Lameness in horses is a condition characterized by an abnormal gait or stance due to pain or mechanical dysfunction affecting the limbs or spine. It is a common issue in equine practice and can result from a variety of causes, including injury, infection, or degenerative diseases. Lameness can affect a horse's performance and quality of life, making accurate diagnosis and management important for equine health. Diagnostic techniques often include physical examination, imaging, and gait analysis. This page aggregates peer-reviewed research studies and scholarly articles that explore the etiology, diagnostic methods, and management strategies for lameness in horses.
Turner AS, Trotter GW.The case histories of 18 horses with hindlimb lameness attributed to fibrotic myopathy were reviewed. In 14 horses, the problem developed after trauma. In 5 others, it developed secondary to intramuscular injections. Other causes of the lameness were surgery, exertional injuries, and purpura hemorrhagica. Eleven of the horses were treated by resection of scar tissue or by semitendinosus myotenotomy. Postoperative complications included pressure necrosis under quill sutures (9 horses), acute disruption of the skin incision (2 horses), dehiscence of the wound during healing (2 horses), and prolo...
Doige CE, Hoffer MA.Navicular bones from 74 horses were examined at necropsy. Animals ranged in age from eight months to 30 years. Eight horses had a clinical history of navicular disease. Degenerative lesions in the fibrocartilaginous surface of the navicular bone and of the surface of the deep flexor tendons were age related changes not necessarily related to lameness. These lesions were more extensive in horses with a history of navicular disease, and were often accompanied by adhesions and subchondral cavitation of the fibrocartilaginous surface of the navicular bone. Osteophytes, present in 12 of the 74 hors...
Kold SE, Hickman J.The clinical features, diagnosis and radiological findings of eight cases of a subchondral bone cyst involving the medial condyle of the femur are described. Surgical treatment, which comprised performing an arthrotomy of the femorotibial joint, curetting and packing the cystic cavity with an autogenous cancellous bone graft, is described.
Lindsell CE, Hilbert BJ, McGill CA.Osteochondrosis dissecans was diagnosed clinically and radiographically in 31 joints of 21 horses. The horses ranged in age from 8 months to 5 years at the time of presentation. The usual age of onset of clinical signs was 18 to 24 months. Presenting complaints included joint effusion and lameness of either gradual or sudden onset. In Thoroughbred horses, the stifle joint was the most common site of lesions and in Standardbred horses lesions occurred more commonly in the hock. In 16 of the 21 horses, the contralateral joint was radiographed and 9 of these horses had bilateral lesions. Thorough...
Coffman JR, Colles CM.Sensitivity to insulin was assessed in ponies episodically affected with chronic laminitis by measurement of blood glucose and arterial blood pressure during insulin tolerance tests. In terms of blood glucose values, laminitic ponies were significantly less sensitive to insulin than controls. Conversely, a post-insulin decline in diastolic, systolic and mean blood pressure values was significantly greater in laminitic ponies than in controls.
Miller RI, Wold D, Lindsay WA, Beadle RE, McClure JJ, McClure JR, McCoy DJ.Five horses with pythiosis of the limbs were treated unsuccessfully by surgery or topical application of amphotericin B, or both. Follow-up immunotherapy resulted in 1 horse responding favorably. Three horses were cured of the fungal infection but developed osteitis or deep-seated laminitis, which necessitated their destruction. The remaining horse, which had severe anemia, died before the course of vaccination was completed.
Leach DH, Crawford WH.This paper describes the major areas that require investigation in equine locomotion and outlines a plan for such research in both the Thoroughbred and Standardbred. Fifteen topics for future investigation have been selected and given an order of priority. These topics deal with characteristics of normal locomotion, factors which influence locomotion, the epidemiology and economics of lameness and the clinical identification of lameness.
Mishra PC, Leach DH.The venous organisation of the dermal lamellae of the equine hoof wall of 18 pairs of forelimb hooves from clinically healthy horses was studied using plastic vascular corrosion casts, and scanning electron microscopic and histological techniques. A consistent pattern of venous organisation was observed in the dermal lamella of the toe, quarter and heel regions. The lamellar corium had an extensive interconnecting capillary network which drained into axially located veins of the primary dermal lamella. Many of the capillaries had a proximodistal orientation and most of those located at the int...
