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.
Yin NH, McCarthy I, Birch HL.Human Achilles tendon is composed of three smaller sub-tendons and exhibits non-uniform internal displacements, which decline with age and after injury, suggesting a potential role in the development of tendinopathies. Studying internal sliding behaviour is therefore important but difficult in human Achilles tendon. Here we propose the equine deep digital flexor tendon (DDFT) and its accessory ligament (AL) as a model to understand the sliding mechanism. The AL-DDFT has a comparable sub-bundle structure, is subjected to high and frequent asymmetric loads and is a natural site of injury similar...
Hellige M, Warnken T, Puff C, Feige K.An 8-year-old Warmblood gelding presented with a history of progressive ataxia for 6 weeks. Intra- and intervertebral ratios measured from lateral radiographs of the cervical spine were within normal limits. Computed tomographic myelography of the cervical spine revealed focal compression of the dorsal and the ventral contrast column as well as a ventral displacement of the spinal cord within the spinal canal due to a bulging of soft tissue attenuating material in the dorsal half of the intervertebral junction of C6 and C7. Post-mortem histopathological examination confirmed chondroid metapla...
Symons J.Pressure boots are applied to hind limbs of showjumping horses with the intent to enhance jumping form. Manufacturers claim acupressure points enhance proprioception of hind limbs. With this increased awareness, horses are expected to retract their hind limbs to clear jump rails. This research aimed to investigate a more direct, mechanical effect of pressure boots on hind limb biomechanics. Cadaveric hind limbs ( = 6) were mechanically loaded in axial compression (3 cycles at 0.25 Hz, displacement control ~3300 N) with (2 trials) and without (2 trials) a pressure boot applied. During mechanica...
Montano C, Auletta L, Greco A, Costanza D, Coluccia P, Del Prete C, Meomartino L, Pasolini MP.The use of platelet-rich plasma (PRP) to enhance tenodesmic lesion healing has been questioned over the years. The aim of this study was to evaluate current literature to establish the effectiveness of PRP for treating tenodesmic lesions through a systematic review, in accordance with the PRISMA guidelines, and a meta-analysis. Studies comparing PRP with placebo or other treatments for horses with tenodesmic injuries or evaluated PRP effect on tendon and ligament explants were included. Outcomes were clinical, ultrasound, histologic, molecular evaluation, and adverse effects. Two authors indep...
Secchi V, Masala G, Corda A, Corda F, Potop E, Barbero Fernandez A, Pinna Parpaglia ML, Sanna Passino E.Early diagnosis of tendon injuries and accurate long-term monitoring of the healing process are key for equine veterinarians that use conventional ultrasonography. The development of strain elastography could improve the management of clinical cases. The aim of the study was to assess the intraobserver repeatability and interobserver reproducibility of manual measurements of the colored areas of the tendons within elastograms and to standardize this manual modality by comparing the analysis of the images with ImageJ. Twenty elastograms of the injured superficial digital flexor tendons (SDFTs) ...
Hawkins A, O'Leary L, Bolt D, Fiske-Jackson A, Berner D, Smith R.Injuries to the oblique (ODSL) or straight (SDSL) distal sesamoidean ligaments are a recognised cause of distal limb lameness in the horse. However, there are only limited publications addressing common diagnostic features and prognosis. Objective: (a) Report findings on ultrasonography and standing low-field magnetic resonance imaging (sMRI) in horses with ODSL or SDSL injury; (b) Identify clinical variables associated with lesion type and (c) Identify factors associated with return to soundness in horses with ODSL or SDSL injury. Methods: Retrospective case series. Methods: Horses with a pri...
Abu-Seida AM, Elemmawy YM.Desmopathy of the collateral sesamoidean ligament (CSL) is an unusual disorder in draft horses. This study records the magnetic resonance imaging (MRI) features of chronic CSL desmopathy in eight draft horses and confirms these features by histopathology. The recorded chronic CSL desmopathy has usually affected the forelimbs (100%) and commonly bilateral (62.5%). All horses showed positive proximal digital nerve block, positive front digital flexion test, and negative interphalangeal extension test. Radiography revealed no osseous abnormalities in all feet. MRI features of chronic CSL desmopat...
