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.
Garrett PD.Thoracic limbs from 8 horses were dissected. The dorsoscapular ligament was determined to consist of a collagenous part that fused to the surface of the thoracolumbar fascia and of an elastic part that extended laterally from the collagenous part to attach to the medial surface of the scapula and interdigitate with fibers of the serratus ventralis thoracis muscle.
Palmieri G, Sanna L, Asole A, Farina V, Bo Minelli L.The origin and course of the collateral sesamoidean (suspensory navicular) ligament of the horse and ass and its attachment to the distal sesamoid bone were studied by means of dissection. Particular attention was given to the topographic relations between this ligament and the deep digital flexor tendon. Numerous sensitive nerve endings are present in this anatomical district. The free and encapsulated nerve endings, displayed by impregnating techniques, are mostly concentrated in the ligament tract connected to the above-named tendon and close to its attachment to the distal sesamoid angle. ...
Jann HW, Stein LE, Good JK.Size 3-0 polydioxanone was used as a single strand, single braid (3 strands), or double braid (6 strands) to create six suture material-pattern combinations for equine tenorrhaphy: single-strand locking loop, single-braid locking loop, double-braid locking loop, single-strand three-loop pulley, single-braid three-loop pulley, and double-braid three-loop pulley. Maximum load to failure for the single-strand locking loop (46.1 +/- 2.9 newtons [N]) was less than for all other sutures (range, 103-155 N). The load required to form a 2 mm gap between tendon ends was greater for the single-braid thre...
Shiroma JT, Engel HN, Wagner PC, Watrous BJ.In horses, dorsal subluxation of the proximal interphalangeal joint in the pelvic limb, which realigned when weight was applied to the limb, improved following surgery. Improvement was observed, if not immediately, at least within two weeks after treatment. The severity and duration of the condition appear to be important considerations in predicting the time necessary for resolution of the condition following surgery. Treatment consisted of surgical resection of a small segment of the medial head of the deep digital flexor tendon in the pelvic limb. The section removed was positioned distal t...
Armstrong RA, Lawrence RA, Jones RL, Wilson NH, Collier A.1. This study describes attempts to compare prostacyclin (IP-) receptors in human, pig, horse, rabbit and rat platelets and in circular muscle of human, rabbit and dog mesenteric and pig gastroepiploic arteries. Three stable prostacyclin analogues, iloprost, cicaprost and 6a-carba-prostacyclin (6a-carba-PGI2) and a prostaglandin endoperoxide analogue EP 157 (previously shown to mimic prostacyclin on human platelets) were used. 2. Our main conclusion is that prostacyclin receptors on human, pig and horse platelets are similar in nature, but distinct from those on rabbit and rat platelets. Funct...
Hoffer MA, Leach DH, Doige CE.The navicular bone, navicular bursa and their associated structures were collected from 20 horses ranging in age from 80 days gestation to 2 years post-gestation. The right front foot of every horse was sampled for light microscopy. The development of the navicular bursa and associated structures were studied. Study of the developmental anatomy of the equine navicular bursa established that the bursa is a distinct entity in both the fetus and the adult horse. Development of the bursal cavity in the fetus was found to be complete by 120 days of gestation. Synovial membrane of the navicular burs...
van Schie HT.The ultrasonic examination of tendons and ligaments of the distal limb of the horse improves the diagnostic possibilities of these frequently injured structures. The successful application is based upon a reliable knowledge of the normal sonographic anatomy and upon a standardized, flawless technic of the examination. Practice and experience allow the recognition of minor alterations which enables a more precise diagnosis, a more reliable prognosis, and in follow-up examinations also more specific information about the further use of the horse.
Ford TS, Ross MW, Orsini PG.To study communications and boundaries of the middle carpal and carpometacarpal joints of the horse, 50 forelimbs were obtained from fresh cadaver specimens. Blue latex solution (20 +/- 2.5 ml) was injected into the middle carpal joint, and the specimens were frozen in extension. Frozen specimens were cut into 1-cm sagittal sections from the middle of the radius to the middle of the metacarpus. The communications between the middle carpal and carpometacarpal joints and the presence, length, and position of the distopalmar outpouchings of the carpometacarpal joint were recorded. The middle carp...
