A standing surgical technique for splitting the medial patellar ligament is described, and the long-term (average 4.5-years) efficacy of the procedure in horses exhibiting delayed patellar release is reported. Medical records of 64 horses that underwent a standing medial patellar ligament splitting surgery performed to treat delayed patellar release were analyzed retrospectively. 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. Results showed that 89% of horses benefitted from the procedure, with complete resolution in 58% of horses and improvement in 31% of horses. A total of 73% of horses were able to perform at the desired level following the procedure; 63% of horses showed signs of improvement or resolution within 30 to 60 days. Two horses had complications following the procedure: 1 horse had an incisional infection, and 1 had a medial patellar ligament rupture. 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 rapid return to desired performance.
Long-term Outcome of Standing Medial Patellar Ligament Splitting to Manage Horses Exhibiting Delayed Patellar Release: 64 Horses
Contributing Authors Sarah James DVM, DABVP & Tim G. Eastman DVM, DACVS, MPVM
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About the Authors
Sarah James DVM, DABVP
Born and raised in Portsmouth, New Hampshire, Sarah grew up with a strong “nothing is for free” work ethic that resulted in the diligence with which she has pursued her dream of becoming a veterinarian. Throughout her time in school, Sarah worked in the veterinary field, gaining diverse experience ranging from raising milk cows for an agricultural cooperative, to preparing research animals (pigs) for surgery, to working on treatment crews at both small and large animal hospitals. She was also the recipient of several academic research awards. Sarah has mucked, fed and managed a stable of horses, taught beginning equestrians, and competed on the University of Vermont Equestrian Team, riding hunt seat and dressage. She also enjoys snow boarding, hiking, lacrosse and salsa dancing. Sarah’s professional interests include Theriogenology, Ophthalmology, Diagnostic Imaging, Sports Medicine and Surgery.
- 2014 Board certified in General Equine Practice with American Board of Veterinary Practitioners (ABVP)
- 2011-2013 Steinbeck Country Equine Clinic, Residency
- 2010-2011 Steinbeck Country Equine Clinic, Internship
- 2010 North Carolina State University, Doctorate of Veterinary Medicine
- 2006 University of Vermont, BS, Biologic Science and Animal Science
- Mansmann RA, James SJ, Blicksager AT. “Long Toes in the Hind Feet and Pain in the Gluteal Region: An Observational Study of 77 Horses,” Journal of Equine Veterinary Science. 2010. Dec. Volume 30 Issue 12: 720-726.
- Sarah J. James, DVM, ABVP, Timothy G. Eastman, DVM, MPVM, DiplDACVS, Justin D. McCormick, MS, DVM. “Long-term Outcome of Standing Medial Patellar Ligament Splitting to Manage Horses Exhibiting Delayed Patellar Release: 64 Horses,” Journal of Equine Veterinary Science. April 2014. Volume 34, Issue 4, Pages 479-483.
Tim G. Eastman DVM, DACVS, MPVM
A native of Salinas, Tim was raised in Monterey County, California, where his family had deep roots in the local horse industry. Like many veterinarians, Tim decided to become an equine veterinarian at a very young age. Tim met his wife, Alexandra (Alex) in veterinary school; they were married during his surgical residency and are proud parents of four children. Tim joined the Steinbeck Country Equine Clinic (SCEC) practice in 2000, where he and Alex now work together as co-owners. Board certified in Equine Surgery, he is committed to ‘round-the-clock equine care, using the most advanced technology.
- 2001 Board Certified in Equine Surgery, American College of Veterinary Surgeons (ACVS)
- 2000 joined SCEC
- 1998-2000 Texas A&M, Surgical Residency
- 1997 Littleton Large Animal Clinic, Littleton, CO, Internship
- 1996 UC Davis, Doctorate of Veterinary Medicine
- 1996 UC Davis, Masters in Preventative Veterinary Medicine
- 1991 Cal Poly, San Luis Obispo, BS Animal Science
Board of Directors:
- Salinas Rodeo
- International Laminitis Committee Member
- Veterinary Managers Group 8 Member (2003-2015)