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Topic:Superficial Digital Flexor Tendon

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.
Further characterisation of an experimental model of tendinopathy in the horse.
Equine veterinary journal    February 28, 2013   Volume 45, Issue 5 642-648 doi: 10.1111/evj.12035
Cadby JA, David F, van de Lest C, Bosch G, van Weeren PR, Snedeker JG, van Schie HT.Injuries in energy-storing tendons are common in both horses and man. The high prevalence of reinjury and the relatively poor prognosis for returning to preinjury performance levels warrant further research, for which well characterised models would be very helpful. Objective: Given the clinical similarities in tendinopathy of energy-storing tendons, we hypothesised that a recently developed experimental model of equine tendon injury would display many of the characteristics of clinical tendinopathy and could therefore be of use for both species, thus providing comparative insight to the human...
Muscle and tendon heating rates with therapeutic ultrasound in horses.
Veterinary surgery : VS    February 1, 2013   Volume 42, Issue 3 243-249 doi: 10.1111/j.1532-950X.2013.01099.x
Montgomery L, Elliott SB, Adair HS.To (1) determine the temperature change in equine tendon and muscle during therapeutic ultrasound and (2) develop guidelines for treating horses for muscular or tendinous injury using therapeutic ultrasound. Methods: Experimental, in vivo study. Methods: Adult horses (n = 10). Methods: Thermistors were inserted in the superficial and deep digital flexor tendons (SDFT and DDFT) of the thoracic limbs of 10 adult horses. On the left, 3.3 MHz therapeutic continuous ultrasound was done for 10 minutes at an intensity of 1.0 W/cm(2) and for the right thoracic limb at 1.5 W/cm(2). Thermistors were pla...
What is your diagnosis? Bilateral SDFT rupture.
Journal of the American Veterinary Medical Association    December 12, 2012   Volume 241, Issue 12 1563-1564 doi: 10.2460/javma.241.12.1563
Levine RS, Pacheco AP, Chope K, García López JM, Gates S, Costa LR.No abstract available
Immunolocalization of collagens (I and III) and cartilage oligomeric matrix protein in the normal and injured equine superficial digital flexor tendon.
Connective tissue research    December 3, 2012   Volume 54, Issue 1 62-69 doi: 10.3109/03008207.2012.734879
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...
Tenosynoviotomy for sepsis of the digital flexor tendon sheath in 9 horses.
Veterinary surgery : VS    November 19, 2012   Volume 42, Issue 1 114-118 doi: 10.1111/j.1532-950X.2012.01033.x
Mc Nally TP, Slone DE, Hughes FE, Lynch TM.To describe a tenosynoviotomy technique for treatment of sepsis of the digital flexor tendon sheath (DFTS) in horses and report long-term outcome. Methods: Case series. Methods: Horses (n = 9). Methods: Horses were positioned in lateral recumbency with the affected limb uppermost. A linear incision was made just lateral to the mesotenon beginning 5 cm proximal to the apices of the proximal sesamoid bones, extending 2 cm distal to the bifurcation of the superficial digital flexor tendon (SDFT). The incision was continued through the skin, subcutaneous tissue, palmar/plantar annular ligament, an...
Stem cell therapy of tendinopathies: suggestions from veterinary medicine.
Muscles, ligaments and tendons journal    October 16, 2012   Volume 2, Issue 3 187-192 
Muttini A, Salini V, Valbonetti L, Abate M.The ideal strategy for tendon healing has not been identified to date. Recently, the use of stem cells based therapy has been proposed, due to their ability to proliferate and to differentiate towards specific connective tissues lineages. Embryonic stem cells should be considered the ideal cell source for regenerative therapies, but ethical factors limit their use in humans. Mesenchymal stem cells are more easily available and can be obtained by different sources. Amnion derived stem cells can differentiate towards all three germ layers, and can be used for allogeneic transplantation and store...
Active hyaluronidase 2 expression in the granulation tissue formed in the healing process of equine superficial digital flexor tendonitis.
