What is Cranial and Caudal Cruciate Ligament?
The cranial and caudal cruciate ligaments are placed within the stifle joint in the form of a cross, the word cruciate signifying cross the shape, and are responsible for the stability of this large joint. The stifle joint allows the rear leg of the horse to flex and bend smoothly as well as maintain weight distribution while standing. As one might deduce, injuries to the soft tissue within the stifle joint, especially injuries to these cruciate ligaments, can potentially cause severe lameness in the horse due to the instability of the stifle joint.
The cranial and caudal cruciate ligaments are two ligaments located within the stifle joint of the horse. These two ligaments provide a great deal of joint stabilization within the stifle. The largest joint in a horse’s skeletal system, the stifle can be compared to the knee on humans and other animals.
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Symptoms of Cranial and Caudal Cruciate Ligament in Horses
The symptoms of cranial and caudal cruciate ligament issues in your horse will likely show up as:
- Swelling of the stifle joint
- Distention or enlargement of joint
- Pain noted in the horse
These symptoms can be displayed or noted in your horse in either or both hind legs. Depending on the type and the extent of the injury sustained in the cruciate ligaments, the lameness and other symptoms may be variable and the response from treatment will likely be variable as well.
There are basically two types or categories of injuries to the cranial cruciate ligament:
- Femoropatellar - which can include locking of the patella, fractures involving the patella and osteochondrosis
- Femorotibial Joints - can include arthritis, bone cysts, various types of meniscal tears and various ligament involved injuries
The types of caudal cruciate injuries usually involve:
- Strain of cruciate ligaments
- Rupture or tear of cruciate ligaments
The stifle, as noted above, can be compared to the human knee in that it contains similar parts such as the patella (knee cap), femur (long upper leg bone of hind leg), and tibia (the inner of the two bones that run downward from the knee to the hock). Many of the maladies that occur in our human knees can also occur in the horse and can range in seriousness from mild to severe. The lameness caused by the various types of injuries to the stifle can be permanent or temporary.
Causes of Cranial and Caudal Cruciate Ligament in Horses
The primary cause of cruciate ligament injuries, whether cranial or caudal, is trauma. This trauma can occur as a result of athletic activity of the horse, whether from working activity or conformation workouts (kicks, jumping, falling, high-speed racing and jumping). Injuries to the cruciate ligaments and other soft tissues in the stifle result in inflammation to cause lameness which can get better over time and with treatment or can be more permanent. The inflammation can recur depending on the extent of the injury to the soft tissue. Osteochondrosis is another cause of these injuries, causing inflammation over time (sometimes from an early age) and ultimately has the potential to cause tissue degeneration in the stifle joint as well as other joints in the body of the horse.
Diagnosis of Cranial and Caudal Cruciate Ligament in Horses
The stifle joint is a very complex joint and, because of this complexity, diagnosis can be difficult for your veterinarian.
- Visual examination, noting unusual configuration of the hind leg and any associated swelling
- Manual manipulation of the joint to assess any possible restrictions or limitations of movement and the pain demonstrated by the horse associated with this manipulation
- Gait evaluation done to determine how the injury affects your horse’s movement
- Because there is not a good way to use MRI and other types of imaging on the stifle joint of the horse, ascertaining the extent of the possible injury to the soft tissue in the joint can usually be done most effectively by arthroscopic examination of the joint
- Radiographic evaluation can be utilized in some of these injuries but will only identify solid abnormalities, not the soft tissue issues that may be present
- Nuclear scintigraphy can be useful especially if secondary ligament involvement is suspected
- Ultrasound has been used successfully to identify soft tissue damage without an invasive procedure
Treatment of Cranial and Caudal Cruciate Ligament in Horses
Treatment options for stifle diseases will vary based upon the extent of the injury. The more mild injuries, as may occur from a strain, respond well to rest for periods of time that can range from days to months for resolution. If the injury is determined to have inflammatory involvement, intra-articular injections of medications may be used. Surgical options are usually reserved for more severe injuries, if the radiographic exam shows lesions or if the horse has not responded adequately to the other options. Administration of anti-inflammatory medications are generally used when indicated. Return to normal activities for your horse should be gradual for best prognosis. Surgical repair or reconstruction of ligaments is not possible at this time due to the weight bearing function of the stifle joint so arthroscopic debridement is the best surgical option when the injury indicates.
Treatment options for osteochondrosis will usually require the removal of the lesion or cyst via arthroscopic surgery especially if the horse is younger. If the lesion is the result of an infection, treatment with antibiotic medications is usually begun.
Recovery of Cranial and Caudal Cruciate Ligament in Horses
Tears to the cruciate ligaments can be partial or complete and the extent of the lameness suffered by your horse will depend on the degree of injury as well as the length of time your horse has had the injury. If the ligament is partially torn, it will usually respond to arthroscopic debridement, intra-articular injections and lots of rest. However, if the tissue is completely torn, the prognosis is poor. If the injury is a result of a bacterial infection in the joint, even with the administration of antibiotics and flushing the joint, the prognosis is guarded. While there are a number of joint disease processes as well as injuries that can cause cruciate issues, the options and resulting efficacy of treatment will be dependent upon the severity of the disease process or the injury.
Since the treatment options for stifle joint problems aren’t as successful as the treatments for other joints, it is important for the owners to be more aware of the signs and symptoms of these diseases and injuries and get medical assistance as soon as possible. Work with your veterinarian for appropriate exercise options and nutrition recommendations for all your horses especially the younger ones who are still in developmental stages. Discuss with the veterinary team how to learn to watch for the signs of lameness, gait changes, swelling of joint tissue, and demonstration of pain, and get medical assessment as soon as possible.