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.
Franks PW.A technique was developed using radioactive isotopes as a source of radiation for the treatment of injuries to the superficial and deep flexor tendons and the associated ligaments in the horse. The treatment area was sub-divided so that different dosages could be applied over the limb as necessary. A plaster of Paris impression was taken of the whole area to be treated. In the isotope laboratory a plaster negative was made and loaded with the dose of radioactive isotope. The loaded cast was then strapped to the horse's limb for the calculated time, usually about three days. A total of 42 horse...
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...
Herrick WC, Kingsbury HB, Lou DY.This paper describes the result of an investigation of strains and strain rates which normally occur in the tendons of the equine foreleg and presents stress-strain curves and moduli for the tendons at these rates. It has previously been demonstrated that resistance to flexion of the joints of the distal part of the equine foreleg is provided by a passive system of tendons and ligaments. It is therefore possible, using a large displacement, high-rate testing machine, to duplicate in the laboratory the strain rates and forces which are normally produced in the tendons of the foreleg of the runn...
Kingsbury HB, Quddus MA, Rooney JR, Geary JE.The distal portion of the forelimb of the horse is provided with a stay apparatus composed of tendons, ligaments, and fascia. This stay apparatus provides the major resistance to joint flexion during the support phase of the stride. The laboratory test system described was shown to be able to reproduce in vitro limb motions and hoof forces measured with a running horse. These results indicated the stay apparatus operates in a largely passive mode, active muscle contraction apparently serving to provide rigidity only early in the support phase of the stride. The testing system described was des...
McIlwraith CW, Fessler JF.The usefulness of inferior check ligament desmotomy as a treatment for acquired tendon contracture in horses was evaluated in 13 cases of deep digital flexor (DDF) contracture and in 3 cases of combined superficial digital flexor (SDF) and DDF contracture. In 8 of 9 cases of DDF contracture in which the dorsal surface of the hoof had not passed beyond being vertical to the ground, the surgical procedure was successful in returning the limb to a normal position and function. Compared with DDF tenotomy, inferior check ligament desmotomy was a superior treatment technique because of decreased pos...
Shively JA, Van Sickle DC.The scanning electron microscopy of synovial membrane from the radiocarpal and intercarpal joints near the lateral and medial borders of the tendon of the extensor carpi radialis muscle was studied in 5 ponies. Three different morphologic types of synovial membrane were observed. Type 1 synovial membrane was folded and had a surface mat of fibers separated by 1- to 5-micron-diameter holes. The 2nd and 3rd types of synovial membrane were both villous. The surface of type 2 synovial membrane was fibrillar but the surface of type 3 synovial membrane was cellular. The type of synovial membrane pre...
Rose RJ.Complications from neurectomy have been well known for many years. A 16-year-old mare suffered bilateral luxation of the coffin joints following palmar neurectomy and was destroyed. Autopsy showed complete rupture of the deep flexor tendons, and the supporting ligaments of the coffin joints. Arthritis of the coffin joints, with erosion of articular cartilage was evident.
Jones RD, Fessler JF.ALTHOUGH METACARPAL TI-IV and metatarsal II-IV (MC II-IV, MT II-IV) fractures are frequent in horses and surgical intervention routine, a review of the current literature revealed little information about this subject. The authors have found only two complete accounts of this problem (1, 6). The incidence of suspensory desmitis has been previously reported (3), but we find no previous correla-tion of MC II-IV, MT II-IV fractures with suspensory, desmitis. On these bases, a re-trospective study was conducted. At Purdue University from 1967 through 1974, 50 Standardbred horses underwent sur-gery...
Rankin JS, Diesem CD.The hindlimbs of 3 ponies and 3 horses were dissected. The hip joint capsule was found to receive articular nerve fibers from the femoral, obturator, cranial gluteal, and sciatic nerves. The nerve fibers were distributed to the fibrous joint capsule and associated capsular ligaments. The stifle joint capsule was found to receive articular branches from the femoral, saphenous, obturator, common peroneal, and tibial nerves. The fibers terminated in the joint capsule, fat pad, patellar and collateral ligaments, and the internally situated meniscal and cruciate ligaments.
