The suspensory ligament in horses is a critical component of the equine musculoskeletal system, primarily responsible for supporting the fetlock joint and absorbing shock during movement. This ligament extends from the back of the knee or hock down to the sesamoid bones and continues into the pastern. Injuries to the suspensory ligament, such as strains or tears, are common in performance horses and can significantly affect their mobility and performance. Diagnosis typically involves clinical examination, ultrasonography, or MRI to assess the extent of the injury. This page compiles peer-reviewed research studies and scholarly articles that explore the anatomy, function, injury mechanisms, and treatment options related to the suspensory ligament in horses.
Brown KA, Johnson AL, Bender SJ, Nolan TJ, Pfisterer B, Slack J, Willis E, Rule EK.A 5-year-old imported Zangersheide gelding was evaluated for SC swellings over both forelimbs and lameness localized to the distal metacarpus. Ultrasound examination of the SC masses was compatible with verminous granulomas. Linear hyperechoic foci were present within the suspensory ligament branches of both forelimbs, suggestive of ligamentous parasitic infiltrates. A diagnosis of onchocerciasis was confirmed on biopsy of a SC mass. The gelding was treated with ivermectin and a tapering course of PO dexamethasone but was eventually euthanized. Necropsy confirmed the presence of SC eosinophili...
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...
Sullivan HM, Barrett MF, Zhou T, Kawcak CE.Ultrasound remains a mainstay in proximal suspensory ligament (PSL) evaluation. Despite recent improvements facilitating earlier diagnosis/treatment, needs exist for (1) characterization of normal ultrasonographic PSL cross-sectional area (CSA) in specific breeds/disciplines, (2) improved detection of early/subtle changes in the PSL, and (3) an understanding of suspensory ligament (SL) morphology change from work-related stress. The objectives of this study were to establish normal PSL CSA in Quarter Horses (QH) used for cutting via angle contrast ultrasonography, ultrasonographically monitor ...
Gerdes C, Morgan R, Terry R, Foote A, Smith R.This descriptive anatomical study investigates the relationship between the third interosseous muscle, also known as the suspensory ligament, and the carpometacarpal joint in forelimbs of horses, with the hypothesis that there was a direct synovial communication between these structures as shown by computed tomographic arthrography, histology, and gross anatomy sections. Computed tomography of the carpus and metacarpal region was performed on two groups. Group 1 consisted of eight cadaver limbs undergoing computed tomographic arthrography following injection of a mixture of positive contrast m...
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 ...
José Antonio G, Jim S, Ramés SJ, Rohrbach BW, Alejandro Rodríguez M, Laura Romero R, Robert D.To examine changes occurring in normal pelvic suspensory ligaments (SLs) of horses after denervating these ligaments and to investigate the effect chronic inflammation might have on these changes. Methods: 10 horses. Methods: The SL of 1 randomly selected pelvic limb of each of 5 horses was injected with collagenase to induce desmitis, and 42 days later, the proximal aspect of both pelvic SLs were denervated. The SLs were harvested 120 days after being denervated, and the morphological and histological characteristics of each collagenase-injected, denervated SL were compared with those of the ...
Hinkle FE, Selberg KT, Frisbie DD, Barrett MF.Comparison of radiography to magnetic resonance imaging (MRI) can help objectively assess the value and limitations of radiographs in orthopaedic disease processes. The tarsus and proximal suspensory origin of the metatarsus are commonly imaged regions for lameness. The knowledge gained by comparison between imaging modalities will aid in improving accuracy of radiographic interpretation. Objective: To compare the radiographic and MRI findings of the proximal third metatarsal bone (MTIII) and proximal suspensory ligament using MRI as the gold standard. Methods: Retrospective observational stud...