Yovich JV, Hilbert BJ, McGill CA.Nineteen cases of fracture of the distal phalanx in horses are reviewed. This represented 1.1% of the total number of horses seen at Murdoch University Veterinary Hospital (MUVH) over a 32-month period. All horses were managed conservatively. Eight horses made a complete recovery. Three are being trained again and are not lame. Four horses made a limited recovery. Two horses are still resting and one horse was killed humanely when it still showed lameness after 2 years. One horse was killed humanely after the fracture was first diagnosed.
Clarke LL, Garner HE, Hatfield D.Acute laminitis-hypertension was produced by carbohydrate overloading of the gastrointestinal tract in 12 adult horses. Obel grade 3 (OG3) lameness developed 40 hours (+/- 3.5, SEM) after overfeeding. At OG3 lameness, mean plasma volume was significantly decreased (P less than 0.005) when compared with base-line values. Before OG3 lameness, transient decreases in serum phosphorus and calcium were recorded. Mild hyponatremia also developed before OG3 lameness and persisted. After establishment of OG3 lameness, persistent hypokalemia and increased plasma aldosterone concentration occurred coinci...
Trotter GW, McIlwraith CW, Norrdin RW, Turner AS.Degenerative joint disease of the proximal interphalangeal joint was diagnosed in 9 joint of 6 horses. All of the horses were 3 years old or younger and the affected joints were in the hindlimbs. Radiographic evidence of osteochondrosis involving the distal end of the proximal phalanx was apparent in 5 joints. Lameness and local soft tissue swelling were prominent in all cases. In 1 horse euthanatized tissues because of lameness, histologic examination of joint tissues revealed osteochondrosis as well as severe osteoarthritis. Surgical arthrodesis of the affected joint was performed on 2 horse...
Bramlage LR, Hanes GE.A 3-year-old Thoroughbred mare was examined because of hindlimb lameness from incomplete fracture of the tibia, which became a complete diaphyseal fracture during the examination. The fracture was repaired by open reduction and internal fixation with lag screws and 2 neutralization plates. A cranial approach was used and the plates were placed craniolateral and medial on the tibia. At 18 months after surgery, there was no evidence of complications resulting from the fracture or its repair. It was concluded that a cranial approach with craniolateral and medial plate placement allows easier inse...
Edwards GB.During a 3 year period 20 horses with bone spavin were treated by surgical arthrodesis of the affected joints. The horses chosen for surgery were those with osteoarthritis, but with little or no evidence of periostitis. Whenever possible they were examined periodically during the postoperative period to evaluate the lameness and to assess the progress of ankylosis by radiography. Three of the horses were still lame 12 months later. The remainder returned to normal work, although one subsequently developed spavin in the other hock and was destroyed. The earliest return to soundness was 3 1/2 mo...
Stick JA, Jann HW, Scott EA, Robinson NE.We reviewed 91 cases of laminitis in horses admitted to the Michigan State University Veterinary Clinical Center between Jan 1, 1973 and Dec. 30, 1978. From information in the case records and from the results of a telephone questionnaire, cases were classified into 4 categories on the basis of return to athletic function. The degree of pedal bone rotation was inversely correlated with return to athletic performance. Horses with less than 5.5 degrees rotation returned to former athletic function, whereas horses with more than 11.5 degrees rotation lost their use as performance animals. Ponies ...
Stewart B, Reid CF.Osseous cyst-like lesions of the medial femoral condyle were found in 32 horses admitted to the University of Pennsylvania between 1971 and 1978. Sex or breed predilection was not found. In 12 horses, osseous cysts were found in both hindlimbs. Of the 25 horses on which follow-up information was obtained, 16 became sound and useful between 4 months and 1 year after diagnosis. Horses that became lame before 3 years of age had a better chance for later soundness. Horses that became sound had significantly smaller cysts than those that remained lame.
Gunson DE, Kowalczyk DF, Shoop CR, Ramberg CF.Several suspect causes of chronic zinc/cadmium toxicosis in horses near a zinc smelter were investigated following observations of lameness, swollen joints, and unthriftiness, particularly in foals. Two foals born and raised near the smelter were lame and had joint swellings that were attributable to severe generalized osteochondrosis. Zinc and cadmium concentrations were markedly increased in the pancreas, liver, and kidney. The serum of 1 foal, zinc and potassium concentrations were high, whereas calcium and magnesium concentrations were low. Marked nephrocalcinosis and osteoporosis were obs...