Bukowiecki CF, Sanders-Shamis M, Bramlage LR.Medial collateral ligament ruptures in horses are rare and difficult to treat. Conservative treatment usually results in degenerative joint disease that causes permanent lameness. Surgical treatment may be an alternative for salvaging horses for breeding purpose.
Sanders-Shamis M, Bukowiecki CF, Biller DS.Medical records of 7 adult horses with single or multiple ligament failure of the femorotibial ligaments were reviewed to evaluate signalment, history, diagnostic and treatment methods, outcome, and long-term follow-up information. Acute onset of lameness was recorded for most of the horses. Horses with multiple ligament injury had more severe clinical signs than did horses with single ligament injury. Horses with single ligament injury generally required manipulative tests to localize the lameness to the stifle. In all horses, radiography of the stifle assisted in the diagnosis. Horses either...
Boero MJ, Kneller SK, Baker GJ, Metcalf MR, Twardock AR.Injury of the lateral collateral ligaments of the tarsocrural joints was diagnosed in nine Standardbred pacers. The average age was 4.9 years. The severity of the lameness varied from severe to subtle and joint effusion was seen in eight of 10 tarsocrural joints. A positive hindlimb flexion test was seen in four of six cases in which results were recorded. The identification of the site of involvement was based on a focal intense 'hot spot' seen on scintigraphy, and new bone formation seen radiographically at the anatomical sites of insertion of the long lateral collateral ligament of the tars...
Bramlage LR, Schneider RK, Gabel AA.Clinical experience continues to expand our understanding of the pathophysiology of pain and injury within the carpal joints. The anatomical and physiological capacity of the equine carpus to neutralise loading stress plays a significant role in the prevention of carpal injury. The ability of joint surfaces to dissipate axial force by transfer to the interosseous ligaments is the principal means by which carpal injury is avoided. In the medial aspect of the intercarpal joint and the dorsal aspect of the radial carpal joint, however, the effects of chronic maximal stress and isolated acute supr...
Riemersma DJ, Schamhardt HC, Hartman W, Lammertink JL.Loads on the suspensory ligament, deep digital flexor tendon, superficial digital flexor tendon, and long digital extensor tendon of the equine hind limb were determined in ponies by use of implanted strain gauges consisting of silicone rubber tubes filled with mercury. Recordings were made simultaneously with force plate measurements and high-speed film recordings while the ponies were walking. The relationship between strain gauge signals and tendon loads was obtained from tension-strain tests performed after death of the ponies. The suspensory ligament and the 2 digital flexor tendons were ...
Riemersma DJ, van den Bogert AJ, Schamhardt HC, Hartman W.Strains of the suspensory ligament and deep digital flexor, superficial digital flexor, and long digital extensor tendons in the equine (pony) hind limb were recorded in vivo, using implanted strain gauges consisting of silicone rubber tubes filled with mercury. The relationship between strain gauge signals and tendon strains was obtained from tension-strain tests performed on isolated tendons after death of the ponies. During normal walking, maximal tendon strain (elongation over initial length, relative to the length of the structures at first ground contact) was 3.1% in the suspensory ligam...
Sanders-Shamis M, Gabel AA.An avulsed carpal medial collateral ligament was diagnosed by clinical and radiographic examination in a 1-day-old foal that was unable to bear weight on the affected limb. The foal had a valgus deviation originating at the carpus and medial to lateral instability of the affected carpus. The ligament was reconstructed with screws and suture tape. Surgical reconstruction is a viable alternative to long-term casting or splinting for treatment of a ruptured carpal medial collateral ligament in a foal.
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.
Boyd JS.A radio-opaque marker was injected intramuscularly at different levels and with needles of different lengths into the cervical musculature of a series of ponies and horses which were under profound anaesthesia prior to euthanasia. Subsequently the necks were sectioned and radiographed to determine the fate of the injected material. The results indicated that care was necessary in the selection of the level for injection in order to prevent deposition of material on to the periosteal surface of the cervical vertebrae or on to the ligamentum nuchae and fascial sheaths. The muscle mass over the t...
Bukowiecki CF, Bramlage LR, Gabel AA.Forty-eight limbs of 12 freshly euthanized horses were used to generate data on the strength of the equine suspensory apparatus. The point of failure of the suspensory apparatus of each limb was determined. Immediately before euthanasia, 6 of the 12 horses (thoroughbreds and standardbreds) had been engaged in active training or racing, and six horses in stall and/or pasture activity. In the actively training or racing horses, the point of acute failure of the suspensory apparatus was within the proximal sesamoid bones in 20 (83%) limbs (resulting in 17 apical fractures, 2 basilar fractures, an...
