Knees up

 severely lame but it depends on the number and location of the fragments of chipped bone. A horse with a small chip may only be mildly lame. As with osteoarthritis of the knee there is likely to be heat and swelling around the joint and the horse will be unwilling to flex the knee. Radiographs, bone scans or MRI scans will confirm the diagnosis of a chip fracture.

Treatment

Keyhole surgery can be used to remove the chip and reduce the chance of significant arthritis developing but for smaller chips medication directly into the joint may help, combined with rest to enable the damage to heal. Full recovery is dependent on many factors including the severity of the fracture and age of the horse but the prognosis for performance horses that have had prompt and effective removal of the bone chips is good.

Proximal suspensory ligament desmitis

This important ligament runs close to the knee. It can result in some knee joint blocks also alleviating lameness caused by inflammation of the proximal suspensory ligament. A horse with proximal suspensory desmitis may be acutely mild to moderately lame but recover following a couple of days of rest and then become lame again when work is reintroduced. The lameness will often be more apparent of soft ground or may manifest as a change in gait. Nerve blocks are usually used to identify the lameness followed by ultrasound for a more specific picture. In some cases MRI, CT or a bone scan to identify concurrent bone lesions may be needed.

Treatment

Rest and a careful return to exercise are key for recovery from proximal suspensory desmitis. Many horses are able to return to full athletic performance. In some instances shockwave therapy, corticosteroid injections or regenerative medicines may be used or the ligament may be surgically split at the point of origin.