Clinical evaluation of the medial patellar desmotomy for treatment of proximal patella fixation in horses and ponies

In this study the clinical and radiological evaluation of 21 equine patient s with medial patellar desmotomy is reported. The group consisted of 15 hor ses and 6 ponies of various breeds and the age ranged from 3 to 19 years. T he desmotomy was performed on the standing sedated horse (except the minish etland horses, where the surgery was done under general anaesthesia) and NS AIDS were given post-operatively. All horses were rested or hand walked for 47 days until resuming work. At the time of the study the desmotomy has be en performed 2 months to six years ago. The operation had been succesfull in all patients and no reoccurence of pro ximal patella fixation was observed. Most of the animals (19/21) went back to their original work including dressage, show lumping, circus and pleasur e riding. Two patients were lame at the time of the examination, in one cas e the cause of the lameness was identified os a bonespavin, the other horse had lesions in the femorotibial joint. The radiologic evaluation, which wa s compared to the pictures before desmotomy, showed several pathologic chan ges of the patella and the margo cranialis of the crista tibiae, but were o f no clinical consequence. None of the ponies showed any radiologic changes . Manual palpation revealed a fibrous structure on the medial aspect of the stifle joint at 4 months after desmotomy suggesting reparation tissue of t he medial patella ligament by this time. Most owners (19/21) were satisfied with the outcome of this treatment. This study demonstrates that the media l patellar desmotomy is an effective treatment of the pathological proximal patellar fixation in equines. The post-operative mangement seems to be of greet importance for the outcome of this treatment.