The Superficial Digital Flexor Tendon (SDFT) in horses is a critical component of the equine musculoskeletal system, primarily responsible for supporting the limb during locomotion. It is located on the back of the leg and extends from the muscle belly in the upper limb to its attachment on the pastern bone in the lower limb. The SDFT is prone to injury due to its high load-bearing function, particularly in performance horses. Injuries to this tendon can result from overuse, sudden trauma, or degenerative changes, leading to conditions such as tendinitis. This page compiles peer-reviewed research studies and scholarly articles that explore the anatomy, function, injury mechanisms, and rehabilitation strategies for the Superficial Digital Flexor Tendon in horses.
The objectives of this prospective, experimental study were to describe changes in the stiffness of the equine superficial digital flexor tendon (SDFT) after induced injury, deep digital flexor tendon (DDFT), accessory ligament (AL-DDFT), and suspensory ligament (SL) during 90 days of healing using acoustic radiation force impulse (ARFI) elastography. Eight healthy horses were selected. Preinjury B mode and ARFI evaluations were performed bilaterally in the palmar metacarpal region. Injury was induced only on the left forelimb (G2) by a single injection of collagenase in SDFT, 15 cm distal to ...
Jacobs CC, O'Neil E, Prange T.To determine the ability of a commercial cryotherapy system (Game Ready Equine) to cool the metacarpal subcutaneous tissue and the superficial digital flexor tendon (SDFT) in horses. Methods: Experimental study. Methods: Six healthy adult horses. Methods: Thermocouples were implanted into the metacarpal subcutaneous tissues and the SDFT of six horses. Two treatments (cryotherapy or cryotherapy with 5-50 mmHg intermittent compression) were randomly assigned to forelimbs and performed for 20 minutes. Temperatures were compared to the target range of 10-19°C and between groups. Results: Only...
Melotti L, Carolo A, Elshazly N, Boesso F, Da Dalt L, Gabai G, Perazzi A, Iacopetti I, Patruno M.In the present case report a show jumping 10-year-old Sella Italiano gelding, presented with severe lameness, swelling and pain at palpation of the mid-metacarpal region of the left forelimb. Clinical and ultrasound examination diagnosed a chronic tendonitis of the central region of the superficial digital flexor tendon (SDFT). The lesion was a reoccurrence since it developed from a previously healed injury. The horse had to stop competing and was unresponsive to gold-standard treatments as Non-steroidal anti-inflammatory drugs (NSAIDs) and conservative management after 6 months of therapy. Th...
Murphy DJ, Kö-Peternelj V, Aleri JW.Superficial digital flexor tendon (SDFT) injury is common in racehorses and a significant cause of lost training days and wastage in the industry. Objective: To compare the post-injury performance of Thoroughbred and Standardbred racehorses diagnosed with SDFT tendonitis treated with intralesional bone marrow and superior check desmotomy or managed conservatively and further to compare this performance with that of uninjured racehorses. Methods: Retrospective and case-controlled. Methods: Medical and race records of racehorses treated surgically or managed conservatively for SDFT tendonitis we...
Maia BT, Vendruscolo CDP, de Souza AF, Zoppa ALDV.The neurovascular bundle of the equine distal cannon can dynamically vary with limb position, and this can affect the performance of low 4- or 6-point block. This study aims to identify and describe the anatomical position and variations of the lateral and medial palmar/plantar nerve at the metacarpal/metatarsal distal level in horses by ultrasonography. Eight mares underwent ultrasound examination on the lateral and medial palmar/plantar sides of the metacarpus/metatarsus. Images were obtained for measurements of the cross-sectional area of the nerve, distances between the nerve and the skin ...
Schade J, de Souza AF, Vincensi LC, Fonteque JH.The objective of this study was to assess the influence of the metacarpophalangeal (MCP) joint angle on the transversal area (TA) and mean echogenicity (ME) of the superficial digital flexor tendon (SDFT) and suspensory ligament (SL) in gaited horses. Ultrasound images were obtained from 50 healthy adult horses of the Mangalarga Marchador (MM; n=25) and Campeiro (n=25) breeds. Static and dynamic angles of the MCP joint were measured from photographs and video recordings. Higher ME values were evinced for the SL only in the group with the smaller dynamic angles of the MCP joint in the MM horses...