Góss GC, Mozzaquatro FD, Vanhove R, Camargo LP, Döwich Pradella G, Leite CT, Gomes EM, Carneiro ALM, Heckler GF, Duarte CA.The physiological measurements of collateral ligaments of distal interphalangeal joint (CL-DIPJ) differ in the literature. The factors that influence these differences are not well described. The aims of this study are to compare CL-DIPJ sizes in equines with different withers height, as well as to correlate body weight and hoof size to the size of these ligaments. In total, 52 horses were used in the study. They were divided into two groups according to wither height: Group 1 (G1) - 21 animals with up to 147 cm - and group 2 (G2) - 21 animals with greater than 148 cm. CL-DIPJ was ultrasonog...
Talbot AM, Rodrigues M, Maddox TW.Mineralisation of the longitudinal odontoid ligament has recently been identified in three horses undergoing computed tomographic (CT) examination, but published studies describing the clinical relevance of this finding are currently lacking. The objective of this retrospective, analytical, cross-sectional study was to investigate the relationship of this image finding to primary presenting complaint, age, breed, use and sex of the patient, and determine any association to the clinical signs of head shaking, neck pain or restricted range of neck motion. Computed tomographic images of 96 horses...
Salcedo-Jiménez R, Koenig JB, Lee OJ, Gibson TWG, Madan P, Koch TG.Extracorporeal shock wave therapy (ESWT) has been shown to induce different biological effects on a variety of cells, including regulation and stimulation of their function and metabolism. ESWT can promote different biological responses such as proliferation, migration, and regenerations of cells. Recent studies have shown that mesenchymal stromal cells (MSCs) secrete factors that enhance the regeneration of tissues, stimulate proliferation and differentiation of cells, and decrease inflammatory and immune reactions. Clinically, the combination of these two therapies has been used as a treatme...
Werpy N, Chapman K, Griffith L.When evaluating suspensory ligament branch splits, there is a discrepancy between high field MRI findings and weight bearing ultrasonographic imaging characteristics. In this descriptive and retrospective case series, ultrasonographic examination was performed on suspensory ligament branches with the limbs in weight bearing and non-weight bearing positions. Suspensory ligament branch splits were defined as linear regions of decreased echogenicity when imaged with the limb in a weight bearing position that increased in size and became anechoic with the limb in a non-weight bearing position. Thi...
Pechanec MY, Boyd TN, Baar K, Mienaltowski MJ.Tendon injuries amount to one of the leading causes of career-ending injuries in horses due to the inability for tendon to completely repair and the high reinjury potential. As a result, novel therapeutics are necessary to improve repair with the goal of decreasing leg lameness and potential reinjury. Small leucine-rich repeat proteoglycans (SLRPs), a class of regulatory molecules responsible for collagen organization and maturation, may be one such therapeutic to improve tendon repair. Before SLRP supplementation can occur in vivo, proper evaluation of the effect of these molecules in vitro n...
Murray RC, Tranquille CA, Walker VA, Milmine RC, Bak L, Tacey JB, Bolas NM.Standing magnetic resonance (MR) images of proximal metacarpal/metatarsal regions are increasingly being acquired. This study aimed at describing ranges of abnormalities detected in sport/racehorses, using retrospective evaluation of magnetic resonance imaging (MRI) reports from horses with lameness isolated to proximal metacarpal/metatarsal regions with images acquired standing. It was hypothesized that MRI features are different between metacarpal and metatarsal regions and between horses doing different sports. Reports from 359 forelimbs and 64 hindlimbs were included. Palmar/plantar metaca...
Rabba S, Petrucci V, Petrizzi L, Giommi DW, Busoni V.Information concerning B-mode ultrasonographic abnormalities and power Doppler (PD) signal in suspensory ligament branches of nonlame working Quarter Horses are not reported. The aims of this study were to investigate the prevalence of B-mode ultrasonographic abnormalities and PD signal in suspensory ligament branches in a group of nonlame working Quarter Horses and to compare B-mode findings with PD findings of horses in two different training (barrel racing and team roping). Twenty-one Quarter Horses in training, 14 barrel racing (Group B) and seven team roping horses (Group R), were assesse...