Moll HD, Slone DE, Humburg JM, Jagar JE.Three horses and three ponies were treated for traumatic luxation of the proximal intertarsal or tarsometatarsal joint. In each case, there were fractures of one or more tarsal bones. Three of the animals had disruption of one of the collateral ligaments. Five animals were treated by closed reduction and external coaptation. One pony was treated by open curettage, a cancellous bone graft, and cast immobilization. No internal fixation was used in any of these animals. From this series of cases, it would appear that closed reduction and external coaption alone is adequate treatment for most case...
Riemersma DJ, De Bruyn P.The cross-sectional area, collagen content, dry weight as a percentage of the wet weight and the tendon fibre percentage of the cross-sectional area of the equine hindlimb were determined in the superficial and deep digital flexor tendons and the suspensory ligament at 10, 12 and six sites between tarsus and insertion respectively. The values of each of the four parameters varied between different sites in the same tendon, between different tendons within a horse and between analogous tendons of different horses. Within a tendon the cross-sectional area was inversely proportional to the collag...
Powers BE, Stashak TS, Nixon AJ, Yovich JV, Norrdin RW.Specimens of ligamentum flavum, joint capsule, and dorsal lamina were collected at surgery or necropsy from 25 horses with cervical static stenosis. All horses had myelographic evidence of dorsal compression of the spinal cord caused by soft tissue and/or bone in the caudal cervical area, primarily at C6-7. Most horses also had radiographic evidence of degenerative joint disease of articular facets. Histologically 19 horses had osteosclerosis and cartilage retention in the dorsal lamina, and 24 horses had increased fibrocartilage at the ligamentum flavum attachment to dorsal lamina. The ligame...
Lyons ET, Tolliver SC, Drudge JH, Swerczek TW, Crowe MW.Examination of the ligamentum nuchae for Onchocerca spp was completed in 523 Thoroughbreds (1 to 29 years old) at necropsy in Kentucky during a 13-month period (1984 to 1985). Onchocerca spp were found in 306 (59%) of the horses. Frequencies of this parasite were 3%, 17%, 40%, 43%, and 42% in 1-, 2-, 3-, 4-, and 5-year-old horses, respectively. For 6- to 29-year-old horses, frequency varied from 71% to 100%, except for 26-year-old horses (50%); 87% of the 304 horses examined in the 6- to 29-year-old age groups was infected. The suspensory ligaments and flexor tendons from fetlocks (thoracic li...
Hauser ML.The diagnostician should be familiar with the normal ultrasound appearance (size, shape, position, and textural quality) of each structure examined. With these factors as reference points, one can describe lesions in the structure involved, the precise location and extent of the lesions, and the degree of structural compromise that is manifested. Documentation of lesions of tendons and ligaments enables one to make an accurate diagnosis and a more precise prognosis. Serial examination during the healing phases allows for a more accurate prediction as to when the structure in question can withs...
Genovese RL, Rantanen NW, Hauser ML, Simpson BS.In our 3 years of clinical experience, we have found that diagnostic ultrasound provides the veterinarian with a valuable diagnostic tool. It allows the clinician to quantify morphologic change that has occurred as a result of soft-tissue injuries, even when the clinical findings are ambiguous or insufficient. In cases in which aggressive postinjury therapy has been instituted prior to presentation, diagnostic ultrasound is often the only noninvasive method that can ascertain the extent of the horse's injury. Diagnostic ultrasound provides the technology to detect injuries before they become p...
Verschooten F, Picavet TM.Desmitis of the fetlock annular ligament was diagnosed in 30 horses during a period of eight years. Most of the horses had been lame for a prolonged period and had chronically distended digital flexor tendon sheaths. Air tendograms demonstrated thickened palmar or plantar annular ligaments. In 25 horses the ligament was cut longitudinally; of these, 16 horses returned to full work without any difficulty and one became sound after a second operation. Follow up time varied from three months to seven-and-a-half years. None of the five untreated horses returned to work.