Iimori M, Tamura N, Seki K, Kasashima Y.The onset of severe injury to the superficial digital flexor tendon (SDFT) is extremely difficult to predict from slight changes in ultrasonographic findings in cases with no apparent clinical signs. This study investigated the relationship between an increased cross-sectional area (CSA) or edema in the subcutaneous tissue around the tendon and the subsequent onset of severe SDFT injury in Thoroughbred racehorses. Horses were classified into three groups based on ultrasound diagnosis (USD) findings: Group A included cases with enlarged tendons; Group B included cases with tendons of normal siz...
Jaafar SE, Al-Bayti AAH, Abdullah SI.High-power laser therapy has been used as a treatment to cure sports injuries; however, there are no controlled standardized studies on its efficacy. Moreover, high-power laser therapy has been applied for the sport horses field. This study aimed to investigate whether high-power laser therapy can cure tendon disorders and reduce the pain in tendon lesions in injured horses and also to examine the effect of laser therapy on injured horses. This retroactive experiential clinical research was performed on50 racing horses between 5 and 15 years old. They were diagnosed with neither superficial di...
Ehrle A, Lilge S, Clegg PD, Maddox TW.Flexor tendon injuries are a major cause of lameness in performance horses and have considerable impact on equine welfare and the wider horse industry. Ageing and repetitive strain frequently cause varying degrees of tendon micro-damage prior to the recognition of clinical tendinopathy. Whilst B-mode ultrasonography is most commonly utilised for detection and monitoring of tendon lesions at the metacarpal/metatarsal level, the emphasis of recent research has focused on the identification of subclinical tendon damage in order to prevent further tendon injury and improve outcomes. The introducti...
James S, Schuijers J, Daffy J, Cook J, Samiric T.Fluoroquinolones are an effective, broad-spectrum antibiotic used to treat an array of bacterial infections. However, they are associated with an increased risk of tendinopathy and tendon rupture even after discontinuation of treatment. This condition is known as fluoroquinolone-associated tendinopathy, the underlying mechanisms of which are poorly understood. While many factors may be involved in the pathophysiology of tendinopathies in general, changes in tenocyte metabolism and viability, as well as alteration of proteoglycan metabolism are prominent findings in the scientific literature. T...
Gaesser AM, Underwood C, Linardi RL, Even KM, Reef VB, Shetye SS, Mauck RL, King WJ, Engiles JB, Ortved KF.Autologous protein solution (APS) has been used anecdotally for intralesional treatment of tendon and ligament injuries, however, its use in these injuries has never been studied . Our objective was to evaluate the effect of APS on tendon healing in an equine superficial digital flexor (SDF) tendonitis model. We hypothesized intralesional injection of APS would result in superior structural and biomechanical healing. SDF tendonitis was induced in both forelimbs of eight horses using collagenase injection. One forelimb was randomly assigned to receive an intralesional injection of APS, while th...
Wagner FC, Reese S, Gerlach K, Böttcher P, Mülling CKW.Long-term cyclic tensile testing with equine palmar/plantar tendons have not yet been performed due to problems in fixing equine tendons securely and loading them cyclically. It is well established that the biomechanical response of tendons varies during cyclic loading over time. The aim of this study was to develop a clamping device that enables repetitive cyclic tensile testing of equine superficial digital flexor tendon for at least 60 loading cycles and for 5 min. Results: A novel cryo-clamp was developed and built. Healthy and collagenase-treated pony SDFTs were mounted in the custom-ma...
Rich AF, Ricci E, Gates S, Hinnigan GJ, Owen KR.A 20-year-old British Warmblood gelding was presented for a progressively worsening right forelimb lameness which developed following an intense dressage training session. Initial ultrasound examination revealed a triangular, intrathecal, hypoechoic region within the superficial digital flexor tendon (SDFT) in the proximal, palmar carpal region distal to the accessory carpal bone (ACB), extending 7cm distally into the proximal metacarpal region. No significant improvement in clinical presentation was observed following an eight-week rehabilitation programme. Repeat ultrasound examination revea...
Johnson SA, Valdés-Martínez A, Turk PJ, Wayne McIlwraith C, Barrett MF, McGilvray KC, Frisbie DD.The range of diagnostic modalities available to evaluate superficial digital flexor tendon (SDFT) injury includes magnetic resonance imaging (MRI), computed tomography (CT) and ultrasonography (US). Direct, comprehensive comparison of multi-modality imaging characteristics to end-point data has not previously been performed using a model of tendinopathy but is required to obtain a better understanding of each modality's diagnostic capabilities. Objective: To compare CT, MRI and US evaluation to outcome measures for histologic, biochemical and biomechanical parameters using an equine surgical m...
