Ligaments in horses are fibrous connective tissues that connect bones to other bones, providing stability and support to the skeletal structure. These structures are integral to maintaining joint function and facilitating movement. In equine anatomy, ligaments are involved in various functions, including supporting the limbs and allowing for efficient locomotion. Common ligaments in horses include the suspensory ligament, which plays a significant role in supporting the fetlock joint, and the nuchal ligament, which supports the head and neck. This page compiles peer-reviewed research studies and scholarly articles that explore the anatomy, function, injury mechanisms, and rehabilitation of ligaments in horses.
Antunes J, Salcedo-Jiménez R, Lively S, Potla P, Coté N, Dubois MS, Koenig J, Kapoor M, LaMarre J, Koch TG.Osteoarthritis (OA) is a leading cause of lameness in horses with no effective disease-modifying treatment and challenging early diagnosis. OA is considered a disease of the joint involving the articular cartilage, subchondral bone, synovial membrane, and ligaments. Osteochondritis dissecans (OCD) is a joint disease consisting of focal defects in the osteochondral unit which may progress to OA later in life. MicroRNAs (miRNAs) have been recognized as small non-coding RNAs that regulate a variety of biological processes and have been detected in biological fluids. MiRNAs are currently investiga...
Larsen EA, Williams MR, Schoonover MJ, Jurek KA, Young JM, Duddy HR.Navicular syndrome is a common cause of forelimb lameness in horses. Beyond changes to the navicular bone itself, horses with a clinical diagnosis of navicular syndrome often have pathology associated with other components of the navicular apparatus, including the navicular bursa, deep digital flexor (DDF) tendon, collateral sesamoidean ligaments, and impar ligament. Palmar digital neurectomy (PDN) is often used as a salvage procedure for horses diagnosed with navicular syndrome that become unresponsive to medical management. There are many potential complications associated with PDN, some of ...
Pérez Fraile A, González-Cubero E, Martínez-Flórez S, Olivera ER, Villar-Suárez V.Musculoskeletal injuries in horses have a great economic impact, predominantly affecting tendons, ligaments, and cartilage, which have limited natural regeneration. Cell therapy, which uses mesenchymal stem cells due to their tissue differentiation properties and anti-inflammatory and immunoregulatory effects, aims to restore damaged tissue. In this manuscript, we performed a systematic review using the Parsifal tool, searching the PubMed and Web of Science databases for articles on regenerative medicine for equine musculoskeletal injuries. Our review covers 17 experimental clinical studies ca...
Frontiers in geneticsAugust 14, 2023
Volume 14 1201628 doi: 10.3389/fgene.2023.1201628
Momen M, Brauer K, Patterson MM, Sample SJ, Binversie EE, Davis BW, Cothran EG, Rosa GJM, Brounts SH, Muir P. Spontaneous rupture of tendons and ligaments is common in several species including humans. In horses, degenerative suspensory ligament desmitis (DSLD) is an important acquired idiopathic disease of a major energy-storing tendon-like structure. DSLD risk is increased in several breeds, including the Peruvian Horse. Affected horses have often been used for breeding before the disease is apparent. Breed predisposition suggests a substantial genetic contribution, but heritability and genetic architecture of DSLD have not been determined. To identify genomic regions associated with DSLD, we recr...
Barrett MF, Goorchenko GE, Frisbie DD.Damage to the soft tissue structures of the digit is a common source of equine lameness. While magnetic resonance imaging (MRI) allows for the most complete diagnostic imaging of the equine digit, ultrasound is more readily available and less expensive. This prospective diagnostic accuracy study compares ultrasound to MRI for the diagnosis of injuries visible with ultrasound within the digit, including the deep digital flexor tendon (DDFT), collateral sesamoidean ligament (CSL), and navicular bursa. Clinical patients underwent an MRI of the digit and a blinded ultrasound of the digit between t...
Schade J, de Souza AF, Vincensi LC, Müller TR, Fonteque JH.The objective of this study was to evaluate and compare the sonographic characteristics of the digital flexor tendons and ligaments of the palmar/plantar of the metacarpal and metatarsal regions in gaited horses, as well as to establish normal reference ultrasound values for Mangalarga Marchador (MM) and Campeiro breeds. Transverse sonographic images were obtained of 50 adult and healthy horses from the MM (n = 25) and Campeiro (n = 25) breeds. The images were taken in six metacarpal/metatarsal zones, and the following measurements were taken: transverse area, circumference, dorsopalmar/planta...