Bardin AL, Taylor NC, Robert Colborne G.Thoroughbred racehorses are often affected by musculoskeletal injuries, leading to involuntary rest, early retirement or death. Hardness and consistency of the track surface have been implicated as major risk factors for limb injury. The purpose was to test the utility of a preliminary AnyBody musculoskeletal model of the equine forelimb for its responses on two perturbing surfaces. A musculoskeletal model was developed using CT, muscle, tendon and ligament properties, and kinematic data were applied from ridden trials using five Thoroughbred horses. Horses were ridden at trot and canter on a ...
Pluim M, Heier A, Plomp S, Boshuizen B, Gröne A, van Weeren R, Vanderperren K, Martens A, Dewulf J, Chantziaras I, Koene M, Luciani A, Oosterlinck M....High-power laser therapy gained popularity recently as a regenerative treatment for tendinitis and desmitis in the horse. However, studies evaluating the effects of laser therapy on tissue repair at the histological level in large mammals are lacking. Objective: To evaluate the effects of high-power laser therapy on suspensory desmitis healing, using a model of suspensory ligament branch injury. Methods: In vivo experiments. Methods: Standardised lesions were surgically induced in all four lateral suspensory branches of 12 healthy Warmblood horses. Laser therapy (class 4, 15W) was applied dail...
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 ...
Scharf A, de Solis CN, Sampson SN, Glass K, Watts AE.To determine the short-term effect of plantar fasciotomy and neurectomy (PFN) of the deep branch of the lateral plantar nerve on the proximal suspensory ligament (PSL) cross-sectional area (CSA) in horses with hindlimb proximal suspensory desmopathy (PSD). Methods: Analytical, observational, cohort study. Methods: Twenty-one horses. Methods: Records of horses with chronic PSD treated by PFN were included if a preoperative ultrasonographic examination was available and at least one postoperative ultrasonographic examination. One masked observer measured the ultrasonographic cross-sectional area...
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...
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...
de Souza AF, Pascual CJ, Maia BT, do Valle De Zoppa AL.This study aimed to evaluate the distribution of dye at two perineural injection sites of the palmar/plantar nerves and describe their anatomical variations of positioning at the level of the distal metacarpus/metatarsus in horses. Two ml of 1% methylene blue solution was injected in 24 limbs (12 forelimbs and 12 hindlimbs) of horse cadavers at two different points: Group 1: between the branch of the suspensory ligament and deep digital flexor tendon, and Group 2: between the deep and superficial digital flexor tendons. This was followed by dissection and evaluation of the solution diffusion. ...
Milner PI, Dimmock O, Barnes K.Neurovascular variation may be relevant when performing surgical techniques to the proximal plantar metatarsal region. Objective: To document variations in the neurovascular anatomy of the proximal plantar metatarsal region and study the relationship of the neurovascular components to each other and other structures located in this area. Methods: Descriptive anatomical study. Methods: Paired cadaver hind limbs from 15 horses were dissected from the distal tibia to the metatarsophalangeal joint. Deep branch of the lateral plantar nerve (DBLPN) length, location of its origin from the lateral pla...
Maleas G, Mageed M.This retrospective study aimed to evaluate the clinical effect of bone marrow aspirate concentrate (BMAC) and leukocyte rich PRP (LR-PRP) compared to horses undergoing controlled exercise alone in horses with >3 months proximal suspensory desmopathy in hindlimbs (HPSD). Nighty-three horses were divided into three groups according to the treatment: a control (n = 22), LR-PRP (n = 46), and BMAC (n = 25) group. Lameness and ultrasound scores were recorded before treatment (T0) and at 6 months (T1) post-treatment. Records horses considered sound at evaluation and level of performance were addition...
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...
Samol MA, Uzal FA, Blanchard PC, Arthur RM, Stover SM.The most prevalent causes of death in racehorses are musculoskeletal injuries, causing ~83% of deaths within the racing industry in California and elsewhere. The vast majority of these injuries have preexisting lesions that predispose to fatal injury. A 4-y-old Thoroughbred colt suffered an acute suspensory apparatus failure, including biaxial proximal sesamoid bone fractures of the right front fetlock, causing loss of support of the fetlock joint and consequent fall with fractures of the cervical and sacral spine. Cervical fracture caused spinal cord damage that resulted in sudden death. A pr...