Hale MJ, Zellner EM, Naiman JH, Kraus KH.To determine the influence of suture patterns on resistance to gap formation after tendon plating STUDY DESIGN: Ex vivo study SAMPLE POPULATION: Suspensory ligament and superficial and deep digital flexor tendons harvested from 16 neonatal cadaver foal limbs. Methods: Each tendon/ligament from a given limb was randomly assigned to one of three treatment groups consisting of a 7-hole veterinary cuttable plate fixed with alternating simple interrupted, figure-8, or hybrid suture patterns. The constructs were distracted at a rate of 1.0 mm/s to failure, as determined by the formation of a 1 m...
Wagner FC, Gerlach K, Geiger SM, Gittel C, Böttcher P, Mülling CKW.The superficial digital flexor tendon (SDFT) is the most frequently injured structure of the musculoskeletal system in sport horses and a common cause for early retirement. This project's aim was to visualize and measure the strain of the sound, injured, and healing SDFTs in a pony during walk and trot. For this purpose, biplanar high-speed fluoroscopic kinematography (FluoKin), as a high precision X-ray movement analysis tool, was used for the first time in vivo with equine tendons. The strain in the metacarpal region of the sound SDFT was 2.86% during walk and 6.78% during trot. When injured...
Giacchi A, McMaster MA.To compare biomechanical characteristics of three-loop pulley (3LP) pattern versus Bunnell technique (BT) using polydioxanone (PDS) suture; to determine the influence of polyester tape (PT) versus PDS on the BT for equine superficial digital flexor tendon (SDFT) tenorrhaphy; to compare BT with PT versus 3LP with PDS. Methods: Ex vivo biomechanical study. Methods: Forty equine forelimb SDFT. Methods: Two experiments were performed: (1) 10 SDFT pairs were repaired with 3LP or BT using PDS; (2) 10 SDFT pairs were repaired with PDS or PT using BT. Load at failure, mode of failure, load at 2 mm g...
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) ...
Depuydt E, Broeckx SY, Van Hecke L, Chiers K, Van Brantegem L, van Schie H, Beerts C, Spaas JH, Pille F, Martens A. Tendon injuries are very common in horses and jeopardize the athletic performance, and due to the high risk of reinjury may lead to early retirement. The use of mesenchymal stem cells for the treatment of equine tendon disease is widely investigated because of their regenerative potential. The objective of this study is to investigate the safety and efficacy of equine allogeneic tenogenic primed mesenchymal stem cells (tpMSCs) for the management of tendinitis in horses. A core lesion was surgically induced in the superficial digital flexor tendon of both forelimbs of eight horses. After 7 da...
Salinas P, Lira-Velásquez D, Bongiorno A, Sandoval C.The aim of this study was to quantify the distribution of aligned and non-aligned collagen in cross-sections of the superficial digital flexor tendon (SDFT) and deep digital flexor tendon (DDFT) in different levels of the distal forelimb of equines diagnosed with NS (Navicular Syndrome). Sixty equine forelimbs were collected. Was compared two groups (NA, Not affected vs. NS-group) by t-Student. Diagnosis of NS was based on clinical and lameness examination, diagnostic analgesia and radiological findings. The proportion of aligned and non-aligned collagens at 2 levels for the SDFT and 3 levels ...
O'Brien C, Marr N, Thorpe C.The forelimb superficial digital flexor tendon (SDFT) is an energy-storing tendon that is highly susceptible to injury during activities such as galloping and jumping, such that it is one of the most commonly reported causes of lameness in the performance horse. This review outlines the biomechanical and biothermal effects of strain on the SDFT and how these contribute to the accumulation of microdamage. The effect of age-related alterations on strain response and subsequent injury risk is also considered. Given that tendon is a slowly healing and poorly regenerative tissue, prompt detection o...
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...
Aimaletdinov A, Mindubaeva G, Khalikova S, Kabwe E, Salmakova A, Alexandrova N, Rutland C, Rizvanov A, Zakirova E.Tendon injuries are one of the most common causes of orthopedic disorders in horses. Such injuries involve a long course of treatment and recovery. The most promising method of treating these injuries is the use of recombinant proteins and gene therapy. In this work, we evaluated the therapeutic efficacy of plasmid DNA (pDNA) containing two species-specific coding sequences, i.e. vascular endothelial growth factor 164 (VEGF164) and fibroblast growth factor 2 (FGF2), in the treatment of severe damage to the tendon of the superficial digital flexor. A pDNA construct was used to restore the damag...