Fraschetto C, Dancot M, Vandersmissen M, Denoix JM, Coudry V.To describe type and distribution of tarsal collateral ligament (CL) injuries and to assess the long-term outcome in horses treated conservatively. Methods: 78 horses (median age, 7 years [IQR, 4 to 9.75 years]) of different breeds and disciplines. Methods: Retrospective analysis (2000 through 2020) of horses with tarsal CL lesions diagnosed on ultrasound. The resting time, ability to return to work, and performance level after the injury were compared between horses having a single ligament (group S) or multiple ligaments (group M) affected and according to the case severity. Results: Most of...
Leal Reis I, Lopes B, Sousa P, Sousa AC, Branquinho M, Caseiro AR, Pedrosa SS, Rêma A, Oliveira C, Porto B, Atayde L, Amorim I, Alvites R, Santos JM....Tendon and ligament injuries are frequent in sport horses and humans, and such injuries represent a significant therapeutic challenge. Tissue regeneration and function recovery are the paramount goals of tendon and ligament lesion management. Nowadays, several regenerative treatments are being developed, based on the use of stem cell and stem cell-based therapies. In the present study, the preparation of equine synovial membrane mesenchymal stem cells (eSM-MSCs) is described for clinical use, collection, transport, isolation, differentiation, characterization, and application. These cells are ...
Likon I, Dyson S, Nagy A.Proximal metacarpal injury is common in endurance horses, yet exercise-induced changes in this region have not been described. This study aimed to document objective exercise-induced changes in the proximal palmar cortex of the third metacarpal bone (PcMcIII) and the suspensory ligament (SL). Low-field magnetic resonance (MR) images of both proximal metacarpal regions were obtained from six novice and six experienced horses, before and after six months of endurance training. Measurements were acquired in T1-weighted transverse MR images at four levels and included the thickness of the PcMcIII,...
Toner S, Crosby C.A 6-year-old chestnut Dutch Warmblood gelding was presented for right front lameness 1 mo after being cast in a stall at a 1.20-meter jumping event. Lameness work-up revealed mild lameness on the right and left front legs, with diffuse swelling over the right front pastern. Ultrasonic evaluation yielded suspicion of collateral desmopathy of the proximal interphalangeal joint that was subsequently confirmed via MRI. Two weeks after initial evaluation, the proximal and distal interphalangeal joints were injected with Pro-Stride Autologous Protein Solution, immediately followed by Extracorporeal ...
Brown KA, Johnson AL, Bender SJ, Nolan TJ, Pfisterer B, Slack J, Willis E, Rule EK.A 5-year-old imported Zangersheide gelding was evaluated for SC swellings over both forelimbs and lameness localized to the distal metacarpus. Ultrasound examination of the SC masses was compatible with verminous granulomas. Linear hyperechoic foci were present within the suspensory ligament branches of both forelimbs, suggestive of ligamentous parasitic infiltrates. A diagnosis of onchocerciasis was confirmed on biopsy of a SC mass. The gelding was treated with ivermectin and a tapering course of PO dexamethasone but was eventually euthanized. Necropsy confirmed the presence of SC eosinophili...
Lin ST, Peter VG, Schiavo S, Pokora R, Patrick H, Bolas N, Foote AK, Sargan DR, Murray RC.Heterotopic mineralization in equine distal limbs has been considered an incidental finding and little is known about its imaging features. The study aimed to identify heterotopic mineralization and adjacent pathology in the fetlock region with cone-beam (CB) computed tomography (CT), fan-beam (FB) CT, and low-field magnetic resonance imaging (MRI). Images from 12 equine cadaver limbs were examined for heterotopic mineralization and adjacent pathology and verified by macro-examination. Retrospective review of the CBCT/MR images from 2 standing horses was also included. CBCT and FBCT identified...
Fjordbakk CT, Marques-Smith P.Interpretation of patellar ligament (PL) ultrasonography may be difficult, as hypoechoic or heterogenous echogenicity are common findings. Verifying suspected disease of equine PLs by histopathology is also problematic as descriptions of normal PL vascularity and histology are scarce. The current study describes the PL and infrapatellar fat pad (IFP) vascular pattern from computed tomography scans of barium perfused normal equine specimens (n = 8; age 10 days to 18 years), as well as routine histology to serve as a reference for future investigations into PL pathology and IFP disease. Re...