The Journal of veterinary medical science    October 5, 2012   Volume 75, Issue 2 219-223 doi: 10.1292/jvms.12-0318
Yuda Y, Kasashima Y, Kuwano A, Sato K, Hattori S, Arai K.Upregulation of hyaluronidase 2 (HYAL2), one of somatic hyaluronidase (HAase), was demonstrated in granulation tissue during the healing of equine superficial digital flexor tendon injuries. The activity of HAase was assessed by hyaluronan (HA)-containing gel zymography and in situ zymography using frozen sections obtained from normal and injured tendon tissues. Elevated HAase activity was identified in the extract from the tendinopathic tissues, with lower levels of the activity in normal tendons. In situ zymography using fluorescently-labeled HA demonstrated HAase activity in the granulation...
Effects of ground surface on the equine superficial digital flexor tendon loading at the walk and trot.
Computer methods in biomechanics and biomedical engineering    October 4, 2012   Volume 15 Suppl 1 143-144 doi: 10.1080/10255842.2012.713733
Ravary-Plumiöen B, Pourcelot P, Vergari C, Desquilbet L, Crevier-Denoix N.No abstract available
Equine superficial digital flexor tendon force and axial speed of sound: a calibration method under clinical conditions.
Computer methods in biomechanics and biomedical engineering    October 4, 2012   Volume 15 Suppl 1 12-13 doi: 10.1080/10255842.2012.713607
Vergari C, Pourcelot P, Ravary-Plumiöen B, Camus M, Holden-Douilly L, Falala S, Chateau H, Crevier-Denoix N.No abstract available
Evaluation of a diode laser for use in induction of tendinopathy in the superficial digital flexor tendon of horses.
American journal of veterinary research    August 29, 2012   Volume 73, Issue 9 1435-1444 doi: 10.2460/ajvr.73.9.1435
Vallance SA, Vidal MA, Whitcomb MB, Murphy BG, Spriet M, Galuppo LD.To evaluate use of a diode laser to induce tendinopathy in the superficial digital flexor tendon (SDFT) of horses. Methods: 4 equine cadavers and 5 adult horses. Methods: Cadaveric SDFT samples were exposed to a diode laser at various energy settings to determine an appropriate energy for use in in vivo experiments; lesion size was assessed histologically. In vivo experiments involved laser energy induction of lesions in the SDFT (2 preliminary horses [0, 25, 75, and 87.5 J] and 3 study horses [0 and 125 J]) and assessment of lesions. Study duration was 21 days, and lesions were assessed clini...
Does firing have a valid place in the treatment of superficial digital flexor tendon injury in the 21st century?
Equine veterinary journal    August 15, 2012   Volume 44, Issue 5 509-510 doi: 10.1111/j.2042-3306.2012.00642.x
Marr CM, Bowen IM.No abstract available
Risk factors for superficial digital flexor tendinopathy in Thoroughbred racehorses in steeplechase starts in the United Kingdom (2001-2009).
Veterinary journal (London, England : 1997)    July 26, 2012   Volume 195, Issue 3 325-330 doi: 10.1016/j.tvjl.2012.06.033
Reardon RJ, Boden LA, Mellor DJ, Love S, Newton JR, Stirk AJ, Parkin TD.The objective of this study was to identify risk factors for superficial digital flexor (SDF) tendinopathy in Thoroughbred horses in steeplechase races in the United Kingdom. Potential risk factors for SDF tendinopathy were studied between 1st January 2001 and 31st December 2009 using a cohort study design with 648 injuries sustained in 102,894 starts. Potential risk factors were screened using univariable logistic regression prior to multivariable model building. In the final multivariable model, 12 statistically significant risk factors were identified. Variables that increased the odds of S...
A preliminary study of diagnostic color Doppler ultrasonography in equine superficial digital flexor tendonitis.
The Journal of veterinary medical science    July 13, 2012   Volume 74, Issue 12 1639-1642 doi: 10.1292/jvms.12-0177
Murata D, Misumi K, Fujiki M.We hypothesized that semi-quantitative determinations of changeable blood flows in granulation and scar tissues during tendon healing could be helpful for differentiation between the acute phase rich in blood vessels and the remodeling phase with fewer vessels. Ten Thoroughbreds with injured superficial digital flexor tendon (SDFT) in a forelimb were used for evaluation of blood flows in the injured tendons of racehorses using color Doppler (CD) ultrasonography. Using longitudinal CD images, features of maximum color activities were defined. These were rhythmically blinking, tiny to small sign...
The pathogenesis of tendon microdamage in athletes: the horse as a natural model for basic cellular research.
