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.
Quiney L, Murray R, Dyson S.This case report describes the successful management of two horses with medial carpal collateral ligament injury. This is a rare cause of forelimb lameness and existing reports indicate a poor prognosis for return to athletic function with conservative management. Both horses were treated with a combination of box rest with controlled exercise and high-intensity laser therapy (HILT). Both horses returned to previous athletic function, one at Grand Prix level dressage and one at Novice level eventing. With appropriate management, the prognosis for carpal collateral ligament injury may be good. ...
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 ...
Legg KA, Colborne GR, Gee EK, Rogers CW.To evaluate the elastic modulus of various ligaments of the forelimbs of cadaveric horses. Methods: 408 ligaments from 37 forelimbs of 10 Thoroughbred cadavers and cadavers of 9 other horse breeds. Methods: Collateral ligaments and straight and oblique sesamoid ligaments were harvested from the proximal interphalangeal, metacarpophalangeal, carpal, and elbow joints of both forelimbs of all 19 horses. Ligament dimensions were measured, and the elastic modulus was determined by tensile testing the ligaments with a strain rate of 1 mm•s. Results: Elastic modulus of the ligaments differed signif...
Kent AV, Chesworth MJ, Wells G, Gerdes C, Bladon BM, Smith RKW, Fiske-Jackson AR.Pathology of the digital flexor tendon sheath is a significant cause of lameness in the horse. Imaging is important to identify lesions and inform on prognosis prior to tenoscopic surgery. Objective: To use a large population to evaluate 1) the sensitivity and specificity of digital flexor tendon sheath (DFTS) contrast radiographs in diagnosing manica flexoria (MF) tears, deep digital flexor tendon (DDFT) tears and constriction of the palmar/plantar annular ligament (PAL) using novel criteria; 2) predisposition to pathology in signalment and limb affected. Methods: Multicentre retrospective co...
Muñoz A, Saitua A, Becero M, Riber C, Satué K, de Medina AS, Argüelles D, Castejón-Riber C.In recent years, exercise on a water treadmill has come to have great relevance in rehabilitation and training centres for sport horses. Its use exploits certain physical properties of water, related to the fundamental principles of hydrodynamics, such as buoyancy, viscosity, hydrostatic pressure, and water temperature. These properties together with deliberate specification of the depth of the water and the velocity of the treadmill provide a combination of parameters that can be varied according to the purpose of the rehabilitation or training programme, the disease to rehabilitate, or the h...
Ahmed W, Kulikowska M, Ahlmann T, Berg LC, Harrison AP, Elbrønd VS.Fascia in the veterinary sciences is drawing attention, such that physiotherapists and animal practitioners are now applying techniques based on the concept of fascia studies in humans. A comprehensive study of fascia is therefore needed in animals to understand the arrangement of the fascial layers in an unguligrade horse and a digitigrade dog. This study has examined the difference between the horse and the dog fascia at specific regions, in terms of histology, and has compared it with the human model. Histological examinations show that in general the fascia tissue of the horse exhibits a t...
Dippel M, Zsoldos RR, Licka TF.Pressure in the atlanto-axial region due to hyperflexion ('rollkur') may influence the development of a nuchal bursa, as adventitious bursae may be caused by pressure. Investigating the pressure between the nuchal ligament and atlas/axis in a flexed position may provide information on the pathogenesis of nuchal bursitis. In this study, ten equine head and neck specimens with one side of the soft tissues over the cervical vertebral spine removed were placed in lateral recumbency on a table in neutral, mildly flexed, and hyperflexed head and neck positions. Angulations of the neck were measured ...
Zellmann P, Ribitsch I, Handschuh S, Peham C.We developed a finite element model (FEM) of the equine stifle joint to identify pressure peaks and simulate translocation and deformation of the menisci. A series of sectional magnetic resonance images (1.5 T) of the stifle joint of a 23 year old Shetland pony gelding served as basis for image segmentation. Based on the 3D polygon models of femur, tibia, articular cartilages, menisci, collateral ligaments and the meniscotibial ligaments, an FEM model was generated. Tissue material properties were assigned based on data from human (Open knee(s) project) and bovine femoro-tibial joint available...
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 ...