Labens R, Jermyn K.To assess suspensory ligament extensor branch location and fracture gap reduction with simulation of standing and recumbent cortical bone screw repair of experimental incomplete parasagittal proximal phalanx (P1) fractures. Methods: Controlled laboratory study. Methods: Twenty equine cadaver forelimbs. Methods: Simulated fractures were repaired twice in random order. A proximal cortical bone screw was placed in lag fashion with the limb unloaded (simulated recumbent repair) and loaded to 38% of body weight (range, 375-568 kg; simulated standing repair). Changes in fracture gap width were ass...
Paraschou G, Adako GM, Priestnall SL, Burden FA.Three donkeys were presented with progressive lameness and distal suspensory ligament breakdown in multiple limbs. Treatment with nonsteroidal anti-inflammatory drugs was only partially effective and eventually the donkeys were euthanized due to further progression of the lameness and concerns for their welfare. At necropsy, the distal part of the suspensory ligaments in multiple limbs, including the suspensory ligament branches, was markedly thickened, enlarged, and mottled white and brown on cut section. In one case, adult sp. nematodes were grossly identified embedded within the suspensory...
Crawford KL, Finnane A, Greer RM, Phillips CJC, Woldeyohannes SM, Perkins NR, Ahern BJ.Musculoskeletal injuries (MSI) remain a concerning cause of racehorse morbidity and mortality with important ethical and welfare consequences. Previous research examining risk factors for MSI report inconsistent findings. Age is thought to affect MSI risk, but, to date, there have been no prospective studies comparing MSI in two-year-old versus older horses. This study aimed to: (1) determine the incidence of MSI for two-year-old and older horses, and whether this was affected by training track, season, or rainfall, and (2) determine the types of MSI affecting two-year-old and older horses, an...
Werpy N, Chapman K, Griffith L.When evaluating suspensory ligament branch splits, there is a discrepancy between high field MRI findings and weight bearing ultrasonographic imaging characteristics. In this descriptive and retrospective case series, ultrasonographic examination was performed on suspensory ligament branches with the limbs in weight bearing and non-weight bearing positions. Suspensory ligament branch splits were defined as linear regions of decreased echogenicity when imaged with the limb in a weight bearing position that increased in size and became anechoic with the limb in a non-weight bearing position. Thi...
Haythorn A, Young M, Stanton J, Zhang J, Mueller POE, Halper J.Equine degenerative suspensory ligament desmitis (DSLD) is a systemic connective tissue disorder first identified in Peruvian Paso horses but afflicting other horse breeds as well. Inappropriate accumulation of proteoglycans in connective tissues, most prominently in tendons and ligaments, leads to progressive and debilitating lameness and pain. It is largely unknown what drives the overproduction of proteoglycans, but our previous studies suggest involvement of bone morphogenetic protein 2 (BMP2), a member of the transforming growth factor-β (TGFβ) family, impacting synthesis of proteoglyca...
Murray RC, Tranquille CA, Walker VA, Milmine RC, Bak L, Tacey JB, Bolas NM.Standing magnetic resonance (MR) images of proximal metacarpal/metatarsal regions are increasingly being acquired. This study aimed at describing ranges of abnormalities detected in sport/racehorses, using retrospective evaluation of magnetic resonance imaging (MRI) reports from horses with lameness isolated to proximal metacarpal/metatarsal regions with images acquired standing. It was hypothesized that MRI features are different between metacarpal and metatarsal regions and between horses doing different sports. Reports from 359 forelimbs and 64 hindlimbs were included. Palmar/plantar metaca...