Olusa TAO, Akbar Z, Murray CM, Davies HMS.Despite many reported cases of carpal lameness associated with intercarpal ligament injuries in horses, the morphometry, movement pattern and general intrinsic biomechanics of the carpus are largely unknown. Using osteoligamentous preparation of the carpus prepared from 14 equine cadaver forelimbs (aged 9.62 ± 4.25 years), locomotory simulations of flexion and extension movements of the carpal joint were carried out to observed carpal biomechanics and, thereafter, the limbs were further dissected to obtain morphometric measurements of the medial and lateral collateral ligaments (MLC and LC...
Pluim M, Martens A, Vanderperren K, van Weeren R, Oosterlinck M, Dewulf J, Kichouh M, Van Thielen B, Koene MHW, Luciani A, Plancke L, Delesalle C.High-power laser therapy is often used as a treatment for human sport injuries but controlled standardized studies on its efficacy are lacking. The technique has also been introduced in the equine field and recently promising results were reported in a retrospective study focusing on 150 sporthorses suffering from tendinopathy and desmopathy of the SDFT, DDFT, suspensory ligament, and suspensory branches. The goal of the present study was to evaluate the effect of high-power laser in a standardized lesion model in horses. Lesions were created in all lateral suspensory branches of 12 warmblood ...
Nocera I, Aliboni B, Sgorbini M, Gracia-Calvo LA, Conte G, Ben David L, Citi S.Ultrasound (US) is a well-established technique for investigating joint diseases in horses, complementary to radiography. Few studies have been performed on the ultrasonographic aspect of the elbow joint in horses and no reports are available on donkeys. The aim of this study is to describe the ultrasonographic appearance of the elbow joint in healthy donkeys. Descriptive cohort study included 34 elbow joints, which were evaluated in 17 donkeys. Inclusion criteria included no lameness or musculoskeletal diseases in the donkeys. The structures evaluated were the lateral and medial collateral li...
Zhang C, Svensson RB, Montagna C, Carstensen H, Buhl R, Schoof EM, Kjaer M, Magnusson SP, Yeung CC.Tendon is a highly organized, dense connective tissue that has been demonstrated to have very little turnover. In spite of the low turnover, tendon can grow in response to loading, which may take place primarily at the periphery. Tendon injuries and recurrence of injuries are common in both humans and animals in sports. It is unclear why some areas of the tendon are more susceptible to such injuries and whether this is due to intrinsic regional differences in extracellular matrix (ECM) production or tissue turnover. This study aimed to compare populations of tenocytes derived from the tendon c...
Sayers E, Tabor G.Clinical reasoning has not been studied in veterinary physiotherapy and so the methods used and factors involved are unknown. Similarly, the practices of veterinary physiotherapists within a certain rehabilitation programme have not been documented. The aim of this study was to explore the clinical reasoning and practices of veterinary physiotherapists during rehabilitation of horses following interspinous ligament desmotomy surgery. Unassigned: A qualitative approach was taken and six members of the Association of Chartered Physiotherapists in Animal Therapy were interviewed using a semi-stru...
Aleman M, Berryhill E, Woolard K, Easton-Jones CA, Kozikowski-Nicholas T, Dyson S, Kilcoyne I.Sidewinder gait in horses is poorly understood and characterized by walking with the trunk and pelvic limbs drifting to 1 side. Objective: To report causes, clinical and diagnostic features. Methods: Horses examined at 2 institutions. Methods: Retrospective study (2000-2019). Cases with sidewinder gait, neurological and orthopedic examination, and diagnostic work up or postmortem evaluation were included. Descriptive statistics were performed. Results: Twenty-four horses (mean age 18.9 years) of various breeds and both sexes were included. Onset was acute (N = 10), subacute (N = 6), and insi...
Berner D, Mader D, Groß C, Gerlach K.In magnetic resonance imaging (MRI) examinations, moderate to severe changes of the distal sesamoidean impar ligament (DSIL) were found in horses with lameness localized to their feet. Histologic abnormalities were detected more commonly in lame horses. Because of its heterogeneity and small thickness, evaluation of the DSIL in MRI can be challenging. The aim of the study was to determine the optimal sequence and the ideal transverse perpendicular angle for visualization of the DSIL before and after arthrography of the distal interphalangeal joint (DIPJ). Twenty-five cadaver forelimbs were exa...