Riemersma DJ, Schamhardt HC.The mechanical properties of the deep digital flexor tendon (DDFT), the superficial digital flexor tendon (SDFT) and the suspensory ligament (SL) of the hindlimb of the horse were studied in vitro. The tendons were observed at several morphologically distinct sites. The loaded tendon is homogeneously strained, in spite of large variations in cross-sectional area. Consequently the modulus of elasticity was inversely proportional to the corresponding cross-sectional area and ranged from 738 MPa (megaPascal, N mm-2) to 1398 MPa within the DDFT, from 1000 MPa to 1282 MPa within the SDFT and from 5...
Updike SJ.The deep fascia of the equine crus was dissected grossly and separated into 2 layers, the superficial and deep laminae of the deep fascia. Attachments of these fascial laminae to the tibia and fibula formed 5 separate osteofascial compartments: cranial, lateral, caudal deep, caudal intermediate, and caudal superficial. Cranial tibial vessels and the deep peroneal nerve entered the cranial compartment through separate fascial hiatuses; this may predispose the equine crus to the occurrence of compartmental syndromes with clinically recognizable neural deficits.
van der Linde-Sipman JS, Kroneman J, Meulenaar H, Vos JH.Four horses are described with rupture of the aortic arch and pulmonary trunk which resulted in a fistula between these vessels. Ruptures were located near the ligamentum arteriosum. Histological examination of the vessel walls revealed media necrosis which was probably due to intimal thickening and/or medial fibrosis of the vasa vasorum.
Verschooten F, Gasthuys F, De Moor A.An experimental and clinical study to investigate the aetiology of distal splint bone fractures is described. In vitro, extension of the fetlock did not appear to alter the position of the distal ends of the splint bones, although tension in the interosseous tendons increased. Flexion of the fetlock resulted in slight outward displacement of the distal ends of the splint bones. It is suggested that concurrent desmitis of the suspensory ligament can cause movement of the ends of the splint bones thus predisposing to a fatigue fracture. In a clinical study of 87 horses, 114 splint bone fractures...
Bischofberger AS, Ringer SK, Geyer H, Imboden I, Ueltschi G, Lischer CJ.To determine via histologic examination and scintigraphy the effect of focused extracorporeal shock wave therapy (ESWT) on normal bone and the bone-ligament interface in horses. Methods: 6 horses without lameness. Methods: Origins of the suspensory ligament at the metacarpus (35-mm probe depth) and fourth metatarsal bone (5-mm probe depth) were treated twice (days 0 and 16) with 2,000 shocks (energy flux density, 0.15 mJ/mm2). One forelimb and 1 hind limb were randomly treated, and the contralateral limbs served as nontreated controls. Bone scans were performed on days -1 (before ESWT), 3, 16,...
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...
Zekas LJ, Forrest LJ.The purpose of this study was to describe ultrasonographic changes of the equine palmar metacarpal area attributed to the infiltration of local anesthetic solution and to determine whether these changes were noted immediately or at 24 h. The palmar metacarpal region of one forelimb in each of six horses was examined ultrasonographically with a 10-MHz linear array transducer and a 7.5-MHz curvilinear transducer. Transverse and longitudinal images were recorded at 5-cm intervals distal to the accessory carpal bone. High and low palmar and palmar metacarpal nerve blocks were performed with a 2% m...
Chesworth M, Brandenberger O, Cheetham J, Windley Z, Schumacher J, Cochran K, Piercy RJ, Perkins JD. To investigate the effect of the transverse arytenoid ligament (TAL) on abduction of the arytenoid cartilage when performing laryngoplasty. Modified prosthetic laryngoplasty was performed on right and left sides of 13 cadaver larynges. Increasing force was sequentially applied to the left arytenoid cartilage at 3 N intervals from 0-24 N, when the force on the right arytenoid cartilage was either 0 or 24 N, before and after TAL transection. Digital photographs of the rostral aspect of the larynx were used to determine the left arytenoid abduction angles for these given force combinations and ...
Röthlisberger U, Kaegi B, Geyer H, Auer JA.The annular ligament constriction is characterized by a disproportion between the available space and the contents within the fetlock tunnel. The main symptoms are a persisting lameness, distention of the tendon sheath, a typical "notch" when the fetlock is viewed from the side and a hyperflexion pain in the fetlock. The surgical treatment consists of the transection of the fetlock annular ligament. The conservative management can be considered as a independent therapy or as a preparation for a subsequent desmotomy. The medical records of 75 horses suffering from fetlock tunnel syndrome presen...