Cannon JK, Ellis KL.Striations are present on ultrasonography of the intermediate (middle) patellar ligament in the transverse plane, which can be confused with tears. Comparison to the contralateral limb is often performed to help differentiate anatomic variation from pathologic change. The purposes of this prospective, observational study were to describe the striation patterns in Warmbloods and Quarter Horses, determine if these patterns are bilaterally symmetrical, and compare striation characteristics between Warmbloods and Quarter Horses. The intermediate patellar ligaments of six Warmblood horses and six Q...
De Gasperi D, Guo D, Guo D, Lu Y, Brounts SH.To develop and describe a minimally invasive, ultrasound-guided, percutaneous technique for the desmotomy of equine palmar/plantar annular ligaments (PALs) using a transecting thread. Methods: Ex vivo study. Methods: Twenty-one normal equine distal limb specimens. Methods: Under ultrasonographic guidance, a surgical thread was percutaneously placed around the PAL through 2 skin punctures (proximal and distal) using a 18 gauge spinal needle in equine limbs (11 forelimbs, 10 hindlimbs) with normal PALs. The ligament was transected by a back-and-forth motion of the thread until the loop emerged...
Manfredi JM, Jacob S, Norton E.Endocrine disorders are associated with joint pain and tendon injury in humans, but the effects in the horse are only starting to be understood. Similar patterns of clinical signs and injury appear to affect horses and humans for both orthopedic and endocrine disorders, supporting the use of a one-health approach to tackle these issues. In this Currents in One Health, we will discuss common equine endocrinopathies, current testing recommendations, dietary management, genetic predispositions, and endocrine disorders' effects on performance. Our aim is to use a one-health lens to describe curren...
Boström A, Asplund K, Bergh A, Hyytiäinen H.To explore the scientific evidence for therapeutic ultrasound (TU), we conducted a systematic review of the literature on TU in dogs, horses, donkeys, and cats. Methods: In three major databases, relevant articles published in 1980-2020 were identified. The risk of bias in each article was evaluated. Results: Twenty-four relevant articles on the effects of TU in dogs, nine in horses, two in donkeys, and one in cats were identified. TU usually involved 2-6 treatments weekly for up to 4 weeks. Articles on tendon, ligament, and bone healing, acute aseptic arthritis, osteoarthritis, paraparesis, h...
Depuydt E, Chiers K, Van Hecke L, Saunders J, Martens A, Pille F, Spaas JH.Injuries to equine tendons and ligaments are career-compromising, causing reduced performance and premature retirement. Promising treatment alternatives have been investigated in the field of mesenchymal stem cells (MSCs). In this study, the tissue adherence and protein expression of tenogenic primed mesenchymal stem cells (tpMSCs) after administration to ex vivo tendon and ligament explants is investigated. First, collagen type I (COL I) and smooth muscle actin (SMA) expression was assessed in cytospins prepared from native MSCs and tpMSCs. Second, equine superficial digital flexor tendon and...
Boström A, Bergh A, Hyytiäinen H, Asplund K.Extracorporeal shockwave therapy (ECSWT) is increasingly used to treat different types of musculoskeletal conditions in sport and companion animals. To explore the scientific basis for the treatment, we conducted a systematic review of the literature on ECSWT used in horses, dogs, and cats. Methods: Relevant articles published in 1980-2020 were identified from three major databases. Each article was assessed for risk of bias. Results: The review identified 27 relevant articles on the effects of ECSWT in horses, nine in dogs, but none in cats. Typically, ECSWT involved one to three treatment se...
Duddy HR, Schoonover MJ, Hague BA.Tendon and ligament injuries are significant causes of loss of use and early retirement in performance horses. Amniotic fluid and tissue are excellent sources of growth factors and cytokines important in tendon and ligament healing. Thus, an equine-origin liquid amnion allograft (ELAA) may be beneficial in the treatment of equine tendonitis and desmitis. Objectives of this study were to report the outcome achieved (i.e. ability to return to work) for horses diagnosed with tendonitis or desmitis lesions treated with local injection of ELAA and to compare these outcomes to those reported for oth...
Sullivan HM, Barrett MF, Zhou T, Kawcak CE.Ultrasound remains a mainstay in proximal suspensory ligament (PSL) evaluation. Despite recent improvements facilitating earlier diagnosis/treatment, needs exist for (1) characterization of normal ultrasonographic PSL cross-sectional area (CSA) in specific breeds/disciplines, (2) improved detection of early/subtle changes in the PSL, and (3) an understanding of suspensory ligament (SL) morphology change from work-related stress. The objectives of this study were to establish normal PSL CSA in Quarter Horses (QH) used for cutting via angle contrast ultrasonography, ultrasonographically monitor ...
