upward fixation of the patella

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santander

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Our boy has upward fixation of the patella - he's only 5 and it doesn't actually lock but it does cause him discomfort it seems. The physio says he may grow out of it but I'm concerned that he can't build correct muscle whilst it is like this.

Apparently the procedure to correct it is done under local anaesthetic and is fairly straightforward.

Has anyone any experience of this condition? and if anyone's had the op done, how much does it cost please?

Thanks in advance

PS He also has an audible snapping sound when he moves. Sounds nasty but is apparently nothing particularly sinister..
 
Never come across a horse that has this .... but if it causes asymmetry in his gait then it will affect his muscle development. Asymmetry will cause the horse to compensate, one side being prodominantly stronger than the other.
Best thing to do is to get the advise of several really good vets. See if they think u should go ahead with procedure or wait to see if it sorts it's self out.
If u wait to see if it sorts itsepf out; seek good advice on exercises and rehab to minimise unbalanced muscle development
Hope all goes well
 
Yes, I've had a Welsh D with this problem in both stifles.......waited 'till he was 4 to see if he would grow out of it, he did not. He had both stifles done on the same day at home under local anaesthetic by our local vet, box rest for, I think it was, four weeks then slowly back into work.

He is still going strong 15 years later both ride and drive, although we were warned that he would be a likely candidate for arthritis in his stifles. We took the risk because he would not have been of any use without the op.
 
Has he been seen by a vet?

The most usual cause of this is lack of muscle and most horses improve with work, especially with hill work. However it would be worth getting a vet out to discount other causes, e.g. I had a horse with stiffle OCD who presented with locking patellas.
 
I had a cob with this it got a bit better with being ridden i sold him at 7 years old, my vets didnt want to operate, he jumped/hacked/drove no problem, my friend also had hers operated on about 3 years ago cost about £130. then. If it isnt locking and can not move i wouldnt get it done.
 
I have a horse wih this in both legs, I've only owned him for a couple of years and he's had it most of his life. He does seem to find standing for a long time on concrete a tad uncomfortable but he is able to work with no problem and I regularly compete him.
I do have to watch out when I pick his back feet up as sometimes his legs shoot out and narrowly miss my head. He's 16 next year and his previous owners didn't consider any op. They believe his joints were damaged after he got stuck in a ditch and had to be rescued by the Fire Brigade.
 
My horse has this and the vets I have seen have told me to just wait and see how he goes. He is rising 3 and they have said once he is in work and the muscles have strengthened, it should right itself.

I have also been told the op should be last resort due to the increased risk of early onset arthritis.

The vet said lots of uphill work if possible, keep him built up, keep the damp off. I have some antiinflammatories for if he gets it for more than one day but he doesn't get it much now.

The amount he locks up has reduced since I increased his feed and lightly rugged him in wet weather. He has to walk up an incline everyday to come in and his field is on a slant too.
 
My horse has this an has also developed abduction in her RH as she does not want to flex the stifle. All xrays and flexions are perfect. I was told she would grow out of it when she was three, she's now 6 and it's it hasn't gone away and although she works very willingly I cannot do shows with her as the abduction is obvious. I'm now hesitating whether to sell her a good hack or have her ligaments cut/split. If any one has had this done to their horse I'd be interested to know the outcome.
 
The first foal I bred had this. One stifle affected. We thought he might grow out of it but he did not. We found that if he was stabled it was quite prevelant but if turned out less so. It seemed to happen when he'd been standing still for a time. He did very well at local and County level as a younghorse , being shown in hand and then became a hack, family pet and was ridden at Pony Club and around the lanes and farm. He lived to be 33 years old. We didnt have him operated on as we felt it unnecessarily risky.
 
It does lessen with muscle development, but as you've correctly guessed, it affects the muscle building in the first place. My girl's never been bad enough for the vets to want to operate, so it's been managed through work. I have enquired several times, but their (and vet college's answer) was that if I really pushed we could, but they'd prefer not to if she could be managed alternatively. She locks occasionally, but it's more manifest as stiffness in her.