Jeffcott LB, Kold SE.A radiographic technique is described for the equine stifle joint with the horse in the standing position or under general anaesthesia. The method with the animal anaesthetised in the dorsal recumbency and the leg extended was preferred because it gave greater flexibility with a better range of views and greatly reduced the safety hazards. In the standing position a useful practical tip for the lateral view was to raise and extent the limb caudally. This provides some flexion and ventral movement of the stifle allowing improved access for the cassette, a more accurate lateral view of the joint...
Sun Y, Chen H, Kandel R, Hurtig M.Lesions in cartilage of equine weightbearing joints commonly result in lameness. Cell-based resurfacing techniques are currently being developed for human and veterinary applications. Biopsies of stifle joint cartilage (1 g) were harvested aseptically and chondrocytes were isolated by sequential enzyme digestion. The cells were grown in vitro on filter inserts. Analysis of cultures 8 weeks later showed that the cells had accumulated extracellular matrix and formed a continuous layer of cartilagenous tissue as determined histologically. The cells maintained their phenotype as they synthesised t...
Ahern BJ, Boston RC, Ross MW.To evaluate equids with enostosis-like lesions (ELLs) and document the clinical and epidemiological features of this disease. Methods: Retrospective case series. Methods: 79 equids with a scintigraphic diagnosis of at least 1 ELL on ≥ 1 occasion. Methods: Medical records of 4,992 equids that underwent bone scintigraphy between March 1997 and March 2009 were reviewed; 78 horses and 1 pony had a scintigraphic diagnosis of an ELL. For those equids, signalment; physical, scintigraphic, radiographic, and lameness examination results; and outcome were reviewed. Results: Of the 79 equids, 4 (5.1%) ...
Ravanetti P, Hamon M, Lechartier A, Zucca E.Surgical repair of unicortical fractures of the distal condyles of the third metacarpal/metatarsal bones (MCIII/MTIII) has been described. In the present case, a bioabsorbable screw was used to stabilize a unicortical fracture in the palmar aspect of the medial condyle of MCIII in a National Hunt Thoroughbred racehorse. The clinical, radiographic, and magnetic resonance imaging findings before and after surgery were recorded. Eighteen weeks after surgery, the lameness had resolved and the bone surrounding the fracture had recovered its normal architecture. One year after surgery, the horse was...
Smith R, Parsons J, Dixon J.Desmopathy of the collateral ligaments of the distal interphalangeal joint is a common cause of equine foot lameness and carries a poor prognosis with conservative management. Intralesional injections may improve healing, although accuracy of radiographically guided injections is significantly less than when guided by MRI, which requires special needles. Longitudinal ultrasound-guided injection of the distal collateral ligament has not been evaluated objectively. In this prospective, anatomic study, seven equine cadaver limbs (14 collateral ligaments) were injected with methylene blue dye and ...
Adkins AR, Yovich JV, Steel CM.To evaluate the outcome of 17 horses that underwent surgical arthrodesis of the tarsometatarsal and distal intertarsal joints for treatment of lameness due to osteoarthritis. Methods: Retrospective clinical study using client-owned animals. Methods: Horses with hindlimb lameness were diagnosed with osteoarthritis of the distal tarsal joints following relief of lameness after intra-articular anaesthesia or intra-articular corticosteroid injection. Surgery to stimulate ankylosis was performed on 27 hocks by placing 3 diverging 3.2 mm drill holes approximately 3 cm through the tarsometatarsal and...
Nemery E, Gabriel A, Piret J, Antoine N.In athletic horses, diseases leading to lameness are of great importance due to the loss of performance and the resultant economic concerns. Although stifle lesions are frequent in the hindlimb, due to the large size and complexity of the joint, and although meniscal tears have been identified as the most common soft tissue injuries in this joint, little is known about the mechanism that causes the painful sensation and thus the lameness. The aim of our study was to highlight any peripheral fibres involved in meniscal nociception in five macroscopically sound cranial horns of the equine medial...
Aldrich ED, Goodrich LR, Contino EK, Kawcak CE, Barrett MF, King MR, Valdés-Martínez A.CASE DESCRIPTION A 12-year-old mixed-breed mare (horse 1) and 6-year-old Friesian gelding (horse 2) were examined for chronic lameness associated with the stifle joint. CLINICAL FINDINGS Lameness examination revealed effusion of the right (horse 1) or left (horse 2) femoropatellar and medial femorotibial joints and grade 3/5 (horse 1) or 4/5 (horse 2) lameness. A diagnosis of cranial cruciate ligament (CCL) injury with associated mineralization and avulsion (horse 1) or mineralization alone (horse 2) was facilitated in both horses with a caudomedial-craniolateral oblique radiographic view obta...