Bouré L, Marcoux M, Laverty S, Lepage OM.To develop a technique for arthroscopic excision of apical sesamoid fracture fragments using electrocautery probes. Methods: A total of 18 Standardbred horses. Methods: Arthroscopic removal of apical sesamoid fracture fragments using both hook and loop electrocautery probes was performed on 18 Standardbred horses. The fracture fragments were approached using either an ipsilateral (3) or contralateral (15) arthroscopic triangulation technique. Distension of the metacarpo- (metatarso)-phalangeal joints was achieved using a 1.5% glycine solution. Under arthroscopic guidance, both the suspensory a...
McCoy AM, Goodrich LR.Annular ligament desmotomy is commonly performed in horses with chronic tenosynovitis. Previously reported tenoscopic techniques have limitations related to haemorrhage and awkward instrumentation. Radiofrequency (RF) energy affords precision and excellent haemostasis and may be a good alternative to sharp transection of the annular ligament in horses. Objective: To describe a technique for using a RF probe for tenoscopic-guided annular ligament desmotomy and to report the clinical outcome of horses in which it was performed. Methods: Cadaver specimens (n = 14) and live horses undergoing unrel...
Nixon AJ, Cummings JF.Serial sections of bone and soft tissue from the metacarpophalangeal joints of 2 mature and 2 immature horses were evaluated for substance P immunoreactive sensory nerve fibers. Formalin-fixed specimens were sectioned, either nondemineralized or demineralized with formic acid or EDTA. Rabbit antiserum to substance P (SP) was used in the streptavidin-biotin-peroxidase complex method for immunolocalization of SP antigen, and staining with 3,3'-diaminobenzidine was used for permanent identification of SP fibers. Abundant sensory nerve fibers were identified in the joint capsule, synovial membrane...
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 ...
Gussekloo SW, Lankester J, Kersten W, Back W.To determine the effect of differences in structural and mechanical tendon properties on functionality of the passive stay apparatus in horses. Methods: 5 forelimbs each from nondwarf Friesians, dwarf Friesians, and ponies. Methods: Harvested forelimbs were loaded to test the passive stay apparatus. Tendons that stabilize the distal portion of the limb (superficial digital flexor tendon, deep digital flexor tendon, and tendo interosseus [suspensory ligament]) were isolated, and force-elongation data were obtained. Bone lengths, initial tendon lengths, and initial tendon cross-sectional areas w...
Raes EV, Vanderperren K, Pille F, Saunders JH.Ultrasonographic findings from 100 horses (103 joints) diagnosed with tarsal region pathology are described. Results of standard orthopaedic, radiographic and ultrasonographic examination of the tarsal region were analysed retrospectively. Periarticular swelling and/or synovial effusion was present in 100% of the joints, a wound was observed in 14.5% and 76.7% of the horses that were lame. Abnormalities were detected in 69.7% of joints using radiography and in 100% with ultrasonography. Our results show that the main disease process can affect all aspects of the tarsus. The most common ultraso...
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 ...
Kersten AA, Edinger J.Little information exists about the normal ultrasonographic appearance of the equine sacroiliac region, but knowledge of the ultrasonographic anatomy is necessary to understand the possible pathological changes in sacroiliac diseases. Objective: The normal ultrasonographic appearance of soft tissues and bony structures of the sacroiliac region in horses was studied in order to establish clinically relevant reference parameters. Methods: Thirteen cadaver specimens were examined using a transcutaneous approach above the tubera sacrale to image the dorsal sacroiliac ligament and the tendon of the...
Waselau M, Sutter WW, Genovese RL, Bertone AL.To determine outcome of Standardbred racehorses with moderate to severe midbody suspensory ligament desmitis (MSD) treated by means of ultrasound-guided intralesional injection of a single dose of platelet-rich plasma (PRP) followed by a program of gradually increased exercise. Methods: Nonrandomized clinical trial. Methods: 9 Standardbred racehorses. Methods: Following injection of PRP, horses were allowed a controlled, gradual return to exercise. Race records for the year prior to injury and for 3 consecutive years after horses returned to racing were reviewed. For comparison purposes, race ...