Zielińska P, Nicpoń J, Kiełbowicz Z, Soroko M, Dudek K, Zaborski D.The aim of this study was to evaluate the effects of high intensity laser therapy (HILT) on tendon and ligament injury treatment in horses. Twenty six horses with tendinopathies were randomly assigned to a HILT treated or to a non-treated group. Each horse was subjected to the same rehabilitation programme. Horses from the treatment group underwent a series of fifteen HILT treatments with the same parameters. Clinical and ultrasound assessments were performed by the same veterinarian and were carried out before (day 0), during (day 13-15) and after treatment (day 38-40). Clinical evaluation in...
Norvall A, Spriet M, Espinosa P, Ariño-Estrada G, Murphy BG, Katzman SA, Galuppo LD.Increased 18 F-Sodium Fluoride (18 F-NaF) uptake at the chondrosesamoidean ligament (ChSL) attachment on the distal phalanx was identified in an exploratory positron emission tomography (PET) study. The prevalence and significance of this lesion has not been previously investigated. Objective: The goal of this study was to assess the prevalence of this lesion, its association with other imaging findings and with clinical signs. Methods: Retrospective cross-sectional analytical study. Methods: All horses with 18 F-NaF PET and computed tomography (CT) imaging of the feet performed between Octobe...
Mostafa MB, Elemmawy YM.There is limited knowledge about causes of musculoskeletal injury in jumping Thoroughbred horses. The objective of this study was to describe the relationships between musculoskeletal disorders and linear and angular limb measurements acquired from photographs of horses with markers at specific reference points. The diagnosed musculoskeletal disorders in either fore or hind limbs were flexor tendonitis, suspensory ligaments desmitis, and osteoarthritis of the distal intertarsal and tarso-metatarsal and carpometacarpal joints. Lengths and angles in 17 clinically normal jumping Thoroughbred hors...
Metzger J, Distl O.Orthopedic diseases are a common cause for limited exercise capacity in the horse. They often underlie genetic risk factors, which can affect bone, articular cartilage, tendons, ligaments, and adnexal structures among others. The genetic effects can directly interfere with tissue development and skeletal growth or can trigger degenerative or inflammatory processes. Many of these diseases of the locomotor system like osteochondrosis are complex and can be affected by multifactorial influences. For this reason, it is important for those performing diagnostic procedures to have a comprehensive kn...
Hontoir F, Paques F, Simon V, Balau B, Nicaise C, Clegg P, Dugdale A, Vandeweerd JM.Foot pain is a frequent cause of lameness in horses and can involve multiple structures within the hoof. The T-ligament (an anatomical structure connecting the synovium of the distal interphalangeal joint, the digital flexor tendon sheath and the navicular bursa) is poorly described. Five pairs of equine cadaver distal forelimbs were collected from a slaughterhouse. Sagittal sections (medial, middle and lateral) were obtained and processed with Haematoxylin Eosin Safran, Unna's Orcein, and Picrosirius red stains. Histological assessment revealed that the T-ligament was covered by the surroundi...
Casillas JM, Jacobs CC, Manfredi JM.To identify radiographic locations of soft tissue attachments in the tarsal region of horses and describe any variability in the gross anatomy of those attachments. Methods: 15 cadaveric limbs from 8 adult horses. Methods: 8 limbs were used for dissection and radiography of soft tissue structures, with metallic markers used to identify radiographic locations of soft tissue attachments. The remaining 7 limbs were used to evaluate anatomic variations in the insertion of the tendon of the fibularis tertius muscle. A consensus list of preferred radiographic views for evaluating each soft tissue at...
May-Davis S, Gee C, Brown WY.Ultrasound is a well-established modality in equine investigative and diagnostic procedures. Although to date, it has not been utilized in examining the attachments of the equine nuchal ligament lamellae (NLL) onto the cervical vertebrae, for which a noninvasive technique is currently lacking. This study presents a standardized methodology for investigating the equine NLL using ultrasonography, and further evaluates the ultrasound images against postmortem dissection in two nonrelated horses. The ultrasound images in both horses clearly presented the attachment points of the NLL to the dorsal ...
Atkinson F, Evans R, Guest JE, Bavin EP, Cacador D, Holland C, Guest DJ.Tendon injuries are a common cause of morbidity in humans. They also occur frequently in horses, and the horse provides a relevant, large animal model in which to test novel therapies. To develop novel cell therapies that can aid tendon regeneration and reduce subsequent reinjury rates, the mechanisms that control tendon tissue regeneration and matrix remodelling need to be better understood. Although a range of chemical cues have been explored (growth factors, media etc.), the influence of the mechanical environment on tendon cell culture has yet to be fully elucidated. To mimic the in vivo e...