Gerdes C, Morgan R, Terry R, Foote A, Smith R.This descriptive anatomical study investigates the relationship between the third interosseous muscle, also known as the suspensory ligament, and the carpometacarpal joint in forelimbs of horses, with the hypothesis that there was a direct synovial communication between these structures as shown by computed tomographic arthrography, histology, and gross anatomy sections. Computed tomography of the carpus and metacarpal region was performed on two groups. Group 1 consisted of eight cadaver limbs undergoing computed tomographic arthrography following injection of a mixture of positive contrast m...
Bernardino PN, Smith WA, Galuppo LD, Mur PE, Cassano JM.Mesenchymal stromal (stem) cells (MSCs) have been studied to treat many common orthopedic injuries in horses. However, there is limited information available on when and how to use this treatment effectively. The aim of this retrospective study is to report case features, treatment protocols, and clinical outcomes in horses treated with MSCs. Methods: 65 horses presenting with tendinous, ligamentous, and articular injuries, and treated with MSCs prepared by a single laboratory between 2016 and 2019. Outcome information was available for 26 horses. Methods: Signalment, clinical signs, diagnosti...
Momen M, Brounts SH, Binversie EE, Sample SJ, Rosa GJM, Davis BW, Muir P.Degenerative suspensory ligament desmitis is a progressive idiopathic condition that leads to scarring and rupture of suspensory ligament fibers in multiple limbs in horses. The prevalence of degenerative suspensory ligament desmitis is breed related. Risk is high in the Peruvian Horse, whereas pony and draft breeds have low breed risk. Degenerative suspensory ligament desmitis occurs in families of Peruvian Horses, but its genetic architecture has not been definitively determined. We investigated contrasts between breeds with differing risk of degenerative suspensory ligament desmitis and ide...
Mieszkowska M, Abako J, Mieszkowski M, Zhalniarovich Y.Desmopathy of the collateral ligaments of the equine interphalangeal joint is caused by a combination of factors, including hoof shape, excessive loading and ground surface. This complex problem poses a diagnostic challenge due to the non-specificity of perineural analgesia and the limitations associated with the most popular imaging methods such as radiography and ultrasonography. The aim of this study was to retrospectively determine the prevalence of desmopathy of the collateral ligaments of the equine distal interphalangeal joint in Poland between 2016 and 2019, and to establish the freque...
Biedrzycki AH, Elane GL. Interspinous ligament desmotomy (ISLD) has been shown to improve the comfort of horses diagnosed with overriding dorsal spinous processes (DSP), but its effects on spine mobility are unknown. To objectively quantify the change in mobility of thoracic vertebrae following ISLD using CT and medical modeling software. Prospective cadaveric manipulation of seven equine thoracolumbar spines collected from T11-L1. Spines were collected from T11-L1 with the musculature intact. Flexion and extension phases were achieved with a ratchet device calibrated to 2000N. Bone volume CT scans were performed ...
Tokawa PKA, Brossi PM, Baccarin RYA.This systematic review aims to compile and present information of studies evaluating the effectiveness of autologous conditioned serum (ACS) in the healing of tendon, ligament and articular lesions in humans and horses. A systematic search of articles using Medline, PubMed, Embase, Bireme and Google Scholar was conducted up to August 2020. Studies regarding ACS' use in human orthopedic lesions were included if classified as RCTs, cohort and case-controls. All studies regarding this therapy in equine medicine were included given their scarcity. Pre-clinical experimental studies were selected if...
Aßmann AD, Ohlerth S, Suárez Sánchez-Andráde J, Torgerson PR, Bischofberger AS.To determine the diagnostic performance of computed tomographic arthrography (CTA) and 3 Tesla magnetic resonance imaging (MRI) for detecting artificial meniscal, meniscotibial ligament (MTL) lesions and cruciate ligament (CL) lesions in horses. Methods: Ex vivo controlled laboratory study. Methods: Nineteen stifles from adult horses. Methods: Stablike defects (n = 84) (16 mm long, 10 mm deep) were created in the menisci (n = 35), CLs (n = 24), and MTLs (n = 25) via arthroscopy prior to MRI and CTA (80 mL contrast at 85 mg/mL per joint). Two radiologists, unaware of the lesions...
