Arthroscopic stifle surgery - regale me with success stories

[Feathered_Feet]

After trying PRP, shockwave, stem cells, and paddock rest, we’re sending my warmblood to arthroscopic stifle surgery at New Bolton Center. The initial diagnosis was a “hypoechoic lesion” in a hard-to-image ligament of the stifle, so the reality is we don’t really know what’s going on in there. Clinically, the original presentation was very subtle, and only evident under saddle at the trot for the first few steps, but she has recently gotten worse to where it’s more obvious in the trot (and several episodes where she comes up almost non-weight bearing after being a doofus in her paddock which resolves after a few days of bute, so paddock privileges have been suspended).

Any success stories? Horse was an FEI dressage horse but I’d be happy for her to come back as a lower-level packer (unless I should be more optimistic?).

And what was recovery like? Assuming 2 weeks or so strict stall rest post-surgery, how much hand walking until tack walking, paddock rest, and (ideally) a return to work? (Obviously I will ask the surgeon but was hoping to get an idea of real-world experience.)

Due to the aforementioned doofusness I plan to send her to a rehab facility (open to suggestions for any near NBC/Pennsylvania/Maryland/Northern Virginia, preferably with aquatread!).

[stargzng386]

Highly recommend this rehab facility and they have an aqua tread. https://www.rehab.vet/

There’s a fb page as well where you can see some of their success stories.

[joiedevie99]

I’ve heard good things about Furlong’s Soundness Center in NJ.

[ATXmom]

Our horse was scheduled for stifle arthroscopic surgery but didn’t end up having it, (see my thread) so I don’t have any experience on that but I would highly recommend sending your horse to a rehab facility afterwards.

We were trying to manage him at home - especially in the beginning when he wasn’t able to aquatread or hot walk - but he was becoming intractable, even on reserpine & Ace. Once he was cleared for work, we sent him to a facility near us and it was the best thing we could have done. He was a little wild the first day or two but settled in quickly and is now his normal, quiet & sweet self. The rehab facilities are, IMO, just better able to manage convalescing horses and the horses are happy to be all on a similar schedule and working.

YMMV

[Feathered_Feet]

Thanks all for the suggestions. She is definitely going to rehab, it’s just a matter of where. She’s already bouncing off the walls on a hefty dose of trazodone and I’m over wrestling with barns to give more sedatives and keep her quiet (not necessarily their fault, she’s just a lot of horse at this point). She’s already re-injured this once and I am done playing lol.

[Feathered_Feet]

Ironically my vet is part of their group but didn’t mention it (I think it’s a bit far for us but I’m fine with that if they are good). Thanks for the suggestion!

[Chall]

Had arthroscopic for a bone chip on p1.
Kool part was I got to watch the surgery. However, he did get stressed under anesthesia, so you may not want to there in that case.
Tip: if they have a horse “football” helmet, ask to use it. My guy staggered up on recover and cut his eyelid. They stitched it and then gave him a helmet.

Recovery: I paid for hand walking by the barn, as I couldn’t handle it. Ace kind of stopped working eventually and when he was ready to be ridden a pro rode him, good thing because he was long backed and could really buck.

[Feathered_Feet]

@Chall

stressed under anesthesia,

Oh, I’m intrigued - what does “stressed under anesthesia” mean? HR/BP/respiration increases?

And yeah I’m pretty nervous about the full anesthesia - she’s already come out of one general anesthesia unscathed but seeing as she seems prone to disaster, everything is a risk. Kinda wish those slings I saw going around on facebook a while back would get implemented in general practice a little quicker.

[Chall]

When they started drilling his heart rate and breathing went up. God bless her, the nurse went up to his head and stroked him, mumbling sweet things into his ear.
He was fully sedated but seemed like he still felt it.

The other fascinating thing, the surgery was done at Aqueduct Racetrack in N.Y.
The clinic looked like an old garage station. They had a set of tracks in the ceiling. After sedation, (he went down on a mattress) they hobbled his front legs together and then his back legs with a leather thing with a chain and hook attached. Then they took the hooks and attached them to a chain on the tracks above.
The train and its engine lifted him up, upside down, and the train track took him to the surgery table and lowered him down.
After the surgery, the table lowered to the ground and tilted and he slid down into a kind of pit, where I guess he recovered until they could walk him to a stall.
It was incredibly efficient in such a physically small building. And the vets were so kind, one started tearing up because we were pleasure horse owners and so concerned with his welfare. My guess is race owners can’t afford to treat unprofitable horses the same way “pet” horse owners do, so that young vet was moved.

[sammy14]

Mine for stifle OCD was one month in a stall, 5 mins hand walk final 2 weeks.One month 2x stall size yard walk in stall combo, one month 4 stall sized yard then careful return to larger paddock.After 3 months of no work ,gradual return to very careful ridden and physio rehab.
It’s longer and harder than the vets told me and i’m wondering if “good prognosis” means what I think it should mean
Hope for the best, but if “good prognosis” means paddock sound and can go for a bit of a jog sometimes, well, that aint me.
Ask questions before they go in…

[Feathered_Feet]

Thanks for sharing! That gives me a better idea of what to expect after, though I suspect my vet will push for handwalking over paddock turnout.

Can you elaborate on what questions you’d recommend asking? Currently the prognosis is terrible (“let’s hope she can be pasture sound”), so I don’t feel like I have a lot of choices, here

[sammy14]

The questions I SHOULD have asked were about what level of work he would be predicted to do based on the “good prognosis” …all going well.
I know they don’t have a crystal ball, but IF pasture sound and a bit more comfortable was the good prognosis I wouldn’t have done surgery as the horse was paddock sound and comfortable enough (he came back well from the stifle surgery so that didn’t occur,but it could have)
Secondly I had NO idea the time frame was 8 to 12 months for the second surgery, 5 months was the time talked about but doesn’t seem a very common occurrence (4 yrs later psd n/f traumatic after a nasty arena wipe out, see hot horse) and i’m pretty sure sharing that info was avoided.
I didn’t know i’d be doing months of walking under saddle as hand walking wasn’t recommended for my horse as he’s too hot go me ha ha, and of course no longeing allowed.
Also pole work in hand every day for another month and counting.
I DO all the things willingly,I adore my horse, but would have really appreciated a heads up, and to avoid the awful anxiety when it was taking longer and I thought i’d done something wrong.
I’d also ask how much follow up the vets will do, apparently physio does most of the rehab supervision which I also wasn’t clear on and didn’t have organized well enough…So ask about physio/rehab recommendations.
So,those sorts of questions, which may not apply in your case, but would be good to know?

[Feathered_Feet]

Thank you. All good points.

For us, we’re going in as an exploratory surgery - last ditch effort to try something. Horse is not really chuck-it-in-a-pasture sound (if I had my own place, I’d feel more comfortable as I’d monitor super closely), so it’s a last ditch effort for … something. But you’re right that surgery with best case scenario meaning pasture sound would typically be pretty disappointing.

But the time frame - that’s a really good point. I just kinda assumed three months rest and hand walking, then start tacking walking and go from there. Again, since this is exploratory, I don’t know if they can tell me exactly what is standard, but I’ll ask for a few different scenarios.

I have a few weeks before the surgery so still time to figure out what questions to ask, so thank you!