May-Davis S, Vermeulen Z, Brown WY.The 55-million-year history of equine phylogeny has been well-documented from the skeletal record; however, this is less true for the soft tissue structures that are now vestigial in modern horse. A recent study reported that two ligamentous structures resembling functional interosseous muscle II and IV were evident in Dutch Konik horses. The current study investigates this finding and compares it to members of the genus Equus to identify either a breed anomaly or functional primitive trait. Distal limbs (n = 574) were dissected from four species of Equus; E. caballus, E. asinus, E. przewalski...
Hoaglund EL, Barrett MF, Daglish J, Contino EK.Intermediate patellar ligament (IPL) desmopathy is a relatively uncommon injury previously reported to have a poor prognosis for return to athletic activity. There is little documentation of the clinical and ultrasonographic features, clinical significance, and outcome for return to work following IPL injury in horses. The aim of this retrospective descriptive study was to describe the clinical and ultrasonographic features of IPL desmopathy, its association with other injuries of the stifle, and outcome for return to work following injury. Forty-two stifles with an ultrasound diagnosis of IPL...
Kamineni S, Ruggles A, Ashfaq H.Ultrasonic debridement as a treatment for tendinopathy and desmitis is a relatively new approach in orthopedic surgery. Previously only used in limited cases, this procedure shows promise for treating ligament-bone and tendon-bone interface injuries. We present a case study of a 2-yr-old thoroughbred male horse, unable to train due to recalcitrant symptoms after extensive conservative management of suspensory branch desmitis. It was then treated with ultrasonic debridement and concurrent manubrial stem cell autograft injection, to treat the ultrasound visualized lesion. Post-surgically, the pa...
Kirkpatrick CJ, Ernst NS, Trumble TN.There are limited radiographic-guided injection techniques of the insertion of the distal interphalangeal joint (DIPJ) collateral ligaments. The objective of this study was to develop and evaluate a palmar/plantar radiographic-guided injection of the collateral ligament insertion in cadavers. Fifty limbs were used to develop the technique and 24 additional limbs were used to evaluate accuracy. An 18 G, 9 cm spinal needle was placed in the depression between the palmar digital neurovascular bundle and arch of the ungular cartilage with dorsodistal advancement towards the distal phalanx collat...
Daniel AJ, Leise BS, Selberg KT, Barrett MF.Injuries to the structures within the digital flexor tendon sheath (DFTS) can lead to lameness with a variable degree of effusion in horses. In some cases, effusion is absent or minimal, and this may be related to the chronicity and type of injury, or veterinary interventions. The purpose of this study was to determine if saline injection into the DFTS would improve ultrasonographic and magnetic resonance imaging of the distal limb without introducing artifact. Nine normal equine cadaver forelimbs were collected. Non-weight-bearing ultrasonographic and magnetic resonance imaging (MRI) examinat...
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...
Hontoir F, Rejas E, Falticeanu A, Nisolle JF, Simon V, Nicaise C, Clegg PD, Vandeweerd JE.Diffusion of drugs injected into the distal interphalangeal joint or the navicular (podotrochlear) bursa can influence diagnosis and treatment of foot pain. Previous anatomical and radiographic studies of the communication between these synovial structures have produced conflicting results and did not identify the location of any communication if present. This anatomic study aimed to assess the presence and site of communication between the distal interphalangeal joint and the navicular bursa in the horse by computed tomography arthrography. Sixty-six pairs of cadaver forelimbs were injected w...
Ehrle A, Ressel L, Ricci E, Merle R, Singer ER.The equine interspinous ligament (ISL) consists of an oblique crossing arrangement of collagenous bundles which are thought to counteract the tensile and rotational forces of distraction between the spinous processes (SPs) in the caudal thoracic and cranial lumbar spine. The aim of this controlled histological study was to assess the structural anatomy and innervation of the ISL in horses with clinically significant overriding (dorsal) SPs (ORSPs) and to compare the findings with the ISL of normal horses. Samples of the ISL were obtained from 10 horses that underwent subtotal ostectomy for tre...
Kadic DTN, Minshall GJ, Wright IM.Suspensory ligament branch injuries are common in horses. Most of these injuries are grouped together and considered as a single pathologic entity. Objective: To report a specific injury of the abaxial margin of the suspensory ligament branches and to report its surgical management and outcome. Methods: Retrospective case series. Methods: All horses with suspensory ligament branch injuries over a 9-year period (2007-2015) were identified. Horses with injuries which, on ultrasonographic examination, appeared to have defects in the abaxial margin of the suspensory ligament branch, that were subs...