Dabareiner RM, White NA, Sullins KE.Case records and radiographs of 71 horses with subchondral lucency, without radiographic evidence of fracture, located on the distal radial carpal bone were examined retrospectively. All horses had lameness and/or joint effusion referable to the carpus. Distal radial carpal bone subchondral lucency was found as a solitary lesion or as a lesion concurrent and symmetric to a contralateral distal radial carpal bone chip fracture. The lesion appeared radiographically as a lucency or shadow on the distal dorsal margin of the radial carpal bone and was most evident on the flexed lateromedial and dor...
Jackson MA, Ohlerth S, Fürst AE.To describe the use of an aiming device (AD) and computed tomography (CT) for preoperative planning and intraoperative guided debridement of subchondral cystic lesions (SCL) in the limbs of horses and to determine the outcome 12 months after surgery. Methods: Prospective case series. Methods: Twelve horses referred because of lameness caused by 1 or 2 SCL (total of 14 SCL). Methods: All horses underwent CT-guided debridement of the SCL. The entry point of the drill bit and direction of drilling were planned and controlled by using a series of CT images and the AD. The SCL were curetted and fil...
Hanson RR, Brawner WR, Blaik MA, Hammad TA, Kincaid SA, Pugh DG.Fourteen horses with a progressive forelimb lameness of 3 to 12 months' duration, diagnosed as navicular syndrome, were selected from clinical cases admitted to Auburn University Equine Hospital for evaluation of the efficacy of an orally administered nutraceutical (Cosequin, Nutramax Laboratories, Inc., Edgewood, MD) for ameliorating clinical signs associated with naturally occurring navicular syndrome. Horses were randomly allocated to treatment with the nutraceutical or a placebo. Treatment was five scoops (16.5 g) of powder twice daily in the feed. The test group (n = 8) received a patente...
Brown MP, Gronwall RR, Houston AE.Four healthy adult mares were each given a single injection of sodium cefoxitin (20 mg/kg of body weight, IV), and serum cefoxitin concentrations were measured serially during a 6-hour period. The mean elimination rate constant was 1.08/hour and the elimination half-life was 0.82 hour. The apparent volume of distribution (at steady state) and the clearance of the drug were estimated at 0.12 L/kg and 259 ml/hr/kg, respectively. Each mare and 2 additional mares were then given 4 consecutive IM injections of sodium cefoxitin (400 mg/ml) at a dosage of 20 mg/kg. Cefoxitin concentrations in serum, ...
Rich AF, Ricci E, Gates S, Hinnigan GJ, Owen KR.A 20-year-old British Warmblood gelding was presented for a progressively worsening right forelimb lameness which developed following an intense dressage training session. Initial ultrasound examination revealed a triangular, intrathecal, hypoechoic region within the superficial digital flexor tendon (SDFT) in the proximal, palmar carpal region distal to the accessory carpal bone (ACB), extending 7cm distally into the proximal metacarpal region. No significant improvement in clinical presentation was observed following an eight-week rehabilitation programme. Repeat ultrasound examination revea...
Simpson CM, Lumsden JM.A 2-year-old Thoroughbred gelding was evaluated for a grade 3 out of 5 unilateral hind limb lameness. Flexion of the right hock and stifle joints (spavin test) exacerbated the lameness. Response to intra-articular and perineural anaesthesia isolated the source of lameness to the tarsocrural area, despite an absence of tarsocrural joint effusion. Routine radiographic examination of the hock did not reveal any significant abnormalities. Skeletal nuclear scintigraphic evaluation revealed a focal region of increased bone activity in the proximal medial trochlear ridge of the talus. Flexed laterome...
Elane GL, Biedrzycki AH, McCarrel TM, Banks SA, Morton AJ.To quantify the translation and angular rotation of the distal sesamoid bone (DSB) using computed tomography (CT) and medical modeling software. Methods: 30 thoracic limbs from equine cadavers. Methods: Partial (n = 12), full (8), and matched full and subsequently transected (10) thoracic limbs were collected. Bone volume CT images were acquired in three positions: extension (200° metacarpophalangeal angle), neutral (180°), and maximal flexion (110°). Mean translation and angular rotation of each DSB were recorded. Differences were determined with two-way ANOVA and post hoc Tukey's tests fo...