Geburek F, Stadler P.Conventional treatments of equine tendon injuries lead to an unsatisfactory healing process that usually results in a relatively high recurrence rate. Therefore, in recent years so-called regenerative therapeutics were studied scientifically in vitro and in laboratory animals. These include substances that ideally lead to the formation of replacement tissue, which in contrast to the low quality scar, has similar functional properties as the original intact tendon. Currently, a plethora of different substrates is either commercially available or can be produced in practice with the help of kits...
Schneider RK, Tucker RL, Habegger SR, Brown J, Leathers CW.To determine clinical signs, diagnostic findings, and outcome for horses with desmitis of the straight sesamoidean ligament (SSL) near its insertion on the middle phalanx. Methods: Retrospective study. Methods: 9 horses. Methods: Medical records were reviewed, and information on signalment, history, clinical signs, diagnostic findings, and treatment was obtained. Follow-up information was obtained through telephone conversations with owners. Results: In all horses, the diagnosis was made by use of high-resolution ultrasonography. Seven horses had moderate lameness on initial examination; lamen...
Whitlock D, Garcia TC, Vallance SA, Stover SM.The specific biomechanical circumstances that induce excessive superficial digital flexor tendon (SDFT) strain in horses are unknown. Objective: Carpal joint hyperextension during axial limb loading during the middle of stance disproportionately enhances SDFT strains compared to suspensory ligament (SL) strains. Methods: Superficial digital flexor tendon and SL strains were measured in 7 cadaver limbs during in vitro loading that maintained carpal extension or allowed carpal hyperextension by constraining, or allowing rotation of, the radius during loading conditions that simulated the middle ...
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...
van Schie HT.The ultrasonic examination of tendons and ligaments of the distal limb of the horse improves the diagnostic possibilities of these frequently injured structures. The successful application is based upon a reliable knowledge of the normal sonographic anatomy and upon a standardized, flawless technic of the examination. Practice and experience allow the recognition of minor alterations which enables a more precise diagnosis, a more reliable prognosis, and in follow-up examinations also more specific information about the further use of the horse.
Brossi PM, Moreira JJ, Machado TS, Baccarin RY.This systematic review aimed to present and critically appraise the available information on the efficacy of platelet rich plasma (PRP) in equine and human orthopedic therapeutics and to verify the influence of study design and methodology on the assumption of PRP's efficacy. We searched Medline, PubMed, Embase, Bireme and Google Scholar without restrictions until July 2013. Randomized trials, human cohort clinical studies or case series with a control group on the use of PRP in tendons, ligaments or articular lesions were included. Equine clinical studies on the same topics were included inde...
Kamm JL, Goodrich LR, Werpy NM, McIlwraith CW.To describe regions of the thoracic and pelvic limb proximal interphalangeal (PIP) joints that are arthroscopically accessible and identify soft tissue structures that should be avoided during arthroscope and instrument placement. Methods: Experimental ex vivo descriptive study. Methods: Horses (n = 15). Methods: Cadaver limbs (n = 36) were used for anatomic modeling, magnetic resonance imaging (MRI) with MRI-compatible needles, computed tomography with contrast arthrography, and arthroscopy of the PIP joint. Two arthroscopic approaches to the dorsal joint pouch were compared. Results: With ar...
Guasco PG, Kelly G, Schumacher J, Henry RW.To assess outcome after neurectomy of the deep branch of the lateral palmar nerve (DBLPaN) as a treatment for horses with persistent lameness associated with chronic proximal suspensory desmitis (PSD) of the thoracic limb. Methods: Case series. Methods: Adult, mixed-breed horses (n = 4), weighing 510-585 kg, used for amateur show-jumping. Methods: Records of 4 horses chronically lame because of PSD of one or both thoracic limbs that were treated by neurectomy of the DBLPaN were reviewed. The site of pain causing lameness was localized using regional anesthesia. The proximal aspect of the suspe...
Arnoczky SP, Lavagnino M, Gardner KL, Tian T, Vaupel ZM, Stick JA.To determine the effects of oxytetracycline on matrix metalloproteinase-1 (MMP-1) mRNA expression and collagen gel contraction by equine myofibroblasts in an effort to explain the mechanistic basis for the pharmacologic treatment of flexural deformities in foals. Methods: Cultured myofibroblasts from the accessory ligament (distal check ligament) of 6 foals. Methods: Collagen gel scaffolds seeded with equine myofibroblasts were cultured in individual culture dishes containing complete media (Dulbecco's modified Eagle medium with 10% fetal bovine serum) and oxytetracycline (0, 12.5, 25, or 75 m...