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...
Kovac M, Litvin YA, Aliev RO, Zakirova EY, Rutland CS, Kiyasov AP, Rizvanov AA.This clinical study describes the intralesional application of the plasmid DNA encoding two therapeutic species-specific growth factors: vascular endothelial growth factor (VEGF164) and fibroblast growth factor 2 (FGF2) in seven horses to restore naturally occurring injuries of the superficial digital flexor tendon (SDFT) (tendinitis) and in three horses with suspensory ligament branch desmitis. Following application all horses were able to commence a more rapid exercise program in comparison to standardized exercise programs. Clinical observation and ultrasonic imaging was used to evaluate th...
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...
Barrett MF, Selberg KT, Johnson SA, Hersman J, Frisbie DD.Injury of the distal tarsus and proximal metatarsus commonly causes lameness. Magnetic resonance imaging (MRI) allows concurrent assessment of both the distal tarsal joints and suspensory ligament origin, and aids identification of lesions that may otherwise go undetected by other modalities. In this retrospective observational study, the medical records of a veterinary imaging center were searched for MRI exams of the distal tarsus and proximal metatarsus for the years 2012 through 2014. Studies for 125 limbs of 103 horses were identified and retrospectively evaluated by two board-certified v...
Ortved KF.Tendon and ligament injuries are a common source of lameness in the athletic horse. Although tendons and ligaments have the ability to spontaneously heal, lesions tend to fill with biomechanically inferior fibrous tissue such that the horse is prone to reinjury. Regenerative medicine is used to improve quality of repair tissue and prevent reinjury. Platelet-rich plasma, stem cells, and autologous conditioned serum are the most commonly used orthobiologics in the horse. A tailored rehabilitation program is key to returning horses to athleticism following injury. The specifics of regenerative me...
O'Brien EJO, Smith RKW.Tendon/ligament mineralization is recognized in horses but information regarding its clinical significance is limited. The aims of this observational study were to report the structures most commonly affected by ultrasonographically detectable mineralization and, for these, determine frequency of diagnosis and key clinical features. Cases presented at our hospital in April 1999-April 2013 and September 2014-November 2015 were included: a total of 27 horses (22 retrospective, five prospective). Mineralizations were most common in deep digital flexor tendons (10) and suspensory ligament branches...
MacDonald JL, Richter RA, Wimer CL.Ultrasonography is an established diagnostic test for evaluating horses with foot pain due to suspected podotrochlear apparatus pathology. However, variations from the previously reported normal appearance of the distal sesamoidean impar ligament have not always coincided with lameness. The objective of this prospective, cross-sectional, descriptive study was to characterize variations in the ultrasonographic appearance of the distal sesamoidean impar ligament in sound horses using the transcuneal approach. Transcuneal ultrasonography of the distal sesamoidean impar ligament was performed on s...
Le Roux C, Carstens A.Axial sesamoiditis or osteitis of the proximal sesamoid bones (PSBs) in the horse is described as a rare condition. The cause remains unknown and speculative, with vascular, infectious, and traumatic aetiologies implicated. It is specifically associated with injury of the palmar or plantar ligament (PL), also known as the intersesamoidean ligament. Imaging findings are generally rewarding and radiological changes are typical, if not pathognomonic, for the condition. Lesions consist of bone lysis at the apical to mid-body axial margins of the PSBs, with variable degrees of joint effusion. Radio...
May-Davis S, Brown W, Vermeulen Z.Conflicting data predominantly describes the equine nuchal ligament lamellae (NLL) attachments as C2-C6 or C2-C7; however, preliminary evidence suggests C2-C5. This study aimed to identify morphological variations in the attachments of the NLL in four species of the family equidae and determine if the variations were species or breed linked. Cadaveric examination evaluated 98 equids; Equusasinus (n = 2), Equus ferus caballus (n = 93), Equus przewalskii (n = 2), and Equus quagga boehmi (n = 1). Twenty breeds of E. f. caballus were included according to breed type-modern horse (n = 81), anc...
