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  Discussion on Sclerosis of Patella?
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New Member:
trilogy

Posted on Saturday, Nov 12, 2011 - 6:11 pm:

Hello Dr O,

My 5 yr old Welsh Cob, had sticking stifle last year, briefly following a period of lessened work. Once work increased, and included pole work, hill work etc, no further problem, except for the fact that we could not get left lead canter under saddle or on lunge, without use of a pole, or jump.On the lunge the situation would vary ,but seemed to improve, from switches of lead, and disunited canter, to increasingly correct work. Three weeks ago, I felt a wrongness under saddle, and the following evening longlined, to see something defnitely not right behind... four days later vet examined, and he was much worsened, definitely appearing lame on outside hind on a circle, and bunny hopping in right canter, and bucking ( not in character). On Wednesday he went in for x-ray, nerve block and ultrasound. Vet states identified problem as being inflammation of the surface of the patella; both hinds. He called it sclerosis.Nerve blocks to the area confirmed this as being the area of the problem. Vet said it had been a fascinating day, as not a common problem.. recommendation, bar shoes and heel raisers behind,fittening work. I should mention that he was being worked 6 days per week, varying jumping, flatwork and hacking.Bute twice daily for 4 days, lessening to one per day for a further three weeks. Review after six weeks, and if after six months we are not recovered, then to consider surgery. DR O, am I right in thinking that the bute is to take down the inflammation of the bone, and allow him to work in a painless way therefore fittening to tighten up the ligaments, by him working as he previously hasnt been able to because of the discomfort? My question is... how/what caused the bone inflammation in the first place, so that we might prevent it from happening again once resolved...in fact is it possible to reverse this inflammation? Also why if both patella equally affected would he have gone lamer on one side... is it a case of weaker side would struggle more, like aleft handed, right handed person would? Sorry for the waffle!
Moderator:
DrO

Posted on Sunday, Nov 13, 2011 - 9:09 am:

Hello Mrs KP,
I am a bit confused. You say there is a problem with the surface of the patella, I am assuming you mean the cartilaginous articular (joint) surface. Then you say the problem is with sclerosis which means there are areas of increased bone density. And while the two conditions are not mutually exclusive, advanced osteoarthritis can cause areas adjacent to the joint surface to become sclerotic, it is not clear this is what you mean. I think we need a exact transcript of the lesions the veterinarian saw on the patella.

Some of your questions can be answered in a general sense. Patellas can become damaged if they stick bad enough or perhaps there could be radiographic changes of the patella associated with rapid changes in work load. With bilateral problems it is not unusual for one side to be lamer than the other. When this is the case only the lamer leg is easy to detect. The prognosis for any lameness problem depends on the cause and the amount of damage done, I really cannot discern either in your horses particular case from the information we have so far.
DrO
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