruciate damage. IRAP would be also helpful; the rehab is as important as the surgery IMO.

Long term the horse will have OA in the stifle -at an earlier age than normal, so even if it regains a working life, it will be a shorter working life than you would normally expect.

It's not great news and is costly, if not insured. However, it is possible to get athletic function at a reasonable level, albeit for a short period of time. Afraid it often comes down to a cost versus benefit decision in a lot of cases.
 
Interesting that he came back sound after being turned away though. I must ask my vet if they think that's an option.
 
gunnergundog said:
How many of the meniscii are torn and what grade tears are they? How old is the pony? Also, any idea what caused the tear/s? Answers to the above will determine likelihood of full athletic recovery.

Arthroscopy is normally needed to fully diagnose as the stifle is so difficult to image and is impossible to MRI. Arthroscopy is then also the route to debride and tidy up and will reveal if any cruciate damage. IRAP would be also helpful; the rehab is as important as the surgery IMO.

Long term the horse will have OA in the stifle -at an earlier age than normal, so even if it regains a working life, it will be a shorter working life than you would normally expect.

It's not great news and is costly, if not insured. However, it is possible to get athletic function at a reasonable level, albeit for a short period of time. Afraid it often comes down to a cost versus benefit decision in a lot of cases.
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Thank you for the reply, that's very helpful. I don't think they know if both are torn yet, and we don't know what caused the injury. There's been nothing significant that's she's done, but she is a polo pony so I wonder if something happened when she was playing and went unnoticed as she remained sound. I wish I knew when it had happened, I can't even remember her pratting about in the field, she's such a laid back mare.

She's 11 and has relatively low mileage as it were , but polo is such a demanding sport on them but I would worry that all that stretching and turning would just b*gger it up again.

And no, she is not insured for vets fees, only for life saving surgery ( which I guess this could be when it comes down to it, but I'm not sure my insurers would agree!).

I guess the next stage is to find out costs and take it from there.
 
T
Mariposa said:
Interesting that he came back sound after being turned away though. I must ask my vet if they think that's an option.
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Yes, prognosis was poor with or without an operation, and I had given up on the horse, who had slipped on an x c course. He actually jumped affiliated with the pro, too, and was sold as a show jumper. He never did return to hacking willingly, as far as I know.
 
Il keep this short but anymore questions do pm me!

My girl went lame in feb 2014 & came sound wih rest but crippled on a turn. Vet out & nerve blocked found it was stifle then X-rays & scans found nothing! We box rest & turned her away after to no avail she was always only 1/10 on a straight line but 3/10 on a turn.

I was very lucky i have a fabulous vet who after 5 months said we needed the surgery as we had no idea what was wrong. I made the decision to turn her away waiting for her surgery (in July) & take her shoes off - she was sound then except for tiny turns (stifle arthroscopy) won't lie it is scary to have a horse go through surgery!! I had roger smith from the RVC come down to perform it & before he insisted on scanning the stifle himself - he found nothing.

At 9;45pm (evening surgery due to travel) I got the call that she had damaged all the carrtlidge & had a bad tear on her meniscus. They cut away the bad cartridges & trimmed the mensicus plus roughing the joint up to act like carrtlidge.

Rehab:
My girl had 6 months of box rest & after 4 months solid boxrest & vet check where she was still sore as no shoes on; walking on hand up to 35 mins a day (I have a very fizzy tb so had to do this in our indoor school incase she got away from me - reared & bronced like a trooper - Sedalin was my friend!!) had her shoes back on & vet out to trot her up - she was sound!! And with her shoes on. During this vet rang numerous times to help me as it was a struggle with a hot sharp horse!
She turned out in October & jumped out her pen & galloped around for 10 minutes!!!

I got on her in the December & were hacking a couple times a week & dos our first dressage test. I only school during a lesson in walk/trot & canter is going to be re-introduced in summer when she's stronger & more balanced. She loves her hacking so much!!
Her vet doesn't really know what her prognosis is as she's supassed most of them for a horse with her degree of injury; yes she's stiff sometimes & can go short on a hack but she comes right & we gained 71% in our dressage test!!
My girl is a tough cookie who isn't in any bute or a joint supplement yet (will be in the summer once she's finished her calmer!! Ha!) please don't right them off with this injury as my girl is defiantly the expcepion. She's 12 aswell.

Well that was long so any questions please ask!!
 
Mariposa said:
I don't think they know if both are torn yet, and we don't know what caused the injury. There's been nothing significant that's she's done, but she is a polo pony so I wonder if something happened when she was playing and went unnoticed as she remained sound. I wish I knew when it had happened, I can't even remember her pratting about in the field, she's such a laid back mare.

She's 11 and has relatively low mileage as it were , but polo is such a demanding sport on them but I would worry that all that stretching and turning would just b*gger it up again.

And no, she is not insured for vets fees, only for life saving surgery ( which I guess this could be when it comes down to it, but I'm not sure my insurers would agree!).

I guess the next stage is to find out costs and take it from there.
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OK...the fewer meniscii that are torn the better. The lower the grade of tear, the better. (Grade 1-3, with 3 being grim.)

