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Fragmentation of the Patella in Horses

By Jane C. Boswell, MA, VetMB, CertVA, CertES (Orth), DECVS, MRCVS, The Liphook Equine Hospital ; James K. Belknap, DVM, PhD, DACVS, Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Ohio State University ; Tracy A. Turner, DVM, MS, Anoka Equine Veterinary Services ; Peter Clegg, MA, Vet MB, DipECVS, PhD, MRCVS, Veterinary Teaching Hospital, School of Veterinary Sciences, University of Liverpool ; Matthew T. Brokken, DVM, The Ohio State University ; Marcus J. Head, BVetMed, Rossdales Equine Hospital and Diagnostic Centre ; James Schumacher, DVM, MS, Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee ; John Schumacher, DVM, MS, Department of Clinical Sciences, College of Veterinary Medicine, Auburn University ; Chris Whitton, BVSc, FANZCVS, PhD, Equine Centre, University of Melbourne

Fragmentation of the apex of the patella usually occurs secondary to medial patellar desmotomy for management of upward fixation of the patella. Lesions are believed to develop due to patellar instability as a result of the surgery. The severity of lameness varies from mild stiffness to moderate lameness. A proximal limb flexion test usually exacerbates lameness, and femoropatellar joint effusion is usually present. Lameness is localized by diagnostic anesthesia of the femoropatellar joint, and diagnosis is confirmed by radiography. Arthroscopic debridement of the apex of the patella with removal of the osteochondral fragments is the treatment of choice. Prognosis is reasonable but depends on the severity of the condition.