Ellis KL, Barrett MF, Selberg KT, Frisbie DD.Pathology involving the oblique sesamoidean ligaments (OSLs) is commonly diagnosed during magnetic resonance imaging (MRI) of the equine distal limb. Presence of striations within the ligament and magic angle artefact can result in an incorrect diagnosis of pathological change. No studies have been performed using histopathology, the gold standard, to corroborate their imaging diagnosis. Objective: (a) To determine which MRI characteristics are associated with normal vs abnormal OSLs and (b) to evaluate the ability of MRI to correctly identify abnormal vs normal oblique sesamoidean ligaments u...
Rabba S, Grulke S, Verwilghen D, Evrard L, Busoni V.Ultrasonography is routinely used to achieve the diagnosis of equine suspensory ligament desmopathy. In human medicine, power Doppler ultrasonography has also been found to be useful for the diagnosis of tendon/ligament injuries. The aim of this prospective, pilot study was to assess the presence or absence of power Doppler signal in suspensory ligament branches and compare B-mode findings with power Doppler findings in suspensory ligament branches of lame and non-lame limbs. Thirteen horses were used (eight lame horses, with lameness related to pain in the suspensory ligament branches, and fi...
Young M, Moshood O, Zhang J, Sarbacher CA, Mueller POE, Halper J.Horses afflicted with degenerative suspensory ligament desmitis (DSLD) suffer from progressive leg pain and lameness without history of trauma. DSLD is a systemic disorder caused by abnormal accumulation of proteoglycans in many connective tissues. One proteoglycan found in higher quantities in DSLD is decorin. The accumulated decorin has an abnormally glycosylated glycosaminoglycan chain in DSLD. In addition to acellular accumulations of proteoglycans foci of active fibroblasts/tenoblasts were observed in some tendons and suspensory ligaments (SLs) from DSLD cases We have hypothesized that th...
Adrian AM, Barrett MF, Werpy NM, Kawcak CE, Chapman PL, Goodrich LR.To evaluate and compare the diagnostic capability of arthroscopy and ultrasonography for the detection of pathological change in equine stifle joints. Although descriptions of the arthroscopic and ultrasonographic boundaries of the normal femorotibial joint exist, there are few examples in the literature comparing the pathological changes observed with each imaging modality. Objective: To evaluate and compare arthroscopic and ultrasonographic examinations for characterising pathological change in the stifle joint. To describe how the results of arthroscopic and ultrasonographic examinations ma...
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 ...
Staszyk C, Wulff W, Jacob HG, Gasse H.The objective of this study was to examine the spatial arrangement of the fiber apparatus of the equine periodontium which is supposed to meet two contrary requirements: (1) to attach the tooth firmly and elastically to the alveolar bone; and, to be appropriately remodeled and reconstructed in order to facilitate the prolonged eruption of the tooth. Specimens of periodontal ligament were obtained from the buccal and lingual/palatal aspects of the first molars from the maxilla and mandible of 12 horses. The animals were assigned to three age groups. Histological sections were prepared from thre...
Swanstrom MD, Zarucco L, Hubbard M, Stover SM, Hawkins DA.Because thoroughbred racehorses have a high incidence of forelimb musculoskeletal injuries, a model was desired to screen potential risk factors for injuries. This paper describes the development of a musculoskeletal model of the thoroughbred forelimb and a dynamic simulation of the motion of the distal segments during the stance phase of high-speed (18 m/s) gallop. The musculoskeletal model is comprised of segment, joint, muscle-tendon, and ligament information. The dynamic simulation incorporates a proximal forward-driving force, a distal ground reaction force model, muscle activations, and ...
Agut A, Martínez ML, Sánchez-Valverde MA, Soler M, Rodríguez MJ.The objectives of this study were to establish normal values for relative echogenicity (RE) and cross-sectional area (CSA) of the flexor tendons and ligaments of the metacarpal region of Purebred Spanish horses (PBSH), and to determine the effect of body mass index (BMI), age, sex and forelimb on these variables. Transverse ultrasonographic images were obtained using 20 normal PBSH (10 females, 10 males; 2-25 years of age; BMI 132.04-152.25; not in training). The images were digitised and values for CSA and RE were determined for each structure. The suspensory ligament was the most echogenic a...