Scott EA, Thrall DE, Sandler GA.Vascular supply of the equine forelimb was partially disrupted by ligation of the medial palmar and medial palmar digital arteries. Vascular architecture was evaluated before and after ligation by angiography. It was apparent from the present study that existing collaterals or newly formed collaterals, or both, were sufficient to maintain limb viability.
Knudsen O.The paper briefly describes the percutaneous tendon splitting operation as performed in general practice and evaluates its effectiveness on the basis of races run during a 2 year follow-up period. The results are compared with similar figures for normal Standardbred trotters. A higher percentage of horses subjected to splitting of the suspensory ligament failed to remain sound long enough to run more than 10 races during the follow-up period. The percentage of horses returning to racing whose superficial flexor was operated upon was somewhat lower than the control group.
Menschik A.Mobility of the knee of the horse. The modification of medial and lateral femoral condyles by additional movement of the cruciate ligaments shown on the animal joint. Final rotation in the human knee-joint shapes the femoral condyles by additional movement of the cruciate ligaments. The roll-slide movement and final rotation lead to curving of the medial condyle of the femur in the transverse plane. The transition from the roll-slide into a tilting movement in the final phase of ultimate rotation reduces the power of the posterior ligamentous system of the knee-joint when there is a force tend...
Quam V.Inflammation plays a role in acute and chronic equine tendon/ligament injury; anti-inflammatories are often indicated. Local corticosteroids provide consistent and profound short-term effects on pain and inflammation across species. However, there is no demonstrated benefit in the long term, and complications can occur. Alternative biologic anti-inflammatory treatments are available and should be used in horses at risk of complications. Nonetheless, corticosteroids remain an affordable and effective anti-inflammatory that, with continued research, may be indicated on a case-by-case basis as pa...
Peeters MWJ, Ott S, van Veggel E, Berner D, Perrier M.Limited reports in the literature are available regarding desmitis of the palmar/plantar ligaments of the proximal interphalangeal joint (PL-PIPJ); the clinical significance of such injuries is unknown. Objective: To describe the ability to differentiate the PL-PIPJ on low-field magnetic resonance (MR) examination. To describe the injury characteristics of the PL-PIPJ on MR examination and the correlation with clinical features and lameness. Methods: Retrospective case series. Methods: Data and MR images of 29 horses were collected from the databases of three institutions. Horses were included...
Ellis K, Van Zeeland EM, Ashton L, Wist S, Broeckling C, Harris M, Frisbie DD, Sikes KJ.To (1) identify tissue-specific metabolic profiles of the superficial digital flexor tendon (SDFT), deep digital flexor tendon (DDFT), and suspensory ligament (SL) and (2) evaluate metabolic profile differences in the SDFT, DDFT, and SL between the equine forelimb and hindlimb. Unassigned: 2 SDFT, DDFT, and SL specimens were collected from the forelimbs and hindlimbs of 10 horses of mixed breed, age, and sex that were euthanized for other reasons. One specimen was processed for histology to confirm that there were no underlying soft-tissue pathologies. One specimen was processed for 2 forms of...
Pluim M, Reynolds A, McClure S.High-power laser therapy and extracorporeal shock wave therapy (ESWT) can be safely used to treat tendon and ligament injuries in horses, and the potential beneficial effects have been described. The power of low level lasers is not sufficient for treatment of tendon and ligament injuries in horses. ESWT is used more often to treat tendon and ligament injuries than it is for any other type of condition in horses, but there is limited supporting scientific evidence. Further research should focus on establishing dosage and treatment protocols for both laser therapy and ESWT in horses with clinic...
