Medial meniscus lesion - experiences?

[ChasseurSauteur]

Hi all - my 14 y/o TB presented recently came up with a very sore right stifle - ultrasound shows a moderate lesion on the medial meniscus (as well as some damage to the patellar ligament). Nothing of concern on x-rays.

We are about a month removed from the initial injury at this point and will be giving him another month of full rest (stalled at night, small paddock during the day.) Our vet has said we should then be able to start walking rehab and will look to start Shockwave, as well as inject polyglycan, about two weeks into that.

Vet feels we’ll have a long, conservative rehab ahead but that if we follow rehab protocols correctly, we should be able to bring him back into work eventually. I’m feeling a bit pessimistic as the only other meniscus injury I’ve ever encountered (a full tear) led to the horse’s immediate retirement as there were no treatment options (and frankly I thought that the meniscus couldn’t really heal without surgery?) I’d love to hear any experiences you may have had with meniscus injuries - this horse does First Level dressage as well as some hunter paces etc so not a hugely demanding job - wondering if anyone on here has brought one back to a similar workload. Many thanks in advance!

[Simkie]

Oh man, this is stretching my memory quite a bit, but years ago when I had a horse with a stifle ligament strain, the vet mentioned treating (I think it was) a meniscus injury with IRAP very successfully. The horse went back to lower level eventing.

Is there a reason why your vet isn’t exploring IRAP or ProStride? It might be worthwhile to discuss!

Good luck!

[beowulf]

They don’t tend to heal well, no – and they need lots of time to heal appropriately. If you have the budget, I would explore every IRAP and shockwave option at your disposal.

I had a gelding with a medial meniscus tear… While he showed improvement with each checkup visit, it was a long time before I rode him. He had a year off of work completely, with half of it being stall-rest and the rest rehab in hand.

I ended up chucking him out on Dr Green for an additional year. My memory of the timeline is hazy, but I recall I gave him the additional year off despite my vet saying he was cleared to go back to work. He just did not look completely comfortable to me. We injected his stifles a few times to help with inflammation, but did not do surgery.

Treatment options are better now than they were then, I wish IRAP had been at my disposal. He was a really nice horse. I took him hacking for the half-year back to work and he did go on to be servicably sound for low level eventing… He did always have a slight hitch in that hind that my vet believed was a lack of flexibility/elasticity versus actively sore since blocks didn’t change it. He was happy to work, and was leased by a rider learning the ropes of eventing until his death. He was not doing much more than your horse and would have been fine for hunter paces and low level dressage.

A few management changes that were critical for him was keeping him in four shoes and always out on 24/7 turnout. If he was stalled overnight he would go from 12 y/o to the creaky 40 y/o pony; he needed to be moving constantly. His lessee had him on a vit E + glucosamine/MSM supplement and he was on Adequan with good results. The polyglycan you mentioned should really help.

Take an objective look at how he is shod behind and see if that could have contributed. In my experience sore stifles are usually caused by a mixture of poor trimming and/or difficult work, such as too small circles, too much lunging, or high speed pursuits. The stifles don’t often exist in a vacuum so if they are sore, chances are something else is too.

Good luck, keep us updated.

[ChasseurSauteur]

Thanks, both! I forgot to ask about IRAP but will definitely do so at our re-check. Super helpful - appreciate you sharing.

[RedHorses]

I spent much of 2019 dealing with a torn meniscus. It was ultrasounded to diagnose, check progress, and confirm healing. The horse was kept in limited turnout and handwalked or long lined. Injured in February and ridden rehab began mid/late July.

I took that slow and used my Equestic clip data to determine if we needed to back off or if we were okay before he showed it. Initial canter work was too early and I stuck to trot for a while longer before introducing canter again.

He was fine for all our riding last year which included small mountain/big hills. I was messing around with dressage work last week and he volunteered a canter half pass.

They can heal. They take a lot of time to do so.