José Antonio G, Jim S, Ramés SJ, Rohrbach BW, Alejandro Rodríguez M, Laura Romero R, Robert D.To examine changes occurring in normal pelvic suspensory ligaments (SLs) of horses after denervating these ligaments and to investigate the effect chronic inflammation might have on these changes. Methods: 10 horses. Methods: The SL of 1 randomly selected pelvic limb of each of 5 horses was injected with collagenase to induce desmitis, and 42 days later, the proximal aspect of both pelvic SLs were denervated. The SLs were harvested 120 days after being denervated, and the morphological and histological characteristics of each collagenase-injected, denervated SL were compared with those of the ...
Bardin AL, Taylor NC, Robert Colborne G.Thoroughbred racehorses are often affected by musculoskeletal injuries, leading to involuntary rest, early retirement or death. Hardness and consistency of the track surface have been implicated as major risk factors for limb injury. The purpose was to test the utility of a preliminary AnyBody musculoskeletal model of the equine forelimb for its responses on two perturbing surfaces. A musculoskeletal model was developed using CT, muscle, tendon and ligament properties, and kinematic data were applied from ridden trials using five Thoroughbred horses. Horses were ridden at trot and canter on a ...
Schnabel LV, Lynch ME, van der Meulen MC, Yeager AE, Kornatowski MA, Nixon AJ.Tendinitis remains a catastrophic injury among athletes. Mesenchymal stem cells (MSCs) have recently been investigated for use in the treatment of tendinitis. Previous work has demonstrated the value of insulin-like growth factor-I (IGF-I) to stimulate cellular proliferation and tendon fiber deposition in the core lesion of tendinitis. This study examined the effects of MSCs, as well as IGF-I gene-enhanced MSCs (AdIGF-MSCs) on tendon healing in vivo. Collagenase-induced bilateral tendinitis lesions were created in equine flexor digitorum superficialis tendons (SDFT). Tendons were treated with ...
Thorpe CT, Godinho MSC, Riley GP, Birch HL, Clegg PD, Screen HRC.While the predominant function of all tendons is to transfer force from muscle to bone and position the limbs, some tendons additionally function as energy stores, reducing the cost of locomotion. Energy storing tendons experience extremely high strains and need to be able to recoil efficiently for maximum energy storage and return. In the equine forelimb, the energy storing superficial digital flexor tendon (SDFT) has much higher failure strains than the positional common digital extensor tendon (CDET). However, we have previously shown that this is not due to differences in the properties of...
Ferris DJ, Frisbie DD, Kisiday JD, McIlwraith CW, Hague BA, Major MD, Schneider RK, Zubrod CJ, Kawcak CE, Goodrich LR.To report outcome of horses with femorotibial lesions (meniscal, cartilage or ligamentous) treated with surgery and intra-articular administration of autologous bone marrow derived mesenchymal stem cells (BMSCs). Methods: Prospective case series. Methods: Horses (n = 33). Methods: Inclusion criteria included horses that had lameness localized to the stifle by diagnostic anesthesia, exploratory stifle arthroscopy and subsequent intra-articular administration of autologous BMSCs. Case details and follow-up were gathered from medical records, owner, trainer or veterinarian. Outcome was defined as...
Thorpe CT, Clegg PD, Birch HL.Tendon injury is one of the most common causes of wastage in the performance horse; the majority of tendon injuries occur to the superficial digital flexor tendon (SDFT) whereas few occur to the common digital extensor tendon. This review outlines the epidemiology and aetiology of equine tendon injury, reviews the different functions of the tendons in the equine forelimb and suggests possible reasons for the high rate of failure of the SDFT. An understanding of the mechanisms leading to matrix degeneration and subsequent tendon gross failure is the key to developing appropriate treatment and p...
Smith RK, Zunino L, Webbon PM, Heinegård D.A protein prominent in guanidine hydrochloride extracts of adult bovine and equine digital flexor tendons was confirmed to be Cartilage Oligomeric Matrix Protein (COMP) by non-reducing and reducing SDS-PAGE, reaction with rabbit anti-COMP polyclonal antiserum on Western blots, trypsin digestion followed by HPLC on a C2/C18 column, and identification of COMP mRNA from tendon on Northern blots. Immunohistochemistry and Western blots of extracts showed COMP to be present in all regions of digital flexor tendons. Equine tendon COMP was purified by ion exchange chromatography and gel filtration and...
