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In upward luxation, reduction is effected by attempting further extension of the stifle joint and at the same time the patella is pulled outward, off the internal rim of the trochlea. This is attempted by securing the subject in a standing position; the sound side is kept against a wall if possible and a rope is tied to the extremity of the affected leg.
It usually communicates with the medial sac of the femerotibial joint cavity by a slit-like opening situated at the lowest part of the medial ridge of the trochlea. A similar, usually smaller, communication with the lateral sac of the femerotibial capsule is often found at the lowest part of the lateral ridge.
Because of the manner in which the patella functionates with the trochlea of the femur, comparatively little energy is required to prevent further flexion of the stifle joint. The patella, according to Strangeways, may be considered a sesamoid bone. The capsules are removed. 1. Middle patellar ligament. 2. Stump of fascia lata. 3. Stump of common tendon of extensor longus and peroneus tertius.
The astragalus is almost of normal shape; the trochlea is slightly prolonged anteriorly, especially on the inner side, from contact with the tibial articular surface. The cartilage on the exposed posterior portion of the trochlea seems healthy. The head of the astragalus is very prominent on the outer side, the scaphoid being depressed downward and inward away from it.
The joint capsule encompasses the articulation and is attached to the brim of the acetabulum and the edge of the head of the femur. The section passes through the middle of the groove of the trochlea of the tibial tarsal bone. 1 and 2. Proximal ends of cavity of hock joint. 3. Thick part of joint capsule over which deep flexor tendon plays. 4.
Laxness of the muscles and ligaments in young animals is a predisposing factor. Hard work that tires the muscles and causes them to become relaxed, strains, unusual movements, as kicking in the stable and slipping, may cause this accident. Congenital displacement results from imperfect development of the external lip of the trochlea. Such a deformity subjects the animal to frequent luxations.
Two forms of true patellar luxation in the horse may be considered; one which is due to the patella becoming fixed upon the internal trochlear rim of the femur and the other when the patella slips over the outer rim of the trochlea. According to Cadiot and Almy, it is only by the rupture of this ligament the femeropatellar that upward luxation may occur.
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