Grewal JS, McClure SR, Booth LC, Evans RB, Caston SS.To characterize the normal ultrasonographic appearance of the podotrochlear apparatus in horses by use of standardized measurements and identify soft tissue changes associated with navicular syndrome. Methods: Prospective study. Methods: 7 clinically normal horses and 28 horses with navicular syndrome. Methods: The feasibility of identifying and measuring the soft tissue structures of the podotrochlear apparatus ultrasonographically via the transcuneal approach was assessed in 2 additional horses without navicular syndrome; both horses were euthanatized, and the structures identified ultrasono...
Ehrle A, Ressel L, Ricci E, Singer ER.Pain related to the osseous thoracolumbar spine is common in the equine athlete, with minimal information available regarding soft tissue pathology. The aims of this study were to describe the anatomy of the equine SSL and ISL (supraspinous and interspinous ligaments) in detail and to assess the innervation of the ligaments and their myofascial attachments including the thoracolumbar fascia. Ten equine thoracolumbar spines (T15-L1) were dissected to define structure and anatomy of the SSL, ISL and adjacent myofascial attachments. Morphological evaluation included histology, electron microscopy...
Burk J, Plenge A, Brehm W, Heller S, Pfeiffer B, Kasper C.Tendon and ligament pathologies are still a therapeutic challenge, due to the difficulty in restoring the complex extracellular matrix architecture and biomechanical strength. While progress is being made in cell-based therapies and tissue engineering approaches, comprehensive understanding of the fate of progenitor cells in tendon healing is still lacking. The aim of this study was to investigate the effect of decellularized tendon matrix and moderate cyclic stretching as natural stimuli which could potentially direct tenogenic fate. Equine adipose-derived mesenchymal stromal cells (MSC) were...
Cohen JM, Schneider RK, Zubrod CJ, Sampson SN, Tucker RL.(1) To describe the clinical signs and abnormalities observed on magnetic resonance imaging (MRI) in 7 horses with desmitis of the distal digital annular ligament (DDAL); (2) to describe the normal magnetic resonance (MR) appearance and thickness of the DDAL in health; and (3) to describe a tenoscopic surgical technique for treating horses with desmitis of the DDAL. Methods: Retrospective study. Methods: Horses (n=7) with desmitis of the DDAL. Methods: MR examinations of 20 sound horses were reviewed to determine the normal appearance of the DDAL. Dimensions obtained from these images were com...
Keg PR, Schamhardt HC, van Weeren PR, Barneveld A.Controversy exists with respect to the innervation of the suspensory ligament (SL) in the fore limb of the horse. It is uncertain whether this structure is exclusively innervated by branches of the ulnar nerve or also to some extent by median nerve branches. Ground Reaction Forces (GRF) were determined in horses before and after the induction of a tendonitis in the lateral branch of the SL by the injection of collagenase, and before and after a high palmar and an ulnar block respectively. The high palmar block succeeded in bringing all GRF variables back to their original values which the ulna...
Palmieri G, Asole A, Panu R, Farina V, Sanna L.A vegetative innervation is described for the first time in this district. On the contrary, the finding of Pacini and pacini-like corpuscles, of Golgi Mazzoni's receptors, of muscle spindles and Golgi's tendon-organs testifies the existence of a sensitive innervation in this anatomical territory. According to Karamanlidis free nervous endings are not present. All the above recorded receptors show the typical structure and can be found isolated, grouped to constitute flower-sprays, organized to form opposito-polar corpuscles or associated to originate pecilomorphic fibers. These two last findin...
Keg PR, Barneveld A, Schamhardt HC, van den Belt AJ.To answer the question whether it is possible to differentiate, by means of a high plantar nerve block in the hind limb, flexor tendon lameness from a suspensory ligament lameness, mid-plantar tendinitis or desmitis was induced with collagenase in five Standardbred horses in two trials. Before the induction of lameness, and on the fourth (D4) and fourteenth day (D14) after the induction of lameness the horses were evaluated subjectively (clinical lameness score), objectively (ground reaction force (GRF) measurements), and ultrasonographically. Clinical evaluation and GRF measurements were also...