Lomas AJ, Ryan CN, Sorushanova A, Shologu N, Sideri AI, Tsioli V, Fthenakis GC, Tzora A, Skoufos I, Quinlan LR, O'Laighin G, Mullen AM, Kelly JL....Tendon injuries represent a significant clinical burden on healthcare systems worldwide. As the human population ages and the life expectancy increases, tendon injuries will become more prevalent, especially among young individuals with long life ahead of them. Advancements in engineering, chemistry and biology have made available an array of three-dimensional scaffold-based intervention strategies, natural or synthetic in origin. Further, functionalisation strategies, based on biophysical, biochemical and biological cues, offer control over cellular functions; localisation and sustained relea...
Torricelli P, Fini M, Filardo G, Tschon M, Pischedda M, Pacorini A, Kon E, Giardino R.Tissue repair in musculoskeletal injuries is often a slow and sometimes incomplete process. Regenerative medicine based on the use of growth factors (GFs) and cell therapy is aimed at improving the quality and speed of tendon and ligament healing. The aim of this study was to evaluate the potential for the administration of a combination of autologous platelet-rich plasma (PRP) and freshly isolated bone marrow mononucleated cells (BMMNCs) in 13 competition horses affected by overuse musculoskeletal injuries (suspensory ligament desmopathy and superficial flexor tendinopathy) and refractory to ...
McGuigan MP, Wilson AM.A horse's legs are compressed during the stance phase, storing and then returning elastic strain energy in spring-like muscle-tendon units. The arrangement of the muscle-tendon units around the lever-like joints means that as the leg shortens the muscle-tendon units are stretched. The forelimb anatomy means that the leg can be conceptually divided into two springs: the proximal spring, from the scapula to the elbow, and the distal spring, from the elbow to the foot. In this paper we report the results of a series of experiments testing the hypothesis that there is minimal scope for muscle cont...
Ely ER, Avella CS, Price JS, Smith RK, Wood JL, Verheyen KL.While fractures and tendon injuries are known to be important diseases in National Hunt (NH) racehorses during racing, there are no accurate estimates of their incidence in NH training yards. Objective: To estimate the incidence of fractures and tendon and suspensory ligament injuries (TLIs) in NH racehorses in training; to describe the injuries incurred and to compare injury incidence rates by horse age, trainer, gender and background (ex-flat vs. ex-store horses). Methods: Cohort data were collected from 14 UK NH training yards for 2 racing seasons. Daily exercise regimens and details of fra...
Clegg PD, Strassburg S, Smith RK.Injuries to tendons are common in both human athletes as well as in animals, such as the horse, which are used for competitive purposes. Furthermore, such injuries are also increasing in prevalence in the ageing, sedentary population. Tendon diseases often respond poorly to treatment and require lengthy periods of rehabilitation. The tendon has a unique extracellular matrix, which has developed to withstand the mechanical demands of such tensile-load bearing structures. Following injury, any repair process is inadequate and results in tissue that is distinct from original tendon tissue. There ...
Birch HL, Bailey JV, Bailey AJ, Goodship AE.Specific tendons show a high incidence of partial central core rupture which is preceded by degeneration. In the performance horse, the superficial digital flexor tendon (SDFT) is most often affected. We have described previously the molecular changes that are associated with degeneration in the central core region of the equine SDFT. The pathophysiological mechanism leading to change in synthetic activity of central zone cells in degenerated tendons is not known. In this study, we test the hypothesis that ageing results in matrix composition changes within the central zone of the SDFT. Extrac...
Reed SA, Johnson SE.Mesenchymal stem cells (MSCs) offer promise as therapeutic aids in the repair of tendon, ligament, and bone damage suffered by sport horses. The objective of the study was to identify and characterize stem-like cells from newborn foal umbilical cord blood (UCB). UCB was collected and MSC isolated using human reagents. The cells exhibit a fibroblast-like morphology and express the stem cell markers Oct4, SSEA-1, Tra1-60 and Tra1-81. Culture of the cells in tissue-specific differentiation media leads to the formation of cell types characteristic of mesodermal and endodermal origins. Chondrogenic...
Parry DA, Craig AS, Barnes GR.A study has been made of the ultrastructural organization of the collagen fibrils and elastic fibres in tendons and ligaments from horses of ages ranging from 2 months premature to 19 years. Diameter distributions of the collagen fibrils in the common digital extensor tendon, the superficial flexor tendon and the suspensory ligament are unimodal in the foetal tissue and at birth, and at these stages of development the three collagenous tissues are virtually indistinguishable. However, at maturity, the ligament and flexor tendon have bimodal distributions similar to that found for rat-tail tend...