Berner D, Brehm W, Gerlach K, Offhaus J, Scharner D, Burk J.Signal intensity (SI) of equine tendinopathies in MRI differs between the superficial digital flexor tendon (SDFT) and the deep digital flexor tendon (DDFT). In DDFT lesions, short tau inversion recovery (STIR) SI decreases earlier than T2-weighted (T2w) SI, while the latter decreases earlier in SDFT lesions, but long-term results using STIR sequences are lacking. Methods: Standing MRI of eight horses with naturally occurring SDFT lesions was performed at the day of treatment as well as 2, 6 and 12 months after treatment. Results: After 12 months, six horses were sound and showed complete reso...
Haussler KK, Wilde SR, Davis MS, Hess AM, McIlwraith CW.Rehabilitation of tendon injuries in horses often involves cryotherapy to reduce inflammation and occasionally tissue heating to increase collagen extensibility. The application of alternating cold and hot (ie contrast therapy) is widely used in human physical therapy; however, its utility in equine rehabilitation is largely unknown. Objective: The objectives of this study were to (a) assess if the equipment could achieve therapeutic tissue temperatures (40°C) at different tissue depths relative to the digital flexor tendons and (b) evaluate the time-temperature profiles during serial heating...
Rajpar I, Barrett JG.Tendon injury is a significant clinical problem due to poor healing and a high reinjury rate; successful treatment is limited by our poor understanding of endogenous tendon stem cells. Recent evidence suggests that adult stem cells are phenotypically diverse, even when comparing stem cells isolated from the same tissue from the same individual, and may in fact exist on a spectrum of proliferation and differentiation capacities. Additionally, the relationships between and clinical relevance of this phenotypic variation are poorly understood. In particular, tenogenic capacity has not been studie...
Yin NH, Parker AW, Matousek P, Birch HL.The lack of clinical detection tools at the molecular level hinders our progression in preventing age-related tendon pathologies. Raman spectroscopy can rapidly and non-invasively detect tissue molecular compositions and has great potential for in vivo applications. In biological tissues, a highly fluorescent background masks the Raman spectral features and is usually removed during data processing, but including this background could help age differentiation since fluorescence level in tendons increases with age. Therefore, we conducted a stepwise analysis of fluorescence and Raman combined s...
Johnston AS, Riggs CM, Cogger N, Benschop J, Rogers CW, Rosanowski SM.Many racing jurisdictions monitor race-day musculoskeletal injury (MSI) but fail to evaluate injuries occurring during training. Additionally, previous risk factor analyses have failed to explore temporal trends in injury occurrence. Objective: To use time-series analysis techniques to identify trends, cyclicity and peaks in MSI incidence, in racehorses training and racing at the Hong Kong Jockey Club (HKJC) from July 2010 to June 2018. Methods: Retrospective longitudinal study. Methods: The monthly incidence of all MSI, superficial digital flexor tendon (SDFT) injury, suspensory ligament inju...
Durgam SS, Altmann NN, Coughlin HE, Rollins A, Hostnik LD.There is increased incidence of tendon disorders and decreased tendon healing capacity in people with diabetes mellitus (DM). Recent studies have also suggested pathological ossification in repair tendon of people with DM. Therefore, the objective of this study is to investigate the effects of insulin supplementation, an important pathophysiologic stimulus of DM, on tendon progenitor cell (TPC) proliferation and in vitro osteogenic capacity. Passage 3 TPCs were isolated from collagenase-digested, equine superficial digital flexor tendons. TPC proliferation was measured via MTT assay after 3 da...
Ikeda Y, Ishihara A, Nakajima M, Yamada K.Thoroughbred racehorses are commonly affected with superficial digital flexor (SDF) tendinopathy. This study aimed to identify risk factors for SDF tendinopathy in racing horses. The authors selected racehorses (n=292) with SDF tendinopathy from the medical records of a racetrack. As a risk factor associated with track-related variables, the SDF tendinopathy odds ratio (OR) was significantly high for a sloppy track surface compared with a standard track surface. Regarding risk factors associated with race-related variables, the SDF tendinopathy OR was significantly high in the following cases:...