Journal of comparative pathology    July 11, 2012   Volume 147, Issue 2-3 227-247 doi: 10.1016/j.jcpa.2012.05.010
Patterson-Kane JC, Becker DL, Rich T.The equine superficial digital flexor tendon (SDFT) is a frequently injured structure that is functionally and clinically equivalent to the human Achilles tendon (AT). Both act as critical energy-storage systems during high-speed locomotion and can accumulate exercise- and age-related microdamage that predisposes to rupture during normal activity. Significant advances in understanding of the biology and pathology of exercise-induced tendon injury have occurred through comparative studies of equine digital tendons with varying functions and injury susceptibilities. Due to the limitations of in-...
Specialization of tendon mechanical properties results from interfascicular differences.
Journal of the Royal Society, Interface    July 4, 2012   Volume 9, Issue 76 3108-3117 doi: 10.1098/rsif.2012.0362
Thorpe CT, Udeze CP, Birch HL, Clegg PD, Screen HR.Tendons transfer force from muscle to bone. Specific tendons, including the equine superficial digital flexor tendon (SDFT), also store and return energy. For efficient function, energy-storing tendons need to be more extensible than positional tendons such as the common digital extensor tendon (CDET), and when tested in vitro have a lower modulus and failure stress, but a higher failure strain. It is not known how differences in matrix organization contribute to distinct mechanical properties in functionally different tendons. We investigated the properties of whole tendons, tendon fascicles ...
Parameters influencing prevalence and outcome of tendonitis in Thoroughbred and Arabian racehorses.
Polish journal of veterinary sciences    June 20, 2012   Volume 15, Issue 1 111-118 doi: 10.2478/v10181-011-0121-9
Kalisiak O.Flexor tendonitis and suspensory desmitis are among most prevalent musculoskeletal injuries observed in racehorses. The aim of this study was to determine which horse and race-related parameters can help to diminish the possibility of injury or--when injury has occurred--to evaluate the potential for the horse to continue a successful career after convalescence. Special attention was given to the comparison of Arabian and Thoroughbred racehorses. 187 horses with ultrasonographically visible lesions were included in the study. Following parameters were analyzed: structure (Superficial Digital F...
Tendon structure changes after maximal exercise in the Thoroughbred horse: use of ultrasound tissue characterisation to detect in vivo tendon response.
Veterinary journal (London, England : 1997)    June 1, 2012   Volume 194, Issue 3 338-342 doi: 10.1016/j.tvjl.2012.04.024
Docking SI, Daffy J, van Schie HT, Cook JL.Investigations into the response of the superficial digital flexor tendon (SDFT) of the Thoroughbred horse to mechanical stimuli have been limited to in vitro cell culture studies focused primarily on gene expression of critical matrix proteins. It is uncertain how well in vitro outcomes translate to the tendon of the horse during exercise. The current study examined changes in tendon structure in response to maximal exercise using ultrasound tissue characterisation (UTC) to scan the SDFT prior to and after competitive racing. UTC uses contiguous transverse ultrasound images to assess the dyna...
Risk factors for superficial digital flexor tendinopathy in Thoroughbred racehorses in hurdle starts in the UK (2001-2009).
Equine veterinary journal    February 28, 2012   Volume 44, Issue 5 564-569 doi: 10.1111/j.2042-3306.2012.00552.x
Reardon RJ, Boden LA, Mellor DJ, Love S, Newton JR, Stirk AJ, Parkin TD.Superficial digital flexor (SDF) tendinopathy is a common injury in Thoroughbred horses racing over hurdles. Identification of risk factors may allow the introduction of measures to minimise the incidence of this injury. Objective: To identify risk factors for SDF tendinopathy in Thoroughbred horses in hurdle races in the UK. Methods: Potential risk factors for SDF tendinopathy were studied between 1 January 2001 and 31 December 2009 using a retrospective cohort study design with 1031 case starts and 168,637 control starts. Potential risk factors were screened using univariable logistic regres...
Macrophage sub-populations and the lipoxin A4 receptor implicate active inflammation during equine tendon repair.
PloS one    February 22, 2012   Volume 7, Issue 2 e32333 doi: 10.1371/journal.pone.0032333
Dakin SG, Werling D, Hibbert A, Abayasekara DR, Young NJ, Smith RK, Dudhia J.Macrophages (Mφ) orchestrate inflammatory and reparatory processes in injured connective tissues but their role during different phases of tendon healing is not known. We investigated the contribution of different Mφ subsets in an equine model of naturally occurring tendon injury. Post mortem tissues were harvested from normal (uninjured), sub-acute (3-6 weeks post injury) and chronically injured (>3 months post injury) superficial digital flexor tendons. To determine if inflammation was present in injured tendons, Mφ sub-populations were quantified based on surface antigen expression of...