Connard SS, Schnabel LV.This review explores the use of biologics in the treatment of tendon and ligament injuries in horses, focusing on current and emerging therapies aimed at enhancing tissue repair and regeneration. It discusses the role of scaffold-based therapies, growth factors, blood-derived and tissue-derived biologics, and gene therapy as biologic regenerative therapies for improving healing outcomes. The review evaluates the mechanisms, efficacy, and challenges of biologics in clinical applications, highlighting recent advances and clinical studies. It provides an overview of current trends and future dire...
Bertone AL, Reinemeyer C, Tsaprailis G, Ragland D, Leise B.The use of micro-particulate allografts is rising, but knowledge about the protein characterization and biocompatibility of umbilical cord-derived allografts (UC) in vivo is limited. Methods: Proteomic analyses using mass spectrometry (MS) determined equine UC protein relative quantification and functions using total spectral counts (TSC). UC cytokines were quantified by enzyme-linked immunosorbent assay (ELISA). Three in vivo studies assessed recipient clinical and tissue biocompatibility in joints and ligaments. Results: Proteomics revealed 2645 annotated TSCs. Proteins of > 89 TSC we...
Durgam S.The mid-metacarpal SDFT, intrasynovial DDFT and suspensory ligament are frequently injured soft tissues in the equine athlete. The mid-metacarpal SDFT exhibits a hierarchical structure and encounters repetitive strains at its functional limit. The intrasynovial DDFT possesses fibrocartilage where opposing bony surfaces to facilitate resistance-free gliding and contains chondrocyte-like cells embedded in a proteoglycan-rich ECM. While suspensory ligament enthesis injuries are common, collagen and non-collagen ECM structure-function specializations at the bone-ligament interface are understudied...
Bosch K, Zsoldos RR, Hartig A, Licka T.The influence of soft tissue structures, including ligaments spanning one or more intervertebral junctions and the nuchal ligament, on motion of the equine cervical joints remains unclear. The present study addressed this using four post-mortem horse specimens extending from head to withers with all ligaments intact. Three-dimensional kinematics was obtained from markers on the head and bone-anchored markers on each cervical and the first thoracic vertebra during rotation, lateral bending, flexion and extension of the whole head, and neck segment. Yaw, pitch, and roll angles in 8 cervical join...
Eren G, López-Albors O, López Corbalán M, Latorre R.Digital technologies have improved the visualization of anatomical structures for veterinary education and clinical practice. In this study, a detailed three-dimensional anatomical model of the equine palmar metacarpal region was generated using E12-based epoxy sheet plastination combined with digital reconstruction in Amira V5.6 software. Serial cross-sections of the metacarpal region provided high-resolution visualization of bones, tendons, ligaments, nerves, vessels, fasciae, and synovial structures, with minimal shrinkage or deformation, ensuring improved anatomical accuracy. These section...
Urion R, Lustgarten M, Hostnik ET.Technological developments in imaging modalities have advanced the diagnostic capabilities for equine tendon and ligament injuries beyond the traditional methods. This review examines elastography techniques in ultrasonography that assess tissue stiffness and strain properties, computed tomography (CT) innovations including PET/CT fusion and dual-energy CT, and emerging applications of diffusion-weighted MRI for evaluating fiber microstructure and functionality. These complementary approaches offer veterinarians improved means to detect early injuries, assess structural integrity, monitor heal...
Moreno C, Rice H.Diagnostic and treatment strategies for infectious equine tendon and ligament disorders are continually evolving where recent progress is focused on advanced imaging and evidence supporting endoscopic lavage and regional antimicrobial therapy.
Beasley B.The overall objective of therapeutic farriery for equine tendon and ligament injuries is to provide a biomechanical environment conducive to healing by limiting excessive strain on the injured structure. With an understanding of equine limb anatomy and the pathophysiology of tendon/ligament injuries, the rationale used in therapeutic farriery for soft tissue injuries of the distal limb is quite logical. Through therapeutic farriery, foot manipulation is used to reduce the tension on the injured tendon(s) or ligament(s).
