Long-Term Outcome of Standing Medial Patellar Ligament Splitting to Manage Horses Exhibiting Delayed Patellar Release: Sixty-Four Horses

Standing medial patellar ligament splitting is a successful, long-term, surgical option for treatment of delayed patellar release. Authors’ addresses: Steinbeck Country Equine Clinic, 15881 Toro Hills Avenue, Salinas, CA 93908 (James, Eastman); and College of Veterinary Medicine, Department of Large Animal Medicine and Surgery, Texas A&M University, College Station, TX 77843 (McCormick); e-mail: sjames@steinbeckequine.com. 

1. Introduction

This study describes a standing technique for medial patellar ligament splitting and reports long-term (average 4.5 years) efficacy in horses exhibiting delayed patellar release.

2. Materials and Methods

The medical records of 64 horses that had a standing medial patellar ligament splitting surgery performed to treat delayed patellar release were retrospectively analyzed. Horses were sedated in standing stocks. A number 15 scalpel blade was used to percutaneously split the medial patellar ligament from just proximal to its insertion on the tibial tuberosity to its attachment on the parapatellar fibrocartilage, with the goal of inducing a localized desmitis and subsequent thickening of the ligament. Aftercare consisted of oral antibiotics, 14 days stall rest with hand walking, light exercise for 14 days, and full work at 4 weeks. Follow-up information was obtained through telephone calls to owners and/or clinical evaluation by a veterinarian.

3. Results

Eighty-nine percent of horses benefitted from the procedure, with complete resolution in 58% of horses and improvement in 31% of horses. Seventy-three percent of horses were able to perform at the desired level of performance following the procedure. Sixty-three percent of horses showed signs of improvement or resolution within 30 to 60 days. Two horses had complications following the procedure: one had an incisional infection and one had a medial patellar ligament rupture.

4. Discussion

This study shows that standing medial patellar ligament splitting is a successful long-term surgical option for treatment of delayed patellar release. The procedure has few complications and allows a rapid return to desired performance.

Acknowledgments

Conflict of Interest

The Authors declare no conflicts of interest.