Ribitsch I, Peham C, Ade N, Dürr J, Handschuh S, Schramel JP, Vogl C, Walles H, Egerbacher M, Jenner F.Meniscal pathologies are among the most common injuries of the femorotibial joint in both human and equine patients. Pathological forces and ensuing injuries of the cranial horn of the equine medial meniscus are considered analogous to those observed in the human posterior medial horn. Biomechanical properties of human menisci are site- and depth- specific. However, the influence of equine meniscus topography and composition on its biomechanical properties is yet unknown. A better understanding of equine meniscus composition and biomechanics could advance not only veterinary therapies for meni...
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...
Biggi M, Dyson SJ.OBJECTIVE To use high-field and low-field MRI to describe the anatomy of the proximal portion of the tarsal region (proximal tarsal region) of nonlame horses. SAMPLE 25 cadaveric equine tarsi. PROCEDURES The proximal portion of 1 tarsus from each of 25 nonlame horses with no history of tarsal lameness underwent high-field (1.5-T) and low-field (0.27-T) MRI. Resulting images were used to subjectively describe the anatomy of that region and obtain measurements of the collateral ligaments of the tarsocrural joint. RESULTS Long and short components of the lateral and medial collateral ligaments of...
Fairburn AJ, Busschers E, Barr ARS.Suspensory ligament branch (SLB) desmopathy is a common cause of lameness and an important cause of lost training in the Thoroughbred racing industry. Studies have assessed the impact of insertional injuries of the SLB on the careers of flat racehorses and established the prevalence of subclinical ultrasonographic SLB abnormalities in this population, but little work has investigated SLB injury in National Hunt (NH) racehorses. Objective: To investigate the prevalence of subclinical ultrasonographic SLB abnormalities in NH racehorses with no clinical signs or history of SLB injury and to estab...
Rothaug PG, Boston RC, Richardson DW, Nunamaker DM.To compare the monotonic tensile and fatigue strength of 16-gauge stainless steel wire (SSW) to ultra-high-molecular weight polyethylene (UHMWPE) cable using a transfixed cerclage technique in an in vitro midbody sesamoid osteotomy model. Endoscopic modifications to Martins transfixed cerclage technique were developed. A new suture technique of fixation was compared with the transfixed cerclage technique by measuring gap formation after cyclic testing. Methods: An in vitro biomechanical paired equine cadaver limb study. Methods: Twenty-one paired cadaveric adult equine forelimbs. Methods: Unia...
Mercati F, Pascucci L, Curina G, Scocco P, Tardella FM, Dall'aglio C, Marini C, Ceccarelli P.The transplantation of multipotent mesenchymal stromal cells (MSCs) is a potentially promising therapy for the treatment of tendon and ligament injuries and some forms of articular pathology in horses. This study investigated the effects of storage conditions on MSCs. Equine adipose tissue-derived MSCs (eAd-MSCs) were stored at 4 °C and at room temperature (RT) for 24 and 48 h, and viability, doubling time, expression of CD44 and CD90 antigens, clonogenic/differentiation potentials, and karyotype were subsequently evaluated. The eAd-MSC viability was significantly affected by the storage ...
Halper J.Though soft tissue disorders have been recognized and described to some detail in several types of domestic animals and small mammals for some years, not much progress has been made in our understanding of the biochemical basis and pathogenesis of these diseases in animals. Ehlers-Danlos syndrome described in dogs already in 1943 and later in cats affects mainly skin in these animals. The involved skin is thin and hyperextensible with easily inflicted injuries resulting in hemorrhagic wounds and atrophic scars. Joint laxity and dislocation common in people are less frequently found in dogs. No...
Halper J.Though soft tissue disorders have been recognized and described to some detail in several types of domestic animals and small mammals for some years, not much progress has been made in our understanding of the biochemical basis and pathogenesis of these diseases in animals. Ehlers-Danlos syndrome described in dogs already in 1943 and later in cats affects mainly skin in these animals. The involved skin is thin and hyperextensible with easily inflicted injuries resulting in hemorrhagic wounds and atrophic scars. Joint laxity and dislocation common in people are less frequently found in dogs. No...
Rumbaugh ML, Burba DJ, Natalini C, Hosgood G, Moore RM.To compare arterial bursting pressure after vessel closure using a vessel-sealing device (LigaSure Atlas Laparoscopic Sealer/Divider Instrument; Valleylab, Boulder, CO), a ligate-and-divide stapling device (LDS), and 2-0 polydioxanone suture. To evaluate the LigaSure Atlas as a method for ligation of the mesenteric vasculature during small intestinal resection in normal horses. Methods: Experimental study. Methods: Part A: jejunal segments from 19 horses. Part B: 6 horses, aged 1 to 18 years, weighing 330 to 509 kg. Methods: Part A: Jejunal segments with mesenteric vessels were collected from ...