Geburek F, Gaus M, van Schie HT, Rohn K, Stadler PM.Regenerative and anti-inflammatory effects on tendinopathies have been attributed to blood-derived biologicals. To date the evidence for the efficacy of autologous platelet-rich plasma (PRP) treatment of naturally occurring equine tendinopathies is limited. The purpose of this placebo-controlled clinical trial was to describe the effect of a single treatment of equine superficial digital flexor tendon (SDFT) disease with PRP on clinical and ultrasonographic parameters. Twenty horses with naturally occurring tendinopathies of forelimb SDFTs were randomly assigned to the PRP-treated group (n =...
Södersten F, Hultenby K, Heinegård D, Johnston C, Ekman S.This is a descriptive study of tendon pathology with different structural appearances of repair tissue correlated to immunolocalization of cartilage oligomeric matrix protein (COMP) and type I and III collagens and expression of COMP mRNA. The material consists of nine tendons from seven horses (5-25 years old; mean age of 10 years) with clinical tendinopathy and three normal tendons from horses (3, 3, and 13 years old) euthanized for non-orthopedic reasons. The injured tendons displayed different repair-tissue appearances with organized and disorganized fibroblastic regions as well as areas o...
Geburek F, Mundle K, Conrad S, Hellige M, Walliser U, van Schie HT, van Weeren R, Skutella T, Stadler PM.Adipose tissue-derived mesenchymal stromal cells (AT-MSCs) are frequently used to treat equine tendinopathies. Up to now, knowledge about the fate of autologous AT-MSCs after intralesional injection into equine superficial digital flexor tendons (SDFTs) is very limited. The purpose of this study was to monitor the presence of intralesionally injected autologous AT-MSCs labelled with superparamagnetic iron oxide (SPIO) nanoparticles and green fluorescent protein (GFP) over a staggered period of 3 to 9 weeks with standing magnetic resonance imaging (MRI) and histology. Methods: Four adult warmbl...
Stanley RL, Fleck RA, Becker DL, Goodship AE, Ralphs JR, Patterson-Kane JC.Injury to the energy-storing superficial digital flexor tendon is common in equine athletes and is age-related. Tenocytes in the superficial digital flexor tendon of adult horses appear to have limited ability to respond adaptively to exercise or prevent the accumulation of strain-induced microdamage. It has been suggested that conditioning exercise should be introduced during the growth period, when tenocytes may be more responsive to increased quantities or intensities of mechanical strain. Tenocytes are linked into networks by gap junctions that allow coordination of synthetic activity and ...
Shojaee A, Parham A.Tendon injuries, as one of the most common orthopedic disorders, are the major cause of early retirement or wastage among sport horses which mainly affect the superficial digital flexor tendon (SDFT). Tendon repair is a slow process, and tendon tissue is often replaced by scar tissue. The current treatment options are often followed by an incomplete recovery that increases the susceptibility to re-injury. Recently, cell therapy has been used in veterinary medicine to treat tendon injuries, although the risk of ectopic bone formation after cell injection is possible in some cases. In vitro teno...
Avella CS, Ely ER, Verheyen KL, Price JS, Wood JL, Smith RK.It is important to ascertain the prevalence of superficial digital flexor tendon (SDFT) injuries and to improve methods of predicting injury in National Hunt (NH) racehorses. Objective: To establish: 1) the prevalence of SDFT tendinopathy in NH horses; 2) whether routine ultrasonography can be used to predict SDFT injuries; 3) whether previous tendinopathy predisposes to reinjury; 4) a normal range for the SDFT cross-sectional area (CSA); and 5) the effects of gender, age, background (ex-flat or ex-store), limb, training and rest periods on SDFT CSA. Methods: Routine ultrasound assessment of t...
Geburek F, Roggel F, van Schie HTM, Beineke A, Estrada R, Weber K, Hellige M, Rohn K, Jagodzinski M, Welke B, Hurschler C, Conrad S, Skutella T....Adipose tissue is a promising source of mesenchymal stromal cells (MSCs) for the treatment of tendon disease. The goal of this study was to assess the effect of a single intralesional implantation of adipose tissue-derived mesenchymal stromal cells (AT-MSCs) on artificial lesions in equine superficial digital flexor tendons (SDFTs). During this randomized, controlled, blinded experimental study, either autologous cultured AT-MSCs suspended in autologous inactivated serum (AT-MSC-serum) or autologous inactivated serum (serum) were injected intralesionally 2 weeks after surgical creation of cen...