Gutierrez SO, Garcia-Lopez JM, Chope KB, Levine DG, Ortved K, Brown KA.To describe the clinical and ultrasonographic findings in horses with desmopathy of the abaxial palmar/plantar ligament (APL) of the proximal interphalangeal joint and the prevalence of concurrent musculoskeletal injuries in the pastern and foot. Unassigned: Horses presenting to New Bolton Center between March 2017 and November 2022 with an age ranging from 5 to 20 years that underwent lameness evaluation in which lameness was localized to the distal limb and had an ultrasonographic diagnosis of APL desmopathy. Unassigned: Horses included were those that (1) presented for a lameness examinatio...
Freeman KD, Adams MN, Salinger AE, White NA, Barrett JG.Suspensory desmopathy is a frequently documented cause of lameness in performance horses; proximal suspensory desmopathy is the most frequent site of injury in dressage horses [...].
Samol MA, Barrett MF, Frisbie DD.Significant distal interphalangeal joint (DIPJ) pathology, particularly affecting soft tissue and articular cartilage, is often not identifiable on radiographs but can be accompanied by joint capsule enthesopathy on the middle phalanx (P2), which can be readily identified. Objective: To explore frequency and correlations between DIPJ capsule enthesopathy identified on magnetic resonance imaging (MRI) and radiographs and DIPJ articular cartilage abnormalities and other concurrent soft tissue or osseous pathology within the foot found on MRI. Methods: Retrospective descriptive case series. Metho...
Nelson B.Complications of equine musculoskeletal procedures and surgery are an inevitable occurrence. This article summarizes complications principally encountered by primary equine veterinarians who perform and manage musculoskeletal procedures and surgeries. Topics discussed include complications of musculoskeletal diagnostic procedures, angular/flexural limb deformities, and muscle, tendon, and ligament surgery; surgery of the foot, orthopedic and arthroscopic surgery, and cast management. Each section lists complications encountered and includes diagnostic and treatment considerations. Awareness of...
Tommasa SD, Raspe S, Farí G, Imperante A, Brehm W.Tendon and ligament injuries in equine athletes pose significant challenges, often leading to prolonged recovery, reduced performance, and increased risk of reinjury. Current treatment strategies, including conservative and surgical approaches, have shown limited success in fully restoring tendon integrity. Autologous blood derivatives, such as autologous conditioned serum (ACS), have emerged as potential regenerative therapies. However, the clinical efficacy of ACS in the treatment of equine tendinopathies remains under investigation. Unassigned: This study aimed to compare the clinical outco...
Góss GC, Mozzaquatro FD, Machado IRL, Gomes EM, Martins NR, Duarte CA.The collateral ligaments of the distal interphalangeal joint (CL-DIPJ) are important structures for athletic horses. Ligament injuries can cause lameness, but ultrasound imaging can detect such lesions, which usually present with changes in echogenicity and an increase in the cross-sectional area (CSA) of the ligament. Measurements of these structures vary among authors, which complicates the diagnosis. Thus, this study aimed to describe the ultrasound measurements (dorsopalmar diameter [DPD], lateromedial diameter [LMD], and CSA) of the CL-DIPJ in Argentine Polo horses. We measured the CL-DIP...
McDonald S, Verheyen KLP, Chang YM, Allen SE.Race-related injuries in horse racing, especially those requiring extended recovery, are a welfare concern and threaten the sport's social licence. Previous studies predominantly report on fatalities; however, serious non-fatal musculoskeletal injuries often end horses' racing careers or have a high recurrence risk. No recent studies have described or quantified long-term injuries (LTIs) in racing Thoroughbreds, which is essential to inform targeted risk prevention strategies. Objective: To describe the types, frequencies and incidences of LTIs in British jump racing. Methods: Retrospective co...
