A Closer Look at Treating Stifle Disease in Horses

The equine stifle is equivalent to a human knee and, like all limb joints, is prone to injury and disease. Colorado State University (CSU) researchers, for instance, recently examined 458 Western horses intended for cutting, during which routine survey radiographs (X rays) identified "abnormalities" in the stifles of almost half the horses. At the 12th Congress of The World Equine Veterinary Association, held Nov. 2-6, 2011 in Hyderabad, India, one CSU researcher discussed what treatment options veterinarians currently have and new treatment modalities in the works.

In the equine stifle, two long bones (the femur and tibia) come together to form a hingelike joint with multiple ligaments and two cartilagelike "discs." These "menisci" lie between the femur and tibia to help cushion the impact of the bones during weight bearing.

David Frisbie, DVM, PhD, Dipl. ACVS, from CSU's Gail Holmes Equine Orthopaedic Research Center, relayed that some of the most common stifle problems include cysts, osteochondritis dissecans (OCD), and injury to the ligaments and tendons stabilizing the joint.

Frisbie said one of the current recommendations for the surgical management of horses with medial femoral condyle cysts is injecting the anti-inflammatory corticosteroid triamcinolone acetonide directly into the lesion. This approach requires only one to two months of rest, whereas horses treated surgically by debridement (scraping the cyst out until healthy bone is reached) requires six to eight months' rest.

Additionally, Frisbie relayed that a study by Wallis et al. found that outcomes also were better in horses with cysts in only one stifle rather than in both, depending on the treating surgeon and if other (negative) changes in the joint are present. In cases that do not respond to injection, the option remains to debride the cyst.

Because many owners, especially those who enjoy competing with their steeds, are often not patient enough to have a horse undergo surgery and then wait three-quarters of a year to determine if the procedure was successful, Frisbie and other equine surgeons are looking into the use of stem cells for treating stifle disease such as cysts and/or OCD.

"Ferris et al. also showed a better return to athletic performance in horses treated with stem cells plus surgery compared to historic studies with surgery alone when meniscal injury is present," Frisbie relayed. "Thus we are now using stem cell in cases that are not getting better with other more routine treatments."

With the numerous therapeutic modalities available or being examined, owners of affected horses can consult their veterinarian to choose the treatment option that best suits each individual situation.

Disclaimer: Seek the advice of a qualified veterinarian before proceeding with any diagnosis, treatment, or therapy.