Bosch G, de Mos M, van Binsbergen R, van Schie HT, van de Lest CH, van Weeren PR.Extracorporeal shock wave therapy (ESWT) is frequently used in equine practice, but little is known about its biological action. Objective: To study the effects of ESWT on matrix structure and gene expression levels in normal, physiologically loaded tendinous structures in ponies. Methods: Six Shetland ponies, free of lameness and with ultrasonographically normal flexor and extensor tendons and suspensory ligaments (SL), were used. ESWT was applied at the origin of the suspensory ligament and the mid-metacarpal region of the superficial digital flexor tendon (SDFT) 6 weeks prior to sample taki...
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...
Thorpe CT, Riley GP, Birch HL, Clegg PD, Screen HRC.Tendon is composed of rope-like fascicles, bound together by interfascicular matrix (IFM). Our previous work shows that the IFM is critical for tendon function, facilitating sliding between fascicles to allow tendons to stretch. This function is particularly important in energy storing tendons, which experience extremely high strains during exercise, and therefore require the capacity for considerable inter-fascicular sliding and recoil. This capacity is not required in positional tendons. Whilst we have previously described the quasi-static properties of the IFM, the fatigue resistance of the...
Lam KH, Parkin TD, Riggs CM, Morgan KL.This study was part of a programme to optimise the longevity and maximise the health and welfare of the Thoroughbred racehorses in Hong Kong. Injuries to the superficial digital flexor (SDF) tendon are the most common veterinary reason for premature retirement in this population. Objective: To describe the frequency and pattern of retirements associated with SDF tendon injuries in Thoroughbred racehorses and to compare the characteristics of these horses with those that retired for other reasons. Methods: A retrospective analysis of retirement records documented in the Hong Kong Jockey Club cl...
Singer ER, Barnes J, Saxby F, Murray JK.Two related studies on injuries sustained by event horses during competition and during training are reported. During the cross-country phase of competition, the most common injuries were lacerations and abrasions to the carpus and stifle. Superficial digital flexor tendonitis and exertional rhabdomyolysis were significantly more common during Cours Complete Internationale (CCI) competitions compared to one-day event (ODE) competitions. The difference in injury types at ODEs and CCI competitions probably relates to the increased athletic demands of the CCI and the closer veterinary observation...
Smith RK, Gerard M, Dowling B, Dart AJ, Birch HL, Goodship AE.Over-strain injury of the superficial digital flexor tendon (SDFT) is a common injury in the horse. Tendon appears to adapt to loads placed on it during development, but fatigue damage accumulates after skeletal maturity, which is inadequately repaired and predisposes to clinical tendinitis. In any population of horses, there is a wide variation in SDFT mechanical properties. A noncollagenous protein, cartilage oligomeric matrix protein (COMP), is particularly abundant during growth in the equine SDFT and has been proposed to have an organisational role in the formation of collagenous matrices...
Patterson-Kane JC, Firth EC, Goodship AE, Parry DA.To measure collagen fibril crimp angles and lengths as well as collagen fibril mass-average diameters in central and peripheral regions of the superficial digital flexor tendon of wild horses, to ascertain any age-related changes in either region in the absence of imposed galloping exercise. Methods: Measurements from a random cull of wild horses. Methods: Superficial digital flexor tendon samples were taken from 23 wild horses ranging in age from two to ten years. Methods: Horses were divided into 'young' (< 5 years, n = 10), 'middle-aged' (5 to < 10 years, n = 9) and 'ol...
Crevier-Denoix N, Collobert C, Pourcelot P, Denoix JM, Sanaa M, Geiger D, Bernard N, Ribot X, Bortolussi C, Bousseau B.The objective of this study was to mechanically characterise superficial digital flexor tendon (SDFT) lesions. Eight pathological SDFTs, isolated from 6 adult horses, were tested in traction until rupture (at 1 mm/s). The stresses and strains simultaneously undergone by each of the 7 segments of a tendon were determined throughout the test, and the modulus of elasticity of each segment was evaluated from the segmental stress-strain curve thus obtained. These mechanical data were compared to those obtained on 10 normal SDFTs. After the test, the tendinous segments were submitted to a histologic...