Goodship AE, Birch HL, Wilson AM.Injury of the collagenous structures comprising tendons and ligaments, either from acute trauma or from repetitive strain lesions, results in protracted periods of disability. The resolution of such injuries often fails to restore the normal morphologic and functional characteristics of the structure and, therefore, either compromises the future performance of the individual or predisposes to an increased risk of recurrent injury.
Becerra P, Valdés Vázquez MA, Dudhia J, Fiske-Jackson AR, Neves F, Hartman NG, Smith RK.This study aimed to investigate immediate cell survival and distribution following different administration routes of mesenchymal stem cells (MSCs) into naturally occurring tendon injuries. Ten million MSCs, labeled with technetium-99m hexamethylpropyleneamine oxime, were implanted into 13 horses with naturally occurring tendon or ligament injuries intra-lesionally, intravenously and by regional perfusion, and traced for up to 48 h using planar gamma scintigraphy. Labeling efficiencies varied between 1.8% and 18.5% (mean 9.3%). Cells were retained in the damaged area after intra-lesional adm...
Fortier LA, Smith RK.After tendon injury, the scar tissue that replaces the damaged tendon results in a substantial risk for reinjury. The goal of regenerative therapies is to restore normal structural architecture and biomechanical function to an injured tissue. Successful restoration processes for any tissue are thought to recapitulate those of development, in which there are spatial and temporal interactions between scaffold, growth factors, and cell populations.
Bosch G, de Mos M, van Binsbergen R, van Schie HT, van de Lest CH, van Weeren PR.Extracorporeal shock wave therapy (ESWT) is frequently used in equine practice, but little is known about its biological action. Objective: To study the effects of ESWT on matrix structure and gene expression levels in normal, physiologically loaded tendinous structures in ponies. Methods: Six Shetland ponies, free of lameness and with ultrasonographically normal flexor and extensor tendons and suspensory ligaments (SL), were used. ESWT was applied at the origin of the suspensory ligament and the mid-metacarpal region of the superficial digital flexor tendon (SDFT) 6 weeks prior to sample taki...
Ortved KF.Tendon and ligament injuries are a common source of lameness in the athletic horse. Although tendons and ligaments have the ability to spontaneously heal, lesions tend to fill with biomechanically inferior fibrous tissue such that the horse is prone to reinjury. Regenerative medicine is used to improve quality of repair tissue and prevent reinjury. Platelet-rich plasma, stem cells, and autologous conditioned serum are the most commonly used orthobiologics in the horse. A tailored rehabilitation program is key to returning horses to athleticism following injury. The specifics of regenerative me...
Harrison SM, Whitton RC, Kawcak CE, Stover SM, Pandy MG.The equine metacarpophalangeal (MCP) joint is frequently injured, especially by racehorses in training. Most injuries result from repetitive loading of the subchondral bone and articular cartilage rather than from acute events. The likelihood of injury is multi-factorial but the magnitude of mechanical loading and the number of loading cycles are believed to play an important role. Therefore, an important step in understanding injury is to determine the distribution of load across the articular surface during normal locomotion. A subject-specific finite-element model of the MCP joint was devel...
Mesenchymal stem cells (MSCs) offer promise as therapeutic aids in the repair of tendon and ligament disorders in sport horses. Equine allogeneic MSCs derived from umbilical cord blood (eUCB-MSCs) can be obtained in a minimally invasive fashion with successful propagation of MSCs. Objective: The objective of this study was to determine the applicability and therapeutic effect of eUCB-MSCs on tendinitis of the superficial digital flexor tendon, desmitis of the suspensory ligament, tendinitis of the deep digital flexor tendon, and desmitis of the inferior check ligament in clinical cases. Method...
Murray RC, Dyson SJ, Tranquille C, Adams V.Although anecdotal reports of increased orthopaedic injury risk in equine sports exist, there is little scientific evidence to support this. Objective: To test whether horses undertaking a single competitive sport have increased risk of specific injuries compared to those used for general purpose riding (GP); and whether injury type varies with sport category and performance level. Methods: Data from 1069 records of horses undergoing orthopaedic evaluation (1998-2003) and meeting inclusion criteria were reviewed. Sport category (GP, showjumping, dressage, eventing, racing), level (nonelite or ...
Evans CH, Chevalier X, Wehling P.Autologous conditioned serum was developed in the mid 1990s as an expeditious, practical, and relatively inexpensive means of generating the interleukin-1 receptor antagonist, a naturally occurring inhibitor of the cytokine interleukin-1. The latter is thought to be an important mediator of inflammation, pain, and tissue destruction in musculoskeletal conditions. ACS has been widely and successfully used in the local treatment of human and equine osteoarthritis and radicular compression; it has also shown promise in treating tendinopathies, muscle injuries, and tunnel widening after reconstruc...