Nagy A, Dyson S.While low-field magnetic resonance (MR) images can provide useful information in the investigation of proximal metacarpal region pain, an in-depth knowledge of anatomy and comparison with more detailed high-field images are essential to understand the meaning of different signal intensities within tissues. This anatomic description is based on low-field and high-field MR examination of 30 cadaver metacarpal regions of mature horses with no history of carpal or proximal metacarpal pain. Normal MR anatomy is described and is illustrated by high-field and low-field MR images in transverse, sagitt...
Pollitt CC, Collins SN.The suspensory apparatus of the distal phalanx (SADP) is functionally and clinically important. Objective: To investigate SADP form and function and the microanatomy of its insertion zone. Methods: Descriptive gross and microanatomy. Methods: The feet of 6 normal Standardbred horses were sectioned into blocks along the traditional perpendicular transverse axis and along functional axes of the SADP, decalcified and processed for staining with haematoxylin and eosin, Jones' periodic acid silver methenamine or Masson's trichrome stains. Results: In traditional midline toe transverse plane section...
Spriet M, Espinosa P, Kyme AZ, Phillips KL, Katzman SA, Galuppo LD, Stepanov P, Beylin D.Positron emission tomography (PET) is a cross-sectional, functional imaging modality that has recently become available to the horse. The use of 18 F-sodium fluoride (18 F-NaF), a PET bone tracer, has not previously been reported in this species. Objective: To assess the feasibility of 18 F-NaF PET in the equine distal limb and explore possible applications in the horse in comparison with other imaging modalities. Methods: Exploratory descriptive study involving three research horses. Methods: Horses were placed under general anaesthesia prior to intravenous (i.v.) administration of 1.5 MBq/kg...
Sampson SN, Schneider RK, Gavin PR, Ho CP, Tucker RL, Charles EM.Seventy-two horses with recent onset of navicular syndrome and normal radiographs were assessed. Horses underwent magnetic resonance (MR) imaging of both front feet. All abnormalities were characterized and the most severe abnormality identified, if possible. Abnormal signal intensity in the navicular bone was the most severe abnormality in 24 (33%) horses. Pathologic change in the deep digital flexor tendon was the most severe abnormality in 13 (18%) horses. Pathologic change in the collateral sesamoidean ligament was the most severe abnormality in 11 (15%) horses. Pathologic change in the di...
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...
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...
Lin ST, Peter VG, Schiavo S, Pokora R, Patrick H, Bolas N, Foote AK, Sargan DR, Murray RC.Heterotopic mineralization in equine distal limbs has been considered an incidental finding and little is known about its imaging features. The study aimed to identify heterotopic mineralization and adjacent pathology in the fetlock region with cone-beam (CB) computed tomography (CT), fan-beam (FB) CT, and low-field magnetic resonance imaging (MRI). Images from 12 equine cadaver limbs were examined for heterotopic mineralization and adjacent pathology and verified by macro-examination. Retrospective review of the CBCT/MR images from 2 standing horses was also included. CBCT and FBCT identified...
Puchalski SM, Galuppo LD, Drew CP, Wisner ER.We compared contrast-enhanced computed tomography (CT) and high field magnetic resonance (MR) imaging in a horse with deep digital flexor tendonopathy. Lesions in the distal extremity were documented grossly and histopathologically. In contrast-enhanced CT, the deep digital flexor tendon lesions were markedly contrast enhancing with evidence of angiogenesis in the core and dorsal border lesions. The lesion morphology was clearly delineated on MR imaging, but without contrast media angiogenesis cannot be identified. Gross examination, histopathologic examination, and CD31 immunohistochemistry c...
Contino EK, King MR, Valdés-Martínez A, McIlwraith CW.Hindlimb proximal suspensory desmopathy is a common injury of sport horses but diagnosis can be difficult because diagnostic analgesia of the region lacks specificity. Perineural analgesia of the deep branch of the lateral plantar nerve (DBLPN) has been proposed as a more specific method of isolating pain of the proximal aspect of the suspensory ligament but the technique has not been evaluated in vivo. Objective: To determine the extent of diffusion of contrast medium and mepivacaine following DBLPN analgesia using a single-needle injection technique and to determine if there is inadvertent i...