Things that help:
- trotting up hills
- jumping (and the level of collection required for a jumping canter, with much sitting on the hocks)
- living out somewhere hilly (but she can't do this now and is ok with work)
- circles
- halt-walk transitions, where you're asking for a specific hind leg to step forward into the outside hand.

Basically, at the beginning of any work session, the whole system needs loosening up, and once that's been achieved, you have a 'normal' horse.
 
I think it's something that they can grow out of once their strength is built up, plenty of turnout and hillwork is also very helpful.
 
As has been said by others, they normally grow out of it as they build up bulk and muscle. Has your youngster lost a bit of weight recently as this can trigger the problem in younger horses? Lots of hill work and schooling over raised poles will help build him up and reduce the problem.
 
Fair enough - with exercise, patellar fixation can be managed, however at 5 years old, I suspect that, in that bone growth / developement should be complete ,it is unlikely that exercise / muscling alone will resolve this.
I suspect that the surgical procedure advised will involve desmotomy ( sectioning) of the medial patellar ligament - the ligament that tends to pull the patella medially allowing it to slip out of its 'groove' and then upwards.
Generally this techique is effective and can be carried out via sedation / local anaesthetic.
There is some concern that longer-term, sectioning the ligament and freeing the movement of the patella may pre-dispose to wear of the cartilage on the joint surface of the patella BUT again there are concerns that persistent fixation of the patella can also cause cartilage degradation - bit of a no win situation.....
Well worth discussing the pros and cons of this procedure with your vet before going ahead with surgery.
 
It's not so much "grow out of it" as building up muscle to allow the patellar ligament to "unhook" from the femur so to speak which then allows the stifle to unlock.

Some cases can be managed like this with keeping good muscle tone up and they do well, but if muscle tone decreases again,it will recur.

There are various surgical options, including cutting the medial patellar lig entirely, but also fenestration/splitting it to create laxity or stretch in it rather than cutting it entirely. Possible long term risks do include fragmentation of the bottom of the patella bone itself, butI've not personally had a case present with this.

Surgery is done standing under sedation and local usually and most cases do very well indeed.

HTH
Imogen
 
Imogen - would it be possible to elaborate on the diagnostic techniques. My vets seem to agree that my horse has partial fixation of the patella but reluctant to do any treatment without syntography to rule out any other conditions (hock, sacro-illiac) as they state often the stifle problem is a secondary cause. Also, are there any risks to do the ligament splitting without full diagnostic?
 
Santander - I've just had the ligament splitting performed on my mare this week after x-rays and scintography showed no deformality. She's now on box rest for two weeks followed by walking exercise for two months (having said that - madam managed to escape already yesterday and go for a buck!!). Will let you know how it goes as the vet thought 50:50 in our case as she was severely abducting the right hind in walk.
 
Had lots of case studies of this whilst at vet chiro school - weakness in pelvic mechanics can cause the gluts to weaken and therefore not be able to release the patella. Chiro adjustments to the pelvis have been shown to help. Good luck.
 
Unfortunately, two months after the op to do splitting on the medial ligament, my mare still shows signs of intermittent fixation of the patella. The abdustion of right hind is slightly improved but if anything the jerking moving and slight locking up is more evident. I don't want to have the ligament cut so I'll be getting her fit and selling as a very well schooled hack. It doesn't feel right to breed from her with this condition although I'm sure lots would!

I'd be interested in the success others have had, but I'm calling it a day.:(
 
FWIW, I had a 4yr old dutch horse with this. Brought him on for two years doing lots of basic schooling and fittening work. He improved gradually, although shoeing was always tricky for the farrier due to his somewhat dodgy balance and kick-back effect to release himself when the leg got stuck. Farrier had to wedge him in a doorway to help him balance (and used to do wobbling about on one leg impressions of my horse down the pub for a laugh :) ).

He is now a Grade A showjumper.
 
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