Rabba S, Petrucci V, Petrizzi L, Giommi DW, Busoni V.Information concerning B-mode ultrasonographic abnormalities and power Doppler (PD) signal in suspensory ligament branches of nonlame working Quarter Horses are not reported. The aims of this study were to investigate the prevalence of B-mode ultrasonographic abnormalities and PD signal in suspensory ligament branches in a group of nonlame working Quarter Horses and to compare B-mode findings with PD findings of horses in two different training (barrel racing and team roping). Twenty-one Quarter Horses in training, 14 barrel racing (Group B) and seven team roping horses (Group R), were assesse...
Pluim M, Martens A, Vanderperren K, van Weeren R, Oosterlinck M, Dewulf J, Kichouh M, Van Thielen B, Koene MHW, Luciani A, Plancke L, Delesalle C.High-power laser therapy is often used as a treatment for human sport injuries but controlled standardized studies on its efficacy are lacking. The technique has also been introduced in the equine field and recently promising results were reported in a retrospective study focusing on 150 sporthorses suffering from tendinopathy and desmopathy of the SDFT, DDFT, suspensory ligament, and suspensory branches. The goal of the present study was to evaluate the effect of high-power laser in a standardized lesion model in horses. Lesions were created in all lateral suspensory branches of 12 warmblood ...
Read RM, Boys-Smith S, Bathe AP. There is limited information concerning the ultrasonographic appearance of suspensory ligament branches (SLB) in sports horses. Publications exist on clinical injuries that lead to loss of training days and retirement, but not on the appearance of SLBs in high level showjumping Warmbloods. To demonstrate the prevalence of subclinical SLB abnormalities in regularly competing high-level showjumpers; to grade each branch 0-3; compare forelimb vs. hindlimb and medial vs. lateral SLBs; subjectively assess periligamentous fibrosis; measure cross sectional area (CSA) and to gather competition follo...
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...
Kornicka-Garbowska K, Pędziwiatr R, Woźniak P, Kucharczyk K, Marycz K.In athlete horses, suspensory ligament (SL) injuries are the most common cause of lameness. Healing of SL injury is still problematic, and even proper rehabilitation and pharmacological therapy do not guarantee returning to the initial performance level. In our previous studies, we have shown that a combination of 5-azacytidine (AZA) and resveratrol (RES) exerts beneficial, rejuvenating effects on metabolic syndrome derived adipose-derived stem cells (ASCs). Thus, in the presented research, we investigate whether not only rejuvenated ASC but also microvesicles (MVsAZA/RES) secreted by them pos...
Labens R, Schramme MC, Murray RC, Bolas N.High-field MRI of the proximal metacarpal/metatarsal region has been associated with great diagnostic potential and clinical reports of standing low-field MRI of the forelimb suggest the same. To better understand diagnostic outcomes with standing low-field MRI of the proximal suspensory region, a prospective survey study was conducted and users of a widely available system questioned on their experience, operating procedures, and interpretation of standing low-field MRI findings. Response data included scores on a modified Likert scale from which weighted ratings were calculated for statistic...
Bischofberger AS, Konar M, Ohlerth S, Geyer H, Lang J, Ueltschi G, Lischer CJ.The diagnosis of lameness caused by proximal metacarpal and metatarsal pain can be challenging. Magnetic resonance imaging (MRI) offers the possibility for further diagnosis but there have been no studies on the normal MRI appearance of the origin of the suspensory ligament (OSL) in conjunction with ultrasonography and histology. Objective: To describe the MRI appearance of the OSL in fore- and hindlimbs of sound horses and compare it to the ultrasonographic and histological appearance. The findings can be used as reference values to recognise pathology in the OSL. Methods: The OSL in the fore...
Pollitt CC, Visser MB.In acute laminitis, the suspensory apparatus of the distal phalanx fails at the lamellar dermal/epidermal interface. A grading system for the histopathology of laminitis is based on the consistent pattern of histologic changes to the secondary epidermal lamellae, basal cells, and basement membrane that occur as carbohydrate-induced laminitis develops. The actual trigger factors of carbohydrate-induced laminitis remain unidentified.