Vekens EV, Bergman EH, Vanderperren K, Raes EV, Puchalski SM, Bree HJ, Saunders JH.To provide a detailed computed tomography (CT) reference of the anatomically normal equine stifle joint. Sample-16 hind limbs from 8 equine cadavers; no horses had evidence of orthopedic disease of the stifle joints. Methods: CT of the stifle joint was performed on 8 hind limbs. In all limbs, CT was also performed after intra-articular injection of 60 mL of contrast material (150 mg of iodine/mL) in the lateral and medial compartments of the femorotibial joint and 80 mL of contrast material in the femoropatellar joint (CT arthrography). Reformatted CT images in the transverse, parasagittal, an...
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...
Roberts JH, Halper J.Repair and healing of injured and diseased tendons has been traditionally fraught with apprehension and difficulties, and often led to rather unsatisfactory results. The burgeoning research field of growth factors has opened new venues for treatment of tendon disorders and injuries, and possibly for treatment of disorders of the aorta and major arteries as well. Several chapters in this volume elucidate the role of transforming growth factor β (TGFß) in pathogenesis of several heritable disorders affecting soft tissues, such as aorta, cardiac valves, and tendons and ligaments. Several member...
Zarucco L, Wisner ER, Swanstrom MD, Stover SM.Biomechanical models that compute the lengths and forces of muscle-tendon units are broadly applicable to the study of factors that promote injury and the planning and effects of orthopedic surgical procedures in equine athletes. A three-dimensional (3D) generic musculoskeletal model of the equine forelimb comprised of bony segment, muscle-tendon, and ligament information, was developed based on high-resolution computed tomographic (CT) and T1-weighted magnetic resonance (MR) images from an isolated forelimb of a Thoroughbred racehorse. Image fusion was achieved through coregistration of CT an...
Barrett MF, Frisbie DD, McIlwraith CW, Werpy NM.While descriptions of the visible soft tissues of the femorotibial joints exist for both arthroscopy and ultrasonography, there are few examples in the literature that discuss in detail the combined findings of these modalities. Objective: To further elucidate the ultrasonographic and arthroscopic boundaries of the normal equine femorotibial joints and improve the understanding of the benefits and limitations of each individual modality. Methods: Simultaneous arthroscopy and ultrasonography were performed in 10 equine cadaver stifles as well as bilateral stifles on a horse that underwent nonre...
O'Brien EJO, Smith RKW.Tendon/ligament mineralization is recognized in horses but information regarding its clinical significance is limited. The aims of this observational study were to report the structures most commonly affected by ultrasonographically detectable mineralization and, for these, determine frequency of diagnosis and key clinical features. Cases presented at our hospital in April 1999-April 2013 and September 2014-November 2015 were included: a total of 27 horses (22 retrospective, five prospective). Mineralizations were most common in deep digital flexor tendons (10) and suspensory ligament branches...
Bowser JE, Elder SH, Pasquali M, Grady JG, Rashmir-Raven AM, Wills R, Swiderski CE.Hereditary equine regional dermal asthenia (HERDA) is an autosomal recessive disorder of Quarter Horses characterised by skin fragility. Horses with HERDA have a missense mutation in peptidyl-prolyl cis-trans isomerase B (PPIB), which encodes cyclophilin B and alters folding and post translational modifications of fibrillar collagen. Objective: The study aimed to test the hypothesis that tendons, ligaments and great vessels, which, like skin, are rich in fibrillar collagen, will also have abnormal biomechanical properties in horses with HERDA. Methods: Ex vivo biomechanical study comparing...
Dahlgren LA, Mohammed HO, Nixon AJ.he treatment of overuse tendon injuries with exogenous growth factors such as insulin-like growth factor-I (IGF-I) may facilitate an improved return to sustained athletic function. The biological effects of IGF-I are exerted under the control of a complex of IGF receptors, binding proteins, and proteases. This IGF system includes a family of six structurally related high-affinity IGF binding proteins (IGFBPs) that protect IGF-I from local proteases and restrict access of IGF-I to its receptor. This study describes the expression of the IGFBPs in flexor tendon after acute injury and during heal...