Daglish J, Frisbie DD, Selberg KT, Barrett MF.High field magnetic resonance imaging (MRI) is increasingly used for horses with suspected stifle disease, however there is limited available information on normal imaging anatomy and potential incidental findings. The aim of this prospective, anatomic study was to develop an optimized high field MRI protocol for evaluation of the equine stifle and provide detailed descriptions of the normal MRI appearance of the stifle soft tissues, using ultrasound and gross pathological examination as comparison tests. Nine cadaver limbs were acquired from clinically normal horses. Stifles were evaluated ul...
Montano C, Auletta L, Greco A, Costanza D, Coluccia P, Del Prete C, Meomartino L, Pasolini MP.The use of platelet-rich plasma (PRP) to enhance tenodesmic lesion healing has been questioned over the years. The aim of this study was to evaluate current literature to establish the effectiveness of PRP for treating tenodesmic lesions through a systematic review, in accordance with the PRISMA guidelines, and a meta-analysis. Studies comparing PRP with placebo or other treatments for horses with tenodesmic injuries or evaluated PRP effect on tendon and ligament explants were included. Outcomes were clinical, ultrasound, histologic, molecular evaluation, and adverse effects. Two authors indep...
Riemersma DJ, van den Bogert AJ, Jansen MO, Schamhardt HC.Strains in the tendons of the m. flexor digitalis superficialis (superficial digital flexor, SDFT) and m. flexor digitalis profundus (deep digital flexor, DDFT) tendons, the accessory ligament of the deep digital flexor muscle (inferior check ligament, ICL) and the m. interosseus medius (suspensory ligament, SL) of 5 ponies were recorded at the walk and trot using mercury-in-silastic strain gauges (MISS), on a hard surface (brick pavement) and on sand. The horses were shod with normal, flat shoes. On pavement, strain in the SDFT, DDFT and SL increased significantly from the walk (2.19%, 1.15% ...
Salcedo-Jiménez R, Koenig JB, Lee OJ, Gibson TWG, Madan P, Koch TG.Extracorporeal shock wave therapy (ESWT) has been shown to induce different biological effects on a variety of cells, including regulation and stimulation of their function and metabolism. ESWT can promote different biological responses such as proliferation, migration, and regenerations of cells. Recent studies have shown that mesenchymal stromal cells (MSCs) secrete factors that enhance the regeneration of tissues, stimulate proliferation and differentiation of cells, and decrease inflammatory and immune reactions. Clinically, the combination of these two therapies has been used as a treatme...
McClure SR, VanSickle D, Evans R, Reinertson EL, Moran L.Extracorporeal shock-wave therapy (ESWT) may stimulate healing of desmitis in multiple species. The objective of this study was to evaluate the ultrasonographic and histologic appearance of collagenase-induced suspensory ligament (SUL) desmitis in untreated ligaments and ligaments treated with ESWT in horses. Four mature horses had SUL desmitis induced in both forelimbs. Beginning 3 weeks after induction of the lesions, one ligament per horse was treated 3 times at 3-week intervals with ESWT. The percent lesion, echogenicity and fiber alignment scores of the SULs were evaluated at 3-week inter...
Raes EV, Bergman EH, van der Veen H, Vanderperren K, Van der Vekens E, Saunders JH.To compare computed tomography (CT) images of equine tarsi with cross-sectional anatomic slices and evaluate the potential of CT for imaging pathological tarsal changes in horses. Methods: 6 anatomically normal equine cadaveric hind limbs and 4 tarsi with pathological changes. Methods: Precontrast CT was performed on 3 equine tarsi; sagittal and dorsal reconstructions were made. In all limbs, postcontrast CT was performed after intra-articular contrast medium injection of the tarsocrural, centrodistal, and tarsometatarsal joints. Images were matched with corresponding anatomic slices. Four tar...