Thorpe CT, Riley GP, Birch HL, Clegg PD, Screen HR.Some tendons, such as the human Achilles and equine superficial digital flexor tendon (SDFT), act as energy stores, stretching and recoiling to increase efficiency during locomotion. Our previous observations of rotation in response to applied strain in SDFT fascicles suggest a helical structure, which may provide energy-storing tendons with a greater ability to extend and recoil efficiently. Despite this specialization, energy-storing tendons are prone to age-related tendinopathy. The aim of this study was to assess the effect of cyclic fatigue loading (FL) on the microstructural strain respo...
Taylor SE, Smith RK, Clegg PD.The goal in the therapeutic use of mesenchymal stem cells (MSCs) in musculoskeletal disease is to harness the regenerative nature of these cells focussing on their potential to grow new tissues and organs to replace damaged or diseased tissue. Laboratory isolation of MSCs is now well established and has recently been demonstrated for equine MSCs. Stem cell science has attracted considerable interest in both the scientific and clinical communities because of its potential to regenerate tissues. Research into the use of MSCs in tissue regeneration in general reflects human medical needs, however...
Beerts C, Suls M, Broeckx SY, Seys B, Vandenberghe A, Declercq J, Duchateau L, Vidal MA, Spaas JH.Poor healing of tendon and ligament lesions often results in early retirement of sport horses. Therefore, regenerative therapies are being explored as potentially promising treatment for these injuries. In this study, an intralesional injection was performed with allogeneic tenogenically induced mesenchymal stem cells and platelet-rich plasma 5-6 days after diagnosis of suspensory ligament (SL) (n = 68) or superficial digital flexor tendon (SDFT) (n = 36) lesion. Clinical, lameness and ultrasonographic evaluation was performed at 6 and 12 weeks. Moreover, a survey was performed 12 ...
Argüelles D, Carmona JU, Climent F, Muñoz E, Prades M.Two horses with acute tendinopathy of a superficial digital flexor tendon (SDFT) and three horses with chronic proximal desmitis of the suspensory ligament (PDSL) were treated by injecting autologous concentrates of their platelets into the lesions. The lesions were monitored ultrasonographically and clinically. There were significant ultrasonographic and clinical improvements in the two horses with SDFT, but no ultrasonographic improvements in the horses with PDSL; however, they improved clinically and became less lame. All the horses had returned to their pre-injury level of performance by s...
Stephens PR, Nunamaker DM, Butterweck DM.Custom-designed Hall-effect strain sensors (HES) were implanted surgically onto the superficial digital flexor tendons of the forelimbs of 4 adult Thoroughbreds. Strains were recorded at various gaits, using a portable amplifer and FM cassette recorder. Strain calculations used the original length (L) as the HES position with the forelimb in the relaxed neutral position during anesthesia. A characteristic deflection in the strain cycle recording was confirmed to correspond to initial hoof contact with the ground (heel strike) by simultaneous recording of weight bearing via a footswitch. Heel s...
Geburek F, Lietzau M, Beineke A, Rohn K, Stadler PM.Autologous blood-derived biologicals, including autologous conditioned serum (ACS), are frequently used to treat tendinopathies in horses despite limited evidence for their efficacy. The purpose of this study was to describe the effect of a single intralesional injection of ACS in naturally occurring tendinopathies of the equine superficial digital flexor tendon (SDFT) on clinical, ultrasonographic, and histological parameters. Methods: Fifteen horses with 17 naturally occurring tendinopathies of forelimb SDFTs were examined clinically and ultrasonographically (day 0). Injured tendons were ran...
Dowling BA, Dart AJ.The in vitro and in vivo mechanical properties of the superficial digital flexor tendon have been described. To date the focus has been on single load to failure testing, however refined in vivo methods may prove useful to evaluate the effects of treatment and exercise on tendons. During maximal exercise, the adult superficial digital flexor tendon operates close to its functional limits with a narrow biomechanical safety margin. This combined with exercise and age associated microdamage, and a limited adaptive ability may increase the risk of fatigue failure. Studies evaluating treatment regi...
Birch HL, McLaughlin L, Smith RK, Goodship AE.The equine superficial digital flexor tendon (SDFT) functions as an energy store during high-speed gaits reducing the energetic cost of locomotion. To enable the SDFT to function effectively, the appropriate mechanical properties are essential. We tested the hypothesis that the SDFT does not undergo gross hypertrophy in response to high-intensity exercise whereas tendons not involved in energy storage undergo adaptive hypertrophy. Two groups (n = 6) of Thoroughbred fillies were trained at high-intensity on a high-speed equine treadmill for 5 months (short-term study) or 18 months (long-term st...
