Less Common
Related Observations
This treatment might be used for a horse exhibiting these signs.
Treatment
A way to improve or resolve a condition or diagnosis. This might include resolving the underlying cause or treating the signs of disease (symptomatic treatment).
Cost: $100 to $500
These cost ranges are approximate and may vary from region to region.
Additional charges may also apply.
YOUR VET MAY Recommend
Medial Patellar Ligament Splitting or Fenestration
Cost: $100 to $500
These cost ranges are approximate and may vary from region to region.
Additional charges may also apply.
Summary
Medial patellar ligament fenestration is a surgical procedure that is performed to correct the upward fixation of the patella (UFP), also known as a “locking” patella. It is the treatment of choice for severe cases of complete locking or in cases that are unresponsive to conservative management (conditioning and/or shoeing). It is successful in a high percentage of those cases. This procedure is often preferred over medial patellar ligament desmotomy (MPD) (wherein the ligament is cut), because of associated side effects from that procedure.
The procedure is done standing. The horse is sedated, and the skin overlying the medial patellar ligament is anesthetized with local anesthetic. A small blade or large needle is used to repeatedly and methodically penetrate the skin and make small splits into the body of the ligament. The tiny holes create an initial release in tension on the ligament, causing immediate improvement. With time, the stabs cause scarring in the ligament which tighten it and reduces locking. Some practitioners perform the procedure using ultrasound guidance.
Postoperative monitoring includes stall rest with gradually increasing hand walking over a 90 day period, then conditioning for work may begin. If successful, the locking of the patella should stop, there should only be mild swelling or increase in lameness. Note, maintaining strength through the quadriceps muscle group is an important part of treatment and prevention of recurrence.
The procedure is done standing. The horse is sedated, and the skin overlying the medial patellar ligament is anesthetized with local anesthetic. A small blade or large needle is used to repeatedly and methodically penetrate the skin and make small splits into the body of the ligament. The tiny holes create an initial release in tension on the ligament, causing immediate improvement. With time, the stabs cause scarring in the ligament which tighten it and reduces locking. Some practitioners perform the procedure using ultrasound guidance.
Postoperative monitoring includes stall rest with gradually increasing hand walking over a 90 day period, then conditioning for work may begin. If successful, the locking of the patella should stop, there should only be mild swelling or increase in lameness. Note, maintaining strength through the quadriceps muscle group is an important part of treatment and prevention of recurrence.
my vet's role
Related Diagnoses
This treatment might be used to treat these conditions or ailments.
Know Related Treatments
Your vet considers other treatments that might be used along with or instead of this treatment.
CONSIDER POTENTIAL SIDE EFFECTS & COMPLICATIONS
Side effects are few in comparision to the MPD. There may be some local swelling and mild soreness for a couple days following the procedure.As with any surgical procedure, there is a small chance for local infection.
CONSIDER REASONS NOT TO USE THIS TREATMENT
This procedure should not be used as a first line of treatment, prior to strengthening exercise. There are cases in which locking stifle relates to other underlying conditions. In those cases, the underlying conditions must be treated first.your role
Related Skills
These are skills you might need if your horse is getting this treatment.
Is it working? Timeframe for effect.
In most cases, there is almost immediate reduction in locking of the stifle. Questions To Ask Your Vet:
- What physical therapy should my horse undergo prior to this treatment?
- What conditioning in the future will strengthen the stifle musculature?