Patterson-Kane JC, Firth EC, Parry DA, Wilson AM, Goodship AE.To determine the effect of a specific galloping exercise regimen on collagen fibril mass-average diameters (MAD) in the deep digital flexor tendon (DDFT) and suspensory ligament (SL) of young Thoroughbreds. Methods: 12 Thoroughbred fillies, 21 +/- 1 (mean +/- SD) months old. Methods: 6 horses underwent a specific 18-month treadmill training program involving galloping exercise. The remaining 6 horses served as controls, undertaking low-volume walking exercise over the same period. Sections were excised from the midpoint of the DDFT and SL, and small strips were dissected from central and perip...
Garrett KS, Bramlage LR, Spike-Pierce DL, Cohen ND.To determine the effects of treatment with platelet- and leukocyte-rich plasma (PRP) on future 2-, 3-, and 4-year-old racing performance of yearling Thoroughbreds with proximal sesamoid bone inflammation and associated suspensory ligament branch (SLB) desmitis. Methods: Randomized clinical trial. Methods: 39 yearling Thoroughbreds. Methods: Yearling Thoroughbreds with radiographic evidence of performance-limiting proximal sesamoid bone inflammation and ultrasonographic evidence of associated SLB desmitis were identified and randomly assigned to undergo PRP (treatment group) or saline (0.9% NaC...
Shikh Alsook MK, Gabriel A, Piret J, Waroux O, Tonus C, Connan D, Baise E, Antoine N.Mesenchymal stem cells (MSCs) harvested from cadaveric tissues represent a promising approach for regenerative medicine. To date, no study has investigated whether viable MSCs could survive in cadaveric tissues from tendon or ligament up to 72 hours of post-mortem. The purpose of the present work was to find out if viable MSCs could survive in cadaveric tissues from adult equine ligaments up to 72 hours of post-mortem, and to assess their ability (i) to remain in an undifferentiated state and (ii) to divide and proliferate in the absence of any specific stimulus. Methods: MSCs were isolated ...
Kovac M, Litvin YA, Aliev RO, Zakirova EY, Rutland CS, Kiyasov AP, Rizvanov AA.In this clinical study, for the first time we used the direct gene therapy to restore severe injuries of the suspensory ligament branch and superficial digital flexor tendon in horses (). We injected the plasmid DNA encoding two therapeutic species-specific growth factors: vascular endothelial growth factor 164 and fibroblast growth factor 2 at the site of injury in the suspensory ligament branch and tendon. Treatment effects were evaluated with the use of clinical observation and ultrasound imaging during a period of a few months. We showed that gene therapy used within a period of 2-3 mont...
Ramzan PH, Palmer L, Dallas RS, Shepherd MC.Ultrasonographic (US) abnormalities of the suspensory ligament branch (SLB) have been poorly investigated but can have considerable impact on market value and career path when encountered in athletic horses. There is a need for determination of the prevalence and relationship to clinical injury of these US abnormalities in the Thoroughbred (TB) racehorse. Objective: To establish the prevalence of, and the repeatability of an US grading system for, subclinical US abnormalities of the forelimb SLB in a population of UK TB flat racehorses. Methods: Ultrasonographic assessment of the forelimb SLBs...
Plevin S, McLellan J.Limited information exists regarding the prognosis for juvenile racehorses sustaining injury to the suspensory ligament branch insertion (JISBI). Objective: To investigate the effect of JISBI on racing performance; and to assess whether the severity of JISBI is prognostically important. Methods: Retrospective cohort study. Methods: Records were reviewed for 896 juvenile Thoroughbreds in training, to identify horses with JISBI limited to one branch (cases). The ability of cases to start a race was compared to their cohorts. Race records of maternal siblings were compared to cases. Results: The ...