Kent AV, Chesworth MJ, Wells G, Gerdes C, Bladon BM, Smith RKW, Fiske-Jackson AR.Pathology of the digital flexor tendon sheath is a significant cause of lameness in the horse. Imaging is important to identify lesions and inform on prognosis prior to tenoscopic surgery. Objective: To use a large population to evaluate 1) the sensitivity and specificity of digital flexor tendon sheath (DFTS) contrast radiographs in diagnosing manica flexoria (MF) tears, deep digital flexor tendon (DDFT) tears and constriction of the palmar/plantar annular ligament (PAL) using novel criteria; 2) predisposition to pathology in signalment and limb affected. Methods: Multicentre retrospective co...
Smith MR, Wright IM, Minshall GJ, Dudhia J, Verheyen K, Heinegård D, Smith RK.To evaluate digital flexor tendon sheath (DFTS) synovial fluid cartilage oligomeric matrix protein (COMP) concentrations as a molecular marker for intrathecal pathology. Methods: Case control study. Methods: Horses (n=46) with DFTS tenosynovitis; 23 fresh cadaver horses. Methods: DFTS synovial fluid samples were collected from clinical cases with noninfected DFTS tenosynovitis and from control DFTS. Clinical and surgical findings were recorded, and dissection of control limbs was performed to confirm the DFTS to be grossly normal. Synovial fluid COMP was quantified using a homologous competiti...
Dyson S, Pinilla MJ, Bolas N, Murray R.There have been no previous studies correlating high-field magnetic resonance imaging (MRI) findings with gross and histological post-mortem examination in horses with hindlimb proximal suspensory desmopathy (PSD). Objective: To determine if adhesions between the suspensory ligament (SL) and adjacent tissues could be detected using high-field MRI and if collagen, adipose tissue and muscle pathology could be differentiated. Methods: Retrospective study. Methods: Nineteen horses with hindlimb PSD were humanely destroyed; 12 limbs of 11 horses with PSD underwent high-field MRI. All lame limbs wer...
Shrestha K, Gilkerson JR, Stevenson MA, Flash ML.The destinations of Thoroughbred (TB) racehorses exiting the racing industry is a high-profile issue with ethical and welfare implications of interest to both animal welfare groups and racing regulators. This cross-sectional study investigated the reasons that TBs temporarily or permanently exited racing and training in Australia in the 2017-2018 racing season and the outcomes for these horses post-racing. An online questionnaire was sent to the last registered trainers of a representative sample of 2,509 'inactive' TBs. Inactive horses were defined as those horses that were recorded as 'activ...
Nagy A, Dyson S.There is limited information on magnetic resonance imaging (MRI) findings in the carpus and proximal metacarpal region of lame horses. Objective: To document MRI findings in horses with lameness localised to the carpus and/or proximal metacarpal region. Methods: Clinical records of horses that underwent MRI of the carpus and/or proximal metacarpal region at the Animal Health Trust between January 2003 and September 2010 were reviewed. Magnetic resonance images of all horses and available radiographs, ultrasonographic and scintigraphic images were assessed. When possible, MRI findings were rela...
Dyson S.Clinical, ultrasonographic and radiographic features of proximal suspensory desmitis in the forelimb and the hindlimb are described. Acute cases may present with slight, localised, oedematous swelling, heat, distension of the medial palmar (plantar) vein and/or pain, whereas chronic cases or those rested immediately after onset of lameness usually have no detectable clinical signs suggestive of the source of pain. In these cases local analgesia is required to identify pain in the proximal metacarpal (metatarsal) region. Transverse ultrasonographic images of the suspensory ligament usually yiel...
Mohanty N, Gulati BR, Kumar R, Gera S, Kumar S, Kumar P, Yadav PS.Mesenchymal stem cells (MSCs) offer promise as therapeutic aid in the repair of tendon and ligament injuries in race horses. Fetal adnexa is considered as an ideal source of MSCs due to many advantages, including non-invasive nature of isolation procedures and availability of large tissue mass for harvesting the cells. However, MSCs isolated from equine fetal adnexa have not been fully characterized due to lack of species-specific markers. Therefore, this study was carried out to isolate MSCs from equine umbilical cord blood (UCB) and characterize them using cross-reactive markers. The plastic...