Use of a pressure plate to analyse the toe-heel load redistribution underneath a normal shoe and a shoe with a wide toe in sound warmblood horses at the walk and trot.
Research in veterinary science    February 17, 2012   Volume 93, Issue 2 1026-1031 doi: 10.1016/j.rvsc.2012.01.010
Oomen AM, Oosterlinck M, Pille F, Sonneveld DC, Gasthuys F, Back W.The objective of this study was to use a pressure plate to quantify the toe-heel load redistribution in the forelimbs of sound warmblood horses with normal shoes and shoes with a wide toe and narrow branches, used empirically in the treatment of superficial digital flexor tendon or suspensory ligament injuries. In a crossover-design study, six horses, randomly shod with normal shoes and shoes with a wide toe, were led over a dynamically calibrated pressure plate to record data from both forelimbs. There were no significant differences between both shoes in the toe-heel index of stance time, pe...
The effect of intralesional injection of bone marrow derived mesenchymal stem cells and bone marrow supernatant on collagen fibril size in a surgical model of equine superficial digital flexor tendonitis.
Equine veterinary journal    December 11, 2011   Volume 44, Issue 5 587-593 doi: 10.1111/j.2042-3306.2011.00514.x
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...
Characterization and differentiation of equine tendon-derived progenitor cells.
Journal of biological regulators and homeostatic agents    December 8, 2011   Volume 25, Issue 2 Suppl S75-S84 
Lovati AB, Corradetti B, Lange Consiglio A, Recordati C, Bonacina E, Bizzaro D, Cremonesi F.Mesenchymal stem cells have been recently investigated for their potential use in regenerative medicine. Population of adult stem cells were recently identified in human and lab animal tendons, but no detailed investigations have been made in the equine species. The aim of our study is to identify a progenitor cell population from tendon tissue (TSPCs) in the horse superficial digital flexor tendon that are able to be highly clonogenic, to grow fast and to differentiate in different induced cell lineages as well as bone marrow derived progenitor cells (BM-MSCs). The hypothesis that TSPCs posse...
Short-term cast immobilisation is effective in reducing lesion propagation in a surgical model of equine superficial digital flexor tendon injury.
Equine veterinary journal    December 5, 2011   Volume 44, Issue 5 570-575 doi: 10.1111/j.2042-3306.2011.00513.x
David F, Cadby J, Bosch G, Brama P, van Weeren R, van Schie H.Larger superficial digital flexor tendon (SDFT) injuries have a poorer prognosis than smaller lesions. During the inflammatory phase enlargement of the initial lesion is frequently noted, with biomechanical loading being recently proposed to play an important role. Objective: To evaluate the effect of lower limb cast immobilisation on tendon lesion propagation in an equine model of surgically induced SDFT injury. Methods: Core lesions were surgically induced in both front SDFTs of 6 young mature horses. At the end of surgery, one leg was randomly placed in a lower limb cast and the other leg (...
Concerted and adaptive alignment of decorin dermatan sulfate filaments in the graded organization of collagen fibrils in the equine superficial digital flexor tendon.
Journal of anatomy    November 28, 2011   Volume 220, Issue 2 156-163 doi: 10.1111/j.1469-7580.2011.01456.x
Watanabe T, Imamura Y, Suzuki D, Hosaka Y, Ueda H, Hiramatsu K, Takehana K.The equine superficial digital flexor tendon (SDFT) has a graded distribution of collagen fibril diameters, with predominantly small-diameter fibrils in the region of the myotendinous junction (MTJ), a gradual increase in large-diameter fibrils toward the osteotendinous junction (OTJ), and a mixture of small- and large-diameter fibrils in the middle metacarpal (MM) region. In this study, we investigated the ultrastructure of the SDFT, to correlate the spatial relationship of the collagen fibrils with the graded distribution. The surface-to-surface distances of pairs of fibrils were found to be...
Axial speed of sound is related to tendon’s nonlinear elasticity.
