Case Study 1  – Poor Performance

Carr Hall (IRE) 2003 Bay Gelding trained and owned by Mrs Joan LeBrocq

History

Carr Hall enjoyed a fruitful summer campaign in 2007 and with the Jersey Derby under his belt he was given a well-earned rest in the paddock. It was noticed however that he appeared lame on a hind leg once he had come back into work. There was fluid swelling in the stifle area (femeropatellar joint) and the lameness was made worse with flexion of the limb.

poor performance pre opPre-Op

Diagnosis

Local anaesthetic was injected into the front of the stifle and after 15 minutes there appeared to be a marked improvement, the lameness was hardly noticeable! Subsequently the stifle joint was x-rayed. The radiograph revealed a detached bony fragment from one of the trochlear ridges (knuckle of the femur).

An ultrasound examination was also performed to pick up more subtle damage to the cartilage in the affected joint (cartilage is mostly made up of water and can be visualised quite well with an ultrasound scan).

This type of injury can be caused by trauma to the joint surface or from a developmental problem known as O.C.D (osteochondrosis dissicans), where defective cartilage creates an inflammatory problem in the joint.

poor performance post opPost-Op

Treatment

The treatment for this condition is to carry out keyhole surgery (arthroscopy) to remove any damaged cartilage and bone. This is done under a general anaesthetic; the joint is also flushed with 10 – 20 litres of sterile fluid to get rid of any debris that might perpetuate the inflammation within the joint. A radiograph is taken during the surgery to check that all fragments have been removed.

poor performance ultrasoundUltrasound

Carr Hall made an uneventful recovery from the anaesthetic and stayed in the clinic for three days post-surgery. Initially the horse was confined to box rest and shorts bouts of hand-grazing for 2 weeks until the stitches were removed. Subsequently the gelding had 4 weeks of controlled walking exercise at a recuperation yard close to the clinic. Upon re-assessment 6 weeks post-surgery Carr Hall was sound and was deemed fit to travel back to the Channel Islands where he was turned out in a nursery paddock for a further 6 weeks. At present Carr Hall is back in ridden work and will hopefully be back racing early Autumn.