Crevier-Denoix N, Collobert C, Pourcelot P, Denoix JM, Sanaa M, Geiger D, Bernard N, Ribot X, Bortolussi C, Bousseau B.The objective of this study was to mechanically characterise superficial digital flexor tendon (SDFT) lesions. Eight pathological SDFTs, isolated from 6 adult horses, were tested in traction until rupture (at 1 mm/s). The stresses and strains simultaneously undergone by each of the 7 segments of a tendon were determined throughout the test, and the modulus of elasticity of each segment was evaluated from the segmental stress-strain curve thus obtained. These mechanical data were compared to those obtained on 10 normal SDFTs. After the test, the tendinous segments were submitted to a histologic...
Clegg PD.Tendon and ligament injuries continue to be one of the most frequent causes of orthopaedic injury and early retirement in the Thoroughbred racehorse. In the UK, the Horserace Betting Levy Board has invested considerable research funding in the last decade in order to investigate aspects of tendon epidemiology, biology and therapy, in order to decrease both the welfare and economic consequence of such injuries. This review summarises key aspects of this research effort and identifies specific research directions for the future.
Smith JJ, Ross MW, Smith RK.The purpose of this study was to investigate the response of suspensory ligament fibroblasts (SLF) to in vitro stimulation using acellular bone marrow (ABM), platelet rich plasma (in vitro PRP), and serum as potential treatment modalities for suspensory desmitis. Blood, bone marrow, and suspensory ligaments were collected from five horses. SLF were harvested, grown until confluent, and stimulated with various concentrations of ABM, PRP, equine serum, foetal bovine serum, and medium (control). The responses to the treatments were assessed using a combination of radio-labeling for total protein ...
Shrivastava SK, Kailash .Extracorporeal shock wave therapy in orthopedics and traumatology is still a young therapy method. Since the last few years the development of shock wave therapy has progressed rapidly. Shock waves have changed the treatment of urolithiasis substantially. Today shock waves are the first choice to treat kidney and urethral stones. Urology has long been the only medical field for shock waves in medicine. Meanwhile shock waves have been used in orthopedics and traumatology to treat insertion tendinitis, avascular necrosis of the head of femur and other necrotic bone alterations. Another field of ...
Innes JF, Clegg P.Examples of naturally occurring musculoskeletal disorders are extremely common in veterinary species and provide a valuable comparative research resource, which can provide compelling comparative data on the aetiopathogenesis and treatment of many common human musculoskeletal diseases. In particular, orthopaedic diseases are a common morbidity in both dogs and horses. In this review, we give an overview of the common musculoskeletal diseases encountered in these species: for instance, tendon and ligament injuries, arthropathies and stress fractures, as well as an insight into the basic biology...
Baker GJ, Moustafa MA, Boero MJ, Foreman JH, Wilson DA.The caudal cruciate ligament assists the medial femorotibial ligament in supporting the medial aspect of the femorotibial joint. It also limits the outward rotation of the tibia during weight bearing. In two lame horses tearing of the caudal portion of the femoral attachment of the caudal cruciate ligament was recorded together with cracking and tearing of the medial meniscus. In one case, synovitis and restrictive fibrous periarthritis were the sequelae of secondary stifle sepsis.
Gupte CM, Bull AM, Murray R, Amis AA.The purpose of this study was to investigate the presence, position and relative sizes of the meniscofemoral ligaments (MFL) in three quadrupeds and humans and relate these to the caudal slope of the lateral tibial plateau. Canine, ovine and equine stifles and human knees were dissected to identify the presence of MFLs, their obliquity in relation to the caudal cruciate ligaments (CCL), the relative size and shape of the MFLs compared with the CCL, the points of femoral attachment of the MFLs and CCL, and the distance between the MFLs and CCL at their midpoints. The lateral tibial condyle was ...
Haussler KK.A thorough understanding of the structure and function of the equine vertebral column can provide a clearer understanding of thoracolumbar spinal disorders. Three primary functions of the vertebral column include protection of the spinal cord, support for weight bearing, and flexibility for locomotion. Osseous structures provide structural support and vary from one vertebral region to another as functional requirements change. The spinal musculature produces complex vertebral movements while the spinal ligaments provide stability to the vertebral column. Proprioception and nociception are two ...