Crawford KL, Finnane A, Greer RM, Phillips CJC, Woldeyohannes SM, Perkins NR, Ahern BJ.Musculoskeletal injuries (MSI) remain a concerning cause of racehorse morbidity and mortality with important ethical and welfare consequences. Previous research examining risk factors for MSI report inconsistent findings. Age is thought to affect MSI risk, but, to date, there have been no prospective studies comparing MSI in two-year-old versus older horses. This study aimed to: (1) determine the incidence of MSI for two-year-old and older horses, and whether this was affected by training track, season, or rainfall, and (2) determine the types of MSI affecting two-year-old and older horses, an...
Caminoto EH, Alves AL, Amorim RL, Thomassian A, Hussni CA, Nicoletti JL.To evaluate the effects of extracorporeal shock wave therapy (ESWT) on affected ligaments in the hind limbs of horses with experimentally induced suspensory ligament desmitis by use of ultrasonographic, ultrastructural, and immunocytochemical techniques. Methods: 10 horses. Methods: Suspensory ligament desmitis was induced in both hind limbs of each horse by use of 2 collagenase injections (administered 2 weeks apart) in each suspensory ligament. Two weeks after the second injection, the right hind limb of each horse was treated with ESWT (3 treatments at 3-week intervals); the left hind limb ...
Werpy NM, Denoix JM, McIlwraith CW, Frisbie DD.Previous studies have proposed that standard ultrasonography may not adequately represent the pertinent anatomic characteristics of the equine proximal suspensory ligament. The purpose of the study was to compare the use of standard ultrasonography, angle contrast ultrasonography, MRI, and histology for identification of the anatomic characteristics of the normal equine suspensory ligament in the forelimb. Horses free from forelimb lameness with no palpable abnormalities in the region of the suspensory ligament were included in the study. The proximal suspensory ligaments in 20 forelimbs were ...
Meershoek LS, van den Bogert AJ, Schamhardt HC.To describe a method to calculate flexor tendon forces on the basis of inverse dynamic analysis and an in vitro model of the equine forelimb and to quantify parameters for the model. Methods: 38 forelimbs of 23 horses that each had an estimated body mass of > or = 500 kg. Methods: Longitudinal limb sections were used to determine the lines of action of the tendons. Additionally, limb and tendon loading experiments were performed to determine mechanical properties of the flexor tendons. Results: The study quantified the parameters for a pulley model to describe the lines of action. Furthermo...
Rabba S, Grulke S, Verwilghen D, Evrard L, Busoni V.Ultrasonography is routinely used to achieve the diagnosis of equine suspensory ligament desmopathy. In human medicine, power Doppler ultrasonography has also been found to be useful for the diagnosis of tendon/ligament injuries. The aim of this prospective, pilot study was to assess the presence or absence of power Doppler signal in suspensory ligament branches and compare B-mode findings with power Doppler findings in suspensory ligament branches of lame and non-lame limbs. Thirteen horses were used (eight lame horses, with lameness related to pain in the suspensory ligament branches, and fi...
Young M, Moshood O, Zhang J, Sarbacher CA, Mueller POE, Halper J.Horses afflicted with degenerative suspensory ligament desmitis (DSLD) suffer from progressive leg pain and lameness without history of trauma. DSLD is a systemic disorder caused by abnormal accumulation of proteoglycans in many connective tissues. One proteoglycan found in higher quantities in DSLD is decorin. The accumulated decorin has an abnormally glycosylated glycosaminoglycan chain in DSLD. In addition to acellular accumulations of proteoglycans foci of active fibroblasts/tenoblasts were observed in some tendons and suspensory ligaments (SLs) from DSLD cases We have hypothesized that th...
Agut A, Martínez ML, Sánchez-Valverde MA, Soler M, Rodríguez MJ.The objectives of this study were to establish normal values for relative echogenicity (RE) and cross-sectional area (CSA) of the flexor tendons and ligaments of the metacarpal region of Purebred Spanish horses (PBSH), and to determine the effect of body mass index (BMI), age, sex and forelimb on these variables. Transverse ultrasonographic images were obtained using 20 normal PBSH (10 females, 10 males; 2-25 years of age; BMI 132.04-152.25; not in training). The images were digitised and values for CSA and RE were determined for each structure. The suspensory ligament was the most echogenic a...