Carlson A, Johnson PJ, Lei Z, Keegan KG.Soluble epoxide hydrolase (sEH) inhibitors are novel anti-inflammatory and analgesic agents that could improve pain management in horses. The objective of the present study was to evaluate the anti-nociceptive effect of a single-dose intravenous administration of the sEH inhibitor trans-4-{4-[3-(4-trifluro-methoxy-phenyl)-ureido]-cyclohexyloxy}-benzoic acid (t-TUCB) using an adjustable heart bar shoe (a-HBS) model of lameness. We hypothesized that t-TUCB would improve objective and subjective lameness measures compared to the control. Methods: Reversible lameness was induced in 8 horses for 24...
Ekman S, Skiöldebrand E, Heinegård D, Hultenby K.One of the most common causes of lameness in racehorses is osteoarthritis (OA). Pathogenesis is not clear and pathological processes of the different joint tissues interact in often progressive events. The interface between cartilage and newly synthesised bone has been shown to be particularly enriched in bone sialoprotein (BSP), a cell-binding matrix protein. Objective: To establish whether changes in the concentration of BSP may serve as a marker for early biochemical changes of the subchondral bone. Methods: Articular cartilage, cartilage/bone interface and subchondral bone of the proximal ...
Sparks HD, Nixon AJ, Boening KJ, Pool RR.To describe the clinical symptoms, treatment, and outcome of meniscal cysts in horses. These structures have not been previously described in the literature as a potential cause of lameness in the horse. Objective: Meniscal cysts are an uncommon condition of the femorotibial joint but can be a significant cause of lameness. Symptoms can be resolved by arthroscopic excision. Methods: Records of horses diagnosed with meniscal cysts and treated by cyst excision and meniscal debridement at 2 surgical practices were reviewed. Clinical outcome was determined by repeat veterinary examination and cont...
Nemeth F.Within the framework of the series 'Papers of yesterday and today', two articles on neurotomy by Moubis (1876 and 1878) are used to evaluate the present status of neurectomy. In 1800 neurotomy was replaced by neurectomy because of the reinnervation which occurred after several weeks. On the basis of a literature review and clinical experience in the Department of Large Animal Surgery the indications, conditions, anatomy, operative techniques, complications and results of neurectomy are discussed. Post-operative neuroma formation is the most important complication following palmar digital neure...
Ball AN, Hoaglund EL, Pool R, Barrett MF, Bass LD.Lameness remains a common cause of retirement in the equine athlete and among hobby enthusiasts. The distal limb is one of the most frequently imaged areas, and recent advances in diagnostic imaging capabilities help practicing veterinarians differentiate normal variants from informative pathology. Although acute, non-weight-bearing lameness is commonly associated with etiologies, such as fractures, abscesses, and laminitis, other uncommon differentials such as cystic lesions and neoplasia might also be considered. This report describes the characterization of a large, cystic lesion in the thi...
Fürst A, Kummer M, Lischer C, Bertolla R, Auer J, Geyer H.Fifty-four horses with hoof cracks were referred to the Equine Hospital of the University of Zurich, for treatment. The horses were admitted because of lameness or other symptoms caused by the cracks. Deep or complicated quarter cracks were the most common type of cracks diagnosed. Poor conformation and abnormal hoof shape were the most important causes of hoof crack development, whereas injury to the coronary band was a less frequently encountered cause. Effective treatment of this problem includes corrective shoeing, removing horn from the weight-bearing surface as well as from the crack wit...
Compagnie E, Ter Braake F, de Heer N, Back W.Report long-term clinical and radiological follow-up in horses after removal of large extensor process fragments occupying >25% of the joint surface of the distal interphalangeal joint (DIJ). Methods: Retrospective case series. Methods: Friesian horses (n=18) that underwent arthroscopic removal of a large extensor process fragment. Methods: Arthroscopic examination of the DIJ was performed in dorsal recumbency with the affected foot in extension using routine portals. Visualization of the fragment was improved using motorized synovial resectors. A dissection plane between the common digital ex...