Caniglia CJ, Schramme MC, Smith RK.Collagen fibril size is decreased in repair tissue following tendon injury compared to normal tendon matrix in horses. Mesenchymal stem cells have been suggested to promote regeneration of tendon matrix rather than fibrotic repair following injury, although this concept remains unproven. Objective: To explore the hypothesis that implantation of autologous mesenchymal stem cells derived from bone marrow into a surgically created central core defect in the superficial digital flexor tendon (SDFT) of horses would induce the formation of a matrix with greater ultrastructural similarities to tendon...
Watts AE, Nixon AJ, Yeager AE, Mohammed HO.A consistent and clinically relevant model for the induction of core lesions confined to the mid-metacarpal superficial digital flexor tendon (SDFT) has not been previously reported. Injection of bacterial collagenase is commonly used but often results in large, irregular and inconsistent lesions that disrupt the superficial tendon layers and epitenon. Objective: To develop and evaluate a new injection technique for collagenase induction of SDFT injury. Methods: Collagenase gel was injected into a physical columnar defect created by longitudinally placing a curved 16 gauge 8.89 cm needle in ...
Sole A, Spriet M, Padgett KA, Vaughan B, Galuppo LD, Borjesson DL, Wisner ER, Vidal MA.Intralesional (i.l.) injection is currently the most commonly used technique for stem cell therapy in equine tendon injury. A comparison of different techniques of injection of mesenchymal stem cells for the treatment of tendon lesions is required. Objective: We hypothesised that vascular perfusion of the equine distal limb with mesenchymal stem cells (MSCs) would result in preferential distribution of MSCs to acute tendon injuries. Methods: In vivo experimental study. Methods: Lesions were surgically induced in forelimb superficial digital flexor tendons of 8 horses. Three or 10 days after le...
Perkins NR, Reid SW, Morris RS.To investigate risk factors for injury to the superficial digital flexor tendon (SDFT) and suspensory apparatus (SA) of the forelimbs in Thoroughbred racehorses in New Zealand. Methods: Poisson and negative binomial regression, with exposure time represented by cumulative training days for each horse, were used to relate explanatory variables to the incidence rate (IR) of cases of inflammation of the SDFT (n=51), and injuries involving the SA (n=48) in a population of 1,571 commercially- trained racehorses over 554,745 study days. Only the first occurrence of an injury for any one horse was el...
van Schie HT, Bakker EM, Jonker AM, van Weeren PR.To describe a method of computerized ultrasonographic tissue characterization that includes structures below the size limits of resolution in equine superficial digital flexor tendons. Methods: 2 damaged and 2 structurally normal superficial digital flexor tendons. Methods: Transverse ultrasonographic images were collected along the tendon long axis. Stability of echo pattern was quantified by means of variation in gray levels of each pixel in contiguous images and expressed as correlation, entropy, and waviness ratios. Results: Normal young and normal old tissues were characterized by high co...
Conze P, van Schie HT, van Weeren R, Staszyk C, Conrad S, Skutella T, Hopster K, Rohn K, Stadler P, Geburek F.To investigate whether autologous adipose tissue-derived mesenchymal stem cells (AT-MSCs) treatment of tendon lesions increases neovascularization during tendon healing. Methods: A standardized surgical model was used to create lesions in both front limb superficial digital flexor tendons (SDFTs) of nine horses. Either AT-MSCs or control substance was injected intralesionally 2 weeks post-surgery. Color Doppler ultrasonography of SDFTs was performed at regular intervals. Horses were euthanized 22 weeks post-treatment and SDFTs were harvested for histology. Results: The color Doppler ultrasonog...
Patterson-Kane JC, Firth EC.Despite the high incidence of superficial digital flexor tendon (SDFT) injury in racehorses, the pathobiology of the condition is not clearly defined. The SDFT improves locomotor efficiency by storing elastic energy, but as a result it has low mechanical safety margins. As with the Achilles tendon in humans, rupture during athletic activity often follows accumulation of exercise and age-induced degenerative change that is not repaired by tenocytes. There is limited understanding of tenocyte biology and pathology, including responses to high mechanical strains and core temperatures during exerc...