Lochner FK, Milne DW, Mills EJ, Groom JJ.Strains gauges were applied to the superficial flexor tendon, deep flexor tendon, and suspensory ligament of sound adult horses. Maximum tendon strain occurred during full weight bearing while walking, when the forelimb was perpendicular to the group surface. There was decrease in tendon strain with increase in hoof angle for the deep digital flexor, but no change in tendon strain for the superficial digital flexor and suspensory ligament with changing hoof angle. At physiologic rates of strain, tendons were able to withstand large loads without yielding. Load strain curves developed in vitro ...
Lischer CJ, Ringer SK, Schnewlin M, Imboden I, Fürst A, Stöckli M, Auer J.The objective of the present clinical report was to investigate the short- and long-term outcomes of chronic proximal suspensory desmitis (PSD) treated with Extracorporeal Shockwave Treatment (ESWT). Fifty-two horses with chronic PSD in the forelimb (34 cases) or hindlimb (22 cases) were included in the study. Three horses had lesions in both hindlimbs and one in both forelimbs. The origin of the suspensory ligament was treated every three weeks for a total of three treatments using 2000 impulses applied by a focused ESWT device (Equitron) at an energy flux density of 0.15 mJ/ mm2. This treatm...
Maleas G, Mageed M.This retrospective study aimed to evaluate the clinical effect of bone marrow aspirate concentrate (BMAC) and leukocyte rich PRP (LR-PRP) compared to horses undergoing controlled exercise alone in horses with >3 months proximal suspensory desmopathy in hindlimbs (HPSD). Nighty-three horses were divided into three groups according to the treatment: a control (n = 22), LR-PRP (n = 46), and BMAC (n = 25) group. Lameness and ultrasound scores were recorded before treatment (T0) and at 6 months (T1) post-treatment. Records horses considered sound at evaluation and level of performance were addition...
Labens R, Schramme MC, Murray RC, Bolas N.High-field MRI of the proximal metacarpal/metatarsal region has been associated with great diagnostic potential and clinical reports of standing low-field MRI of the forelimb suggest the same. To better understand diagnostic outcomes with standing low-field MRI of the proximal suspensory region, a prospective survey study was conducted and users of a widely available system questioned on their experience, operating procedures, and interpretation of standing low-field MRI findings. Response data included scores on a modified Likert scale from which weighted ratings were calculated for statistic...
Cohen ND, Mundy GD, Peloso JG, Carey VJ, Amend NK.To estimate the relative risk of injury among horses deemed to be at increased risk of injury on the basis of prerace physical inspection findings and to examine the association of injury during races with race-related characteristics. Methods: Cohort study. Methods: 2,187 Thoroughbred horses that started 3,227 races in Kentucky. Methods: All race starts for which a horse was deemed to be at increased risk of injury on the basis of prerace physical inspection findings and a random sample of race starts for which horses were not deemed at increased risk of injury were included in the study. Fin...
McClure SR, VanSickle D, Evans R, Reinertson EL, Moran L.Extracorporeal shock-wave therapy (ESWT) may stimulate healing of desmitis in multiple species. The objective of this study was to evaluate the ultrasonographic and histologic appearance of collagenase-induced suspensory ligament (SUL) desmitis in untreated ligaments and ligaments treated with ESWT in horses. Four mature horses had SUL desmitis induced in both forelimbs. Beginning 3 weeks after induction of the lesions, one ligament per horse was treated 3 times at 3-week intervals with ESWT. The percent lesion, echogenicity and fiber alignment scores of the SULs were evaluated at 3-week inter...