McLellan J, Plevin S.Sesamoiditis is believed to be associated with injury to the suspensory branch attachment and is a common radiographic finding in yearling Thoroughbreds. No study has investigated relationships between yearling sesamoiditis and subsequent development of suspensory ligament branch injury (SLBI) in early racehorse training. Objective: To establish the prevalence of SLBI within a population of juvenile training racehorses and retrospectively investigate relationships between clinical signs of SLBI and sesamoiditis to determine if sesamoiditis is a risk factor for clinical suspensory branch injury...
Ohba T, Ebata S, Ando T, Ichikawa J, Clinton D, Haro H.Hematoma of the ligamentum flavum is a rare cause of neural compression, for which treatment has consisted of excising the hematoma via open surgical approaches, including total laminectomy or bilateral partial laminectomy. This article presents the first report of a microscope-assisted endoscopic decompression to resect a hematoma of the ligamentum flavum.A 52-year-old man presented with back and leg pain, as well as difficulty initiating micturation. Magnetic resonance imaging demonstrated an epidural mass at L5/S1 that was continuous with the facet joint. Visualization was obtained via an e...
Butcher MT, Hermanson JW, Ducharme NG, Mitchell LM, Soderholm LV, Bertram JE.Racing and training related lesions of the forelimb superficial digital flexor tendon are a common career ending injury to racehorses but aetiology and/or predisposing causes of the injury are not completely understood. Objective: Although the injury takes place within the tendon, the lesion must be considered within the context of the function of the complete suspensory system of the distal limb, including the associated muscles. Methods: Both muscle and tendon function were investigated in vivo using implanted strain gauges in 3 Thoroughbred horses walking, trotting and cantering on a motori...
Hermanson JW, Cobb MA.Two of the forearm flexors of the horse, the superficial and deep digital flexor muscles, are critical to support the digital and fetlock joints, exhibit differing insertions, and are passively supported by the proximal and distal check ligaments, respectively. These two muscles differ in histochemical composition and architecture. The differences are correlated with the different stress levels transmitted through their tendons, and the different frequencies of clinical breakdown that have been reported. Both muscles contain type I and type IIa fibers. A few type IIb fibers occurred in the dee...
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...
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 ...
Werpy NM, Denoix JM.Injury to the suspensory ligament can result in significant lameness. Multiple imaging modalities may be required to fully characterize injury to the suspensory ligament. Ultrasonography of the suspensory ligament is challenging, due to the normal anatomy. This article describes imaging of the proximal suspensory ligament in the front and hind limbs of the horse.
Santschi EM.Articular injuries to the fetlock joint can be categorized as injuries to the soft tissues (synovium, ligaments, cartilage) or bone (third metacarpus/metatarsus, first phalanx, proximal sesamoids). This article focuses on the traumatic injuries to the cartilage and bone from anatomic, functional, and pathophysiological perspectives. An understanding of fetlock motion and loading will assist clinicians in the diagnosis, treatment, and, most importantly, prevention of fetlock injury in working horses.
Padaliya NR, Ranpariya JJ, Kumar D, Javia CB, Barvalia DR.The present study was conducted to evaluate the equine palmar tendon by ultrasonography (USG) in standing the position. Methods: USG of palmar tendons was performed in 40 adult horses using linear transducer having frequency of 10-18 MHz (e-soate, My Lab FIVE) and L52 linear array transducer (Titan, SonoSite) with frequencies ranging from 8 to 10 MHz. Palmar tendon was divided into 7 levels from distal to accessory carpal bone up to ergot in transverse scanning and 3 levels in longitudinal scanning. Results: The USG evaluation was very useful for diagnosis of affections of the conditions such ...
Wilson DA, Baker GJ, Pijanowski GJ, Boero MJ, Badertscher RR.Suspensory ligaments (SL) from 32 Thoroughbreds and 32 Standardbreds were collected to evaluate the variation in muscle content with respect to age, breed, sex, limb, and use. Six transverse sections, each 3 to 5 mm thick, were obtained from each SL. Four sections were taken from the body of the SL and 1 from the midportion of each branch. Sections were stained with van Gieson picric acid-fuchsin solution, then photographed, and black-and-white slides were made from the processed negatives. The transverse-sectional area of the SL and the contained muscle were determined by use of a computer wi...