Honnas DH, Fiske-Jackson AR, Fulkerson CV, Wilhite DR.An injury of a tendon or ligament of the equine foot is frequently a cause of lameness. The optimal radiographic projections delineating the entheses of five commonly injured tendons and ligaments of the foot should be described. Methods: The entheses of the collateral ligaments of the distal interphalangeal joint, the collateral sesamoidean ligaments of the navicular bone, the deep digital flexor tendon, the common digital extensor tendon and the distal sesamoidean impar ligament were isolated from a thoracic foot of three cadavers. Three standard radiographic projections (60-degree, dorsopro...
Qiu Z, Wang J, Zhang Y, Liu X, Wei C, Ma T.Musculoskeletal injuries represent a primary cause of suboptimal performance and early retirement in equine athletes. To address this challenge, the veterinary community has long endeavored to develop safer and more effective therapeutic strategies. Extracorporeal shock wave therapy (ESWT), as a treatment for equine musculoskeletal injuries, has garnered substantial attention among equine veterinarians. Focused on the theme ESWT Therapy for Equine Musculoskeletal Disorders: From biological mechanisms to clinical applications, this article systematically reviews existing literature on the biolo...
Sfraga H, Demeter EA, Pinn-Woodcock T, Guarino C, Young R, Cronk B, Cercone M.To investigate the presence of subclinical cranial nuchal bursitis and characterize its histopathologic features and association with Borrelia burgdorferi. Unassigned: This was a prospective descriptive cadaver study on a convenience population of horses in a B burgdorferi-endemic region (15 horses: 5 geldings and 10 mares of various breeds; 4 to 29 years old). Horses without history or clinical signs of cranial nuchal bursitis underwent euthanasia and tissue donation. Cranial nuchal bursa, synovial fluid, and nuchal ligament were collected postmortem. The bursa and ligament were evaluated via...
Wood AD, Parker RA.To describe a tenoscopically guided technique for desmotomy of the proximal digital annular ligament (PDAL). Methods: Ex vivo study and clinical case series. Methods: A total of 10 normal cadaver equine hindlimbs and five clinical cases of PDAL desmitis. Methods: The digital flexor tendon sheath (DFTS) was approached via a lateral basisesamoid portal and a palmar/plantar annular ligament (PAL) desmotomy was performed to improve maneuverability in the DFTS. Additional proximolateral and distal midline instrument portals were created to facilitate transection of the proximolateral attachment, th...
García-López JM.Intrathecal and intrasynovial tendon and ligament injuries can result in extrusion of tendon/ligament fibers, granuloma, and adhesion formation that not only impairs healing of the original injury but can create new injuries that negatively affect adequate healing and return to athletic work. In these cases, endoscopic evaluation and debridement, not only of the lesion, but also any other secondary injury present, can enhance the healing of the tendon or ligament and improve the athletic prognosis. Careful planning of the approach, positioning, instrumentation, and thorough knowledge of the an...
Nowicka B, Torres A, Polkowska I, Jackow-Nowicka J, Przewozny M, Jackow-Malinowska J.Chronic tendon and ligament diseases are commonly encountered in both athletic humans and animals, especially horses. Distal limb diseases, including suspensory ligament (SL) pathology due to anatomical, histological, and biomechanical properties, can be considered a model for tendon and ligament pathologies in humans. The appropriate selection of therapy is often crucial in optimising the healing process. One decisive factor influencing the possibility of returning to pre-disease training levels appears to be the utilisation of physical activity, including controlled movement, during the reha...
Taguchi T, Lopez MJ, Aoun R, Helber L.Over the last few decades, cell and cell-based therapies emerged as treatment options for equine tendinopathy and desmopathy. The objective of this study was to critically evaluate outcomes following treatment of equine tendinopathy or desmopathy with adult multipotent stromal/stem cells (MSCs). Unassigned: The PubMed and Web of Science databases were searched for "equine/horse," "tendon/tendinopathy/tendonitis/ligament/ligamentopathy/desmopathy/desmitis," "stem/stromal/mesenchymal/multipotent," and "cell" from January 2001 to June 2025. Studies were identified according to PRISMA guidelines, ...