Rutherford DJ, Textor J, Fretz PB.A 4-week-old Thoroughbred filly presented with lameness of acute, severe onset of the left foreleg (LF) of 3 days' duration. Results: Diffuse swelling was present around the distal radius and carpus of the LF. Carpal varus that could be reduced manually was present. Radiographs revealed an intra- articular frontal-plane fracture in the distal radial epiphysis, which continued cranially through the distal radial physis (DRP). The lateral aspect of the DRP was wider than expected. Latero-medial carpal instability was resolved by placement of a lag screw from the dorsal midline through the epiphy...
Danton CA, Peacock PJ, May SA, Kelly DF.A 16-year-old showjumping gelding was examined because of a non-painful, slowly progressive caudal thigh swelling, which was associated with 2/10th lameness at the trot. Radiography, real time beta-mode ultrasonography and gamma-scintigraphy of the caudal thigh for the presence of chip fractures, sequestrum formation and, or, abscessation were inconclusive. Radiographic examination of the chest revealed multifocal, nodular cannon ball-like opacities throughout the entire lung fields from which a diagnosis of a primary soft tissue tumour with metastasis to the thorax was made. An anaplastic sar...
Dutton DM, Honnas CM, Watkins JP.To determine the outcome of horses with suprascapular nerve injury treated with stall rest alone. Methods: Retrospective case series. Methods: 8 horses. Methods: Information on signalment, history, limbs affected, severity of lameness, degree of muscle atrophy, gait abnormalities, and results of radiography and electromyography was obtained from medical records. All horses were treated with stall rest. Follow-up information on severity of lameness, gait abnormalities, degree of muscle atrophy, time between injury and resolution of gait abnormalities, and outcome was obtained during reexaminati...
Kalck KA, Frank N, Elliott SB, Boston RC.To ascertain whether laminitis can be induced via administration of oligofructose (OF) at doses of 5.0 and 7.5 g/kg in horses and to assess glucose and insulin dynamics before and after treatment. Methods: 19 adult horses. Methods: Horses were fed OF (1.0 g/kg) mixed with oats for 6 days. Oligofructose at doses of 5.0 and 7.5 g/kg was then mixed with 4 L of water and administered (0 hours) to 8 (group A) and 4 (group B) horses, respectively, via nasogastric intubation; 8 horses received water alone. One horse in group A that did not develop laminitis was subsequently treated again and included...
Page AE, Wood C, Partridge E, Horohov DW, Adam E.The use of lipopolysaccharide to induce a localized source of inflammation (acute synovitis) and allow for monitoring of changes in systemic mRNA expression has been recently reported. Here, the goal was to maintain a significant systemic mRNA response while limiting the severity of lameness such that this model can be used to examine the effects of various anti-inflammatory treatment modalities on mRNA expression. Three mixed breeds, four-year-old geldings were utilized for this study. One milliliter of phosphate-buffered saline containing 1,000 ng or less of lipopolysaccharide from E. coli O...
Goodman NL, Baker BK.Lameness problems constitute a major part of racing Quarter Horse practice. This article considers the diagnosis, prognosis, and treatment of the frequently encountered lamenesses. The main conditions included are synovitis, intra-articular fractures, osteochondritis dissecans, and degenerative joint disease as they relate to the coffin, fetlock, carpal, and tarsal joints. Intra-articular injection techniques and medications are discussed because of the frequency of joint disease. Bucked shins and stress fractures are also reviewed.
Grøndahl AM, Gaustad G, Engeland A.Radiographic examination of the metacarpo- and metatarsophalangeal joints was performed on 753 Standardbred trotters (6-21 months of age): 21 showed obvious changes in 26 proximal sesamoid bones on lateromedial projection. The radiographic changes were divided into 6 different types: (1) irregular abaxial margin (8 horses); (2) enlargement of the sesamoid bone (6 horses); (3) 'fracture' or separate centre of ossification of the apex (4 horses); (4) vertical, non-articular fracture of the plantar part of the sesamoid bone (1 horse); (5) a small bony fragment located in a defect in the apical pa...
Major MD, Grant BD, White KK, Ratzlaff MH, Gallina AM, Donati RM.The suspensory apparatus of one forelimb was surgically disrupted in six adult horses by transecting the distal sesamoidean ligaments. A double-braided prosthetic ligament made of aramid yarn was installed to support the flexor surface of the metacarpophalangeal joint. The prosthesis was routed through tunnels in the third metacarpal bone and proximal phalanx, and secured to bone with screws. Evaluation by radiography, synovial fluid analysis, cinematography, and dynamography was performed before surgery and at weeks 16 and 30. Supracondylar cortical lysis and periosteal proliferation were obs...