McLellan J, Plevin S.Sesamoiditis is believed to be associated with injury to the suspensory branch attachment and is a common radiographic finding in yearling Thoroughbreds. No study has investigated relationships between yearling sesamoiditis and subsequent development of suspensory ligament branch injury (SLBI) in early racehorse training. Objective: To establish the prevalence of SLBI within a population of juvenile training racehorses and retrospectively investigate relationships between clinical signs of SLBI and sesamoiditis to determine if sesamoiditis is a risk factor for clinical suspensory branch injury...
Butcher MT, Hermanson JW, Ducharme NG, Mitchell LM, Soderholm LV, Bertram JE.Racing and training related lesions of the forelimb superficial digital flexor tendon are a common career ending injury to racehorses but aetiology and/or predisposing causes of the injury are not completely understood. Objective: Although the injury takes place within the tendon, the lesion must be considered within the context of the function of the complete suspensory system of the distal limb, including the associated muscles. Methods: Both muscle and tendon function were investigated in vivo using implanted strain gauges in 3 Thoroughbred horses walking, trotting and cantering on a motori...
Firth EC, Rogers CW, Anderson BH.To determine the weight, volume, density and cross-sectional area (CSA) of the digital flexor tendons, common digital extensor tendon (CDET) and suspensory ligament (SL) of the forelimb of young Thoroughbred horses in early training, and to assess the response to a training programme of known parameters of superficial digital flexor tendon (SDFT) tissue at mid-metacarpal level. Methods: The tendons of seven 2-year-old Thoroughbred horses in training were inspected, transected into segments of known length, and compared with those from seven untrained horses matched for age, sex and breed. The ...
Carlier S, Depuydt E, Suls M, Bocqué C, Thys J, Vandenberghe A, Martens A, Saunders J, Hellmann K, Braun G, Beerts C, Spaas JH.Mesenchymal stem cells are an innovative therapeutic for various equine orthopaedic diseases, including soft tissue injuries. Objective: To evaluate the safety and efficacy of tenogenic primed equine allogeneic peripheral blood-derived mesenchymal stem cells (tpMSCs) in horses with naturally occurring superficial digital flexor tendon (SDFT) and suspensory ligament (SL) injuries. Methods: Multicentre, blinded, randomised, placebo-controlled clinical trial. Methods: One hundred client-owned horses with SDFT and SL injuries were randomised to receive an intralesional tpMSC (66) or saline (34) in...
Werpy NM, Denoix JM.Injury to the suspensory ligament can result in significant lameness. Multiple imaging modalities may be required to fully characterize injury to the suspensory ligament. Ultrasonography of the suspensory ligament is challenging, due to the normal anatomy. This article describes imaging of the proximal suspensory ligament in the front and hind limbs of the horse.
Riemersma DJ, Schamhardt HC, Hartman W, Lammertink JL.Loads on the suspensory ligament, deep digital flexor tendon, superficial digital flexor tendon, and long digital extensor tendon of the equine hind limb were determined in ponies by use of implanted strain gauges consisting of silicone rubber tubes filled with mercury. Recordings were made simultaneously with force plate measurements and high-speed film recordings while the ponies were walking. The relationship between strain gauge signals and tendon loads was obtained from tension-strain tests performed after death of the ponies. The suspensory ligament and the 2 digital flexor tendons were ...
Dyson SJ, Arthur RM, Palmer SE, Richardson D.The gross and functional anatomy of the suspensory ligament (SL) and its ultrasonographic variability are described. Injuries of the suspensory apparatus are divided into lesions confined to the proximal one third of the metacarpus or metatarsus (proximal suspensory desmitis and avulsion fractures), lesions of the body, and branch lesions. Complete breakdown injuries are also discussed. In view of the close association of the SL, the second, third, and fourth metacarpal or metatarsal bones, and the proximal sesamoid bones, associated bony lesions are also considered.
Wilson DA, Baker GJ, Pijanowski GJ, Boero MJ