Henson FM, Lamas L, Knezevic S, Jeffcott LB.Injury to the supraspinous ligament (SSL) is reported to cause back pain in the horse. The diagnosis is based on clinical examination and confirmed by ultrasonographic examination. The ultrasonographic appearance of the supraspinous ligament has been well described, but there are few studies that correlate ultrasonographic findings with clinical pain and/or pathology. This preliminary study aims to test the hypothesis that unridden horses (n = 13) have a significantly reduced frequency of occurrence of ultrasonographic changes of the SSL consistent with a diagnosis of desmitis when compared to...
Waguespack RW, Burba DJ, Hubert JD, Vidal MA, Lomax LG, Chirgwin SR, Lopez MJ.To evaluate the effects of extracorporeal shock wave therapy (ESWT) on collagenase-induced lesions in the accessory ligament of the deep digital flexor tendon (ALDDFT) of horses. Methods: Paired, blinded controlled study. Methods: Eight Thoroughbred horses (3 mares, 5 geldings; mean ± SD weight, 464 ± 26 kg, mean age, 8 ± 1.7 years). Methods: Lesions were created in both ALDDFTs of all horses by injection of 2 × 10(3) IU of collagenase type I. Percent lesion and structure (fiber alignment and echogenicity) were quantified with ultrasonographic imaging 3, 6, and 9 weeks after collagenase ...
Vanderperren K, Ghaye B, Snaps FR, Saunders JH.To determine the detailed computed tomography (CT) anatomy of the metacarpophalangeal (MCP) joint in healthy horses. Methods: 10 cadaveric forelimbs from 10 adult horses without orthopedic disease. Methods: CT of the MCP joint was performed on 4 forelimbs. In 1 of the limbs, CT was also performed after intra-articular injection of 30 mL of contrast medium (40 mg of iodine/mL). Transverse slices 1-mm thick were obtained, and sagittal and dorsal planes were reformatted with a slice thickness of 2 mm. The CT images were matched with corresponding anatomic slices from 6 additional forelimbs. Resul...
Bosch G, Lameris MC, van den Belt AJ, Barneveld A, van Weeren PR.Clinical tendon lesions usually enlarge during the first days to weeks after sustaining the injury due to enzymatic and biomechanical influences. Limiting this enlargement would positively influence prognosis related to lesion size. Objective: To investigate the effect of cyclic loading on the propagation of enzymatically and physically induced tendon lesions and to assess the effect of immobilisation thereon in an ex vivo model. Methods: Equine cadaver limbs with either physically or collagenase-induced SDFT lesions were placed in a pneumatic loading device. Groups consisted of unloaded limbs...
Murray RC, Tranquille CA, Walker VA, Milmine RC, Bak L, Tacey JB, Bolas NM.Standing magnetic resonance (MR) images of proximal metacarpal/metatarsal regions are increasingly being acquired. This study aimed at describing ranges of abnormalities detected in sport/racehorses, using retrospective evaluation of magnetic resonance imaging (MRI) reports from horses with lameness isolated to proximal metacarpal/metatarsal regions with images acquired standing. It was hypothesized that MRI features are different between metacarpal and metatarsal regions and between horses doing different sports. Reports from 359 forelimbs and 64 hindlimbs were included. Palmar/plantar metaca...
Brokken MT, Schneider RK, Sampson SN, Tucker RL, Gavin PR, Ho CP.Magnetic resonance (MR) imaging abnormalities in horses with lameness localized to the proximal metacarpal or metatarsal region have not been described. To accomplish that, the medical records of 45 horses evaluated with MR imaging that had lameness localized to either the proximal metacarpal or metatarsal region were reviewed. Abnormalities observed in the proximal suspensory ligament or the accessory ligament of the deep digital flexor tendon included abnormal high signal, enlargement, or alteration in shape. Twenty-three horses had proximal suspensory ligament desmitis (13 hindlimb, 10 fore...
Kraus-Hansen AE, Fackelman GE, Becker C, Williams RM, Pipers FS.The vascular and microvascular anatomy of normal equine superficial digital flexor tendons was studied by dissection of vinyl-perfused specimens and by microangiography on high detail film. The presence of an extensive intratendinous vascular latticework was confirmed, and a 'nutrient artery' described closely associated with the accessory ligament of the superficial digital flexor tendon (proximal check ligament). Circumferential stripping of the paratenon from the tendon to eliminate afferent vessels was performed bilaterally in three horses and unilaterally in a fourth, followed by a treadm...