Journal of biomechanics    November 10, 2011   Volume 45, Issue 2 263-268 doi: 10.1016/j.jbiomech.2011.10.032
Vergari C, Ravary-Plumioën B, Evrard D, Laugier P, Mitton D, Pourcelot P, Crevier-Denoix N.Axial speed of sound (SOS) measurements have been successfully applied to noninvasively evaluate tendon load, while preliminary studies showed that this technique also has a potential clinical interest in the follow up of tendon injuries. The ultrasound propagation theory predicts that the SOS is determined by the effective stiffness, mass density and Poisson's ratio of the propagating medium. Tendon stiffness characterizes the tissue's mechanical quality, but it is often measured in quasi-static condition and for entire tendon segments, so it might not be the same as the effective stiffness w...
Biomechanical testing of a novel suture pattern for repair of equine tendon lacerations.
Veterinary surgery : VS    October 31, 2011   Volume 41, Issue 2 278-285 doi: 10.1111/j.1532-950X.2011.00905.x
Everett E, Barrett JG, Morelli J, DeVita R.To compare in vitro biomechanical properties of a novel suture pattern to a current standard for primary repair of equine superficial digital flexor tendon (SDFT) laceration. Methods: In vitro randomized, paired design. Methods: Cadaveric equine forelimb SDFT (n = 24). Methods: The 3-loop pulley (3LP) and 6-strand Savage (SSS) suture patterns were applied to transected equine SDFT. Ultimate failure load, stiffness, mode of failure, and load required to form a 3-mm gap were obtained using a materials testing system and synchronized high-speed video analysis. Statistical comparisons were made us...
Injury induces a change in the functional characteristics of cells recovered from equine tendon.
Journal of equine science    October 25, 2011   Volume 22, Issue 3 57-60 doi: 10.1294/jes.22.57
Kihara R, Kasashima Y, Arai K, Miyamoto Y.Injury initiates a repair process characterized by influx of fibroblasts and the rapid formation of fibrous scar tissue and subsequent tissue contraction. The response to injury and behavior of the different tendon fibroblast populations, however, has been poorly characterized. We hypothesized that the fibroblasts recovered from tendon with acute injury would exhibit different cell properties relating to adhesion, migration and tensegrity. To test this hypothesis we evaluated the ability of fibroblasts recovered from normal and injured equine superficial digital flexor tendons (SDFTs). The inj...
Intralesional injection of insulin-like growth factor-I for treatment of superficial digital flexor tendonitis in Thoroughbred racehorses: 40 cases (2000-2004).
Journal of the American Veterinary Medical Association    October 4, 2011   Volume 239, Issue 7 992-997 doi: 10.2460/javma.239.7.992
Witte TH, Yeager AE, Nixon AJ.OBJECTIVE-To evaluate outcome after intralesional injection of insulin-like growth factor-I (IGF-I) for treatment of superficial digital flexor (SDF) tendonitis in Thoroughbred racehorses. DESIGN-Retrospective case series. ANIMALS-40 Thoroughbred racehorses. PROCEDURES-Medical records of racehorses with SDF tendonitis treated within 13 weeks after injury by intralesional injection of IGF-I (25 or 50 μg every other day for 4 or 5 treatments) were reviewed. Outcome was determined via analysis of race records, owner follow-up, and examination. RESULTS-Mean age of the horses was 3.1 years (range,...
A collagenase gel/physical defect model for controlled induction of superficial digital flexor tendonitis.
Equine veterinary journal    September 25, 2011   Volume 44, Issue 5 576-586 doi: 10.1111/j.2042-3306.2011.00471.x
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 ...
Possible role of carpal hyperextension in superficial digital flexor tendinopathy.
Equine veterinary journal    August 26, 2011   Volume 44, Issue 5 559-563 doi: 10.1111/j.2042-3306.2011.00466.x
Whitlock D, Garcia TC, Vallance SA, Stover SM.The specific biomechanical circumstances that induce excessive superficial digital flexor tendon (SDFT) strain in horses are unknown. Objective: Carpal joint hyperextension during axial limb loading during the middle of stance disproportionately enhances SDFT strains compared to suspensory ligament (SL) strains. Methods: Superficial digital flexor tendon and SL strains were measured in 7 cadaver limbs during in vitro loading that maintained carpal extension or allowed carpal hyperextension by constraining, or allowing rotation of, the radius during loading conditions that simulated the middle ...
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