Medial patellar ligament splitting in horses with upward fixation of the patella: A long-term follow-up.
Authors: Andersen C, Tnibar A
Journal: Equine veterinary journal
Summary
# Editorial Summary: Medial Patellar Ligament Splitting for Upward Fixation of the Patella Upward fixation of the patella (UFP) remains a challenging condition in performance horses when conservative management fails, making reliable surgical alternatives essential for practitioners. Andersen and Tnibar conducted a retrospective analysis of 85 horses undergoing medial patellar ligament splitting (MPLS) between 1999 and 2013, with long-term follow-up data collected from medical records and direct communication with owners, trainers and referring veterinarians over periods of up to 14 years. Resolution was remarkable: 97.6% of horses achieved complete UFP resolution either immediately post-operatively or within two weeks of surgery, with only two cases (2.4%) showing unilateral rather than bilateral success despite repeat procedures; notably, 90.5% of cases were successfully followed for 3–14 years post-surgery with zero recurrence observed in horses that returned to exercise and no short- or long-term complications documented. MPLS represents a highly effective, minimally invasive option that permits rapid return to athletic work—outcomes that should encourage practitioners to refer cases unresponsive to conservative therapy, whilst the absence of complications and recurrence in this cohort provides robust evidence to support its use over longer rehabilitation periods associated with alternative surgical approaches.
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Practical Takeaways
- •MPLS is highly effective for UFP unresponsive to conservative therapy, with >97% success rate and no recurrence during long-term follow-up
- •Both standing and general anaesthesia approaches are viable options, allowing flexibility in surgical planning for different horses and facilities
- •Horses can return to work very rapidly post-operatively with minimal risk of complications, making this an attractive option for sport horses
Key Findings
- •97.6% of horses (83/85) achieved complete resolution of UFP immediately after MPLS or within 2 weeks of surgery
- •Only 2.4% of cases (2/85) had incomplete bilateral resolution despite repeat surgery
- •90.5% of horses were followed up for 3-14 years post-operatively with no recurrence of UFP
- •No short-term or long-term complications were reported in any of the 85 cases