If she's been ultrasounded they should be able to tell which are torn. Make sure you are using a specialist vet as it costs the same for joe bloggs to ultrasound and come up with a 'err....dunno' as a specialist to do same and come up with something more helpful.
The younger the horse, the better the chance of recovery. Also, the more laid back the temperament of the horse, the more likely it is to cope with the rehab.

Surgery is about 3-4K, but depends who is doing it and how many meniscii/stifles are involved.
 
That's is hugely helpful - thank you ilvpippi! This sounds similar to my mare, she's pretty much sound on the straight, you can just notice something it amiss on a turn -but after a flexion test she is really sore.

Sounds like a very long rehab, really interesting to read your mare's journey, thank you for sharing, I may well PM you with some annoying questions!

Gosh it's so ironic that I was so happy when my vet said she'd found something on the scan, as I thought we could get her right, but now I realise how serious this injury is.

gunnergundog said:
OK...the fewer meniscii that are torn the better. The lower the grade of tear, the better. (Grade 1-3, with 3 being grim.)

If she's been ultrasounded they should be able to tell which are torn. Make sure you are using a specialist vet as it costs the same for joe bloggs to ultrasound and come up with a 'err....dunno' as a specialist to do same and come up with something more helpful.
The younger the horse, the better the chance of recovery. Also, the more laid back the temperament of the horse, the more likely it is to cope with the rehab.

Surgery is about 3-4K, but depends who is doing it and how many meniscii/stifles are involved.
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My vet isn't a specialist so I think that will be the next step, as we're not established how many are torn - we have been put onto a surgeon at the Newmarket Equine Hospital and I'm due to talk to them tomorrow so will ask about getting her rescanned. The mare is very laid back, so that's one thing in her favour I guess :/
 
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Please do pm me!
I wish I had; had someone to talk to. I remained very positive through - out; even when on the first day of walking ended up with her broncing for 10 minutes on the car park 5 steps from her stable!!! She has been ace through out & Tbf I was very happy when they found something however 'unknown' purely because my girl is. Real busy bee & loves to work! The hardest thing for her was coming from full fitness to a field pet. She did ok once that transition was made.

The two days Ive cried was the day after her surgery & going to see her looking so poorly @ sore broke my heart. The vet was fantastic at ringing /emailing me. & our first dressage test.

I wouldn't read up about it either as its a very doom & gloom thing!
 
My Welsh D had arthroscopy on his left stifle at Liphook. It turned out that he had not torn the meniscus but did have cartilage damage and had debris removed. He had about one week on box rest with a daily graze in the neighbour's garden! We then turned him out in a small paddock, about the size of a tennis court, as he is a total nightmare in a stable and was getting dangerous. He was in that for 8-10 weeks when we turned him back out with his herd. He immediately bronced around the large field which was definitely very worrying moment! He made a full recovery and was back in work for another 6 or 7 years. We estimate that he was probably around 18 years old when he had the arthroscopy. He is retired now and still keeping his herd in order! Liphook were amazing but I understand that the success rate for these operations is not great. However, I would go through this again, especially with a younger horse as the arthroscopy gave a clear picture of what was wrong. We were lucky that old lad is quite tough, a good healer and that the injury was not as bad as expected.
 
Right, very tough decision to make but after talking to another vet today, and our insurers, we've decided not to go ahead. It's a real head over heart decision, but both vets said that even if she did come back 100%, asking her to go back and play polo would be asking for trouble. The estimated cost of surgery is more than she is worth, and that doesn't take into account the cost of getting her up to Newmarket and box rest afterwards.

I've dropped a line to the retirement home where we sent another mare, in lovely Cornwall, to see if they have space. I'm going to have our vet inject some steroids into the stifle on her suggestion, and then we are going to hopefully send her to have a good retirement and we will keep tabs on how she is. Feels very final and I'm absolutely gutted about the whole thing. But as our vet said, she doesn't appear to be feeling it, is very well in herself and could have a very happy lazy rest of her life. If my finances change drastically we can always revisit the surgery option.

Thanks to all for the advice, it was much appreciated and helped me to come to what I hope was the right decision.
 
I only know stifle injuries are serious,
From my own [human] experience of meniscus, the best thing I did was to go barefoot ..... I got this idea from background reading about my barefoot pony.
When I got injured, my first idea was to wear my walking boots, but these completely prevented proprioreception, which is automatic response to any surface irregularity.
It has taken three years for me to get back to where I was intitially, but no one on the medical community advised bare feet, so for the first four months I had recurrent problems.
My advice............ remove shoes. Wait.
 
My daughters mare had a stifle injury. She was improving but once the rehab and increase in work started she deteriorated and she really struggled mentally with not being busy. For what its worth i think you have made the best decision,its a notoriously difficult area.
 
My young mare has torn hers, but I can offer no advice as she has torn almost everything in her stifle, and destroyed the joint beyond any repair.
I do hope your fears are unfounded an you are able to get your horse back into work.
 
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