_The causes_ of "stifle out" may be described as follows: The patella or knee-cap rests on a pulley-like articular surface belonging to the inferior extremity of the thigh-bone. The external lip of this articular surface is smaller than the internal lip. The patella is held in place from above by the heavy muscles of the anterior region of the thigh, and from below, by straight ligaments that attach it to the leg-bone. If the retaining structures mentioned become relaxed, the patella may, when the limb is extended, become so displaced as to rest on the superior portion of the external lip. 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. _The symptoms may vary_. The displacement may be first noticed when the horse is backed out of the stall or turned quickly. A slight "hitch" in the movement of the limb is noted, that is followed by more noticeable flexion of the hock than normal. In case the luxation is more permanent, the horse stands quietly with the affected leg held stiffly and extended backward. When made to move forward, it hops on the well leg and carries the affected one, or drags it on the toe. If both limbs are affected, the animal is unable to move. The inability to move the limb is due to the patella resting on the external lip of the pulley surface, and a locking of the stifle- and hock-joint. This accident is annoying, and in case the horse is subject to it should be considered an unsoundness. The following _treatment_ may be recommended: The luxation may be reduced in the large majority of cases by backing or turning the animal. If this does not reduce the displacement, a collar should be placed on the animal, and a hobble strap fastened to the pastern of the involved limb. One end of a long rope is tied to the collar, passed backward between the front limbs, through a ring in the hobble and back over the outside of the shoulder and under the collar. While an attendant pulls the limb a little forward with the rope, the operator takes hold of the foot and attempts to flex the limb, at the same time pushing inward on the patella. After reducing the luxation it is advisable to tie the rope to the collar, so that the limb is carried forward. This prevents the animal from throwing weight on the foot. It may be advisable to tie the animal so that it can not lie down, if the foot is to be left hobbled for a few days. A fly blister should be applied to the front and outside of the stifle and the application repeated in two or three weeks.