b'SPORTS MEDICINEexercises, as well as treadmill work and(the hip on the lame side pops up higher water exercise. He also recommendsthan the other when viewed from behind) treating the horse with hyperbaric oxygenis often observed, and the lameness may therapy (HBOT) if available. appear worse with the lame leg on the Bell says rehab program structure isoutside of the circle at a trot.very important and should be monitoredHow theyre diagnosedVeterinarians by the veterinarian throughout the fiveconduct a lameness exam, looking for to nine months typically needed to healevidence of joint effusion, using joint these tissues. manipulation (evaluating how the stifle PrognosisDepending on the injurysfunctions when its extended beyond its severity and how well owners stick to thenormal physiological limits), administer-treatment and rehab plan (and how theing a joint block to localize pain, and horse tolerates it), Bell says the prognosisimaging the region (generally radiographs for returning to soundness is fair to good. and ultrasound, sometimes nuclear scin-Dryden adds, Anytime we have a truetigraphy, and, if its available for use on core lesion (essentially, a hole) on thestifles, CT and MRI). Surgeons might also deep flexor tendon, I worry about returnmake a definitive diagnosis via stifle joint to full athletic abilities. But we see a lotarthroscopy, Bell says. of deep flexor tendinopathies that are in- How theyre treatedTreatment depends flamed but not necessarily a tear that doon the injurys cause and severity. Acute, quite well with rehab and treatment. traumatic injuries not affecting the soft-tissue structures within or stabilizing the Stifle Injuries joint can be managed with systemic anti-Winning in their blood. Bell says he often sees stifle injuries ininflammatories and rest, Bell says. mature working horses. If injuries involve those soft-tissue These horses will develop acute,structuressuch as the cruciate liga-in their joints.severe lameness in the hind end, whichments, collateral ligaments, or meniscus will gradually improve over three to sevenwithin the stifletreatment is generallyVeterinarian trusteddays following the injury, but distinctmore complex and might also include:lameness will remain, he says. Cold therapy or icing, and/or since 2006 The affected joint often swells, and the Ultrasound- or arthroscopic-guidedPatented formulation horse is painful during joint flexion andPRP, interleukin-1 receptor antagonist extension. protein (IRAP, a biologic therapy), orHigh viscosity solution ofThe horse will stand and walk withstem cell injection.Hyaluronic Acid, Chondroitinthe leg abducted (held out from the body)Ultimately, Bell says, arthroscopic sur-and foot turned out from the body, andgery might be the best bet so the surgeon and Glucosamine the affected limb will have a shortenedcan identify and address all the issues stride, Bell says. A hip-hike lamenessduring the procedure.For more information, pleasevisit www.Polyglycan.com or call 1-888-524-6332.VeterinaryUseOnly.Patent Nos.:6,979,679/7,485,629/ 8,455,458.CAUTION:This device isrestrictedtousebyoronthe orderofalicensedveterinarian. WARNING:Donotadministerto animals that are to be slaughtered AMY KATHERINE DRAGOOfor use in food. Keep out of reach of children. Polyglycan is a registered trademark of Bimeda, Inc. All rights reserved.2019 Bimeda, Inc.Veterinarians typically use radiographs and ultrasound (pictured) to diagnose sti\x0be injuries.40August 2019The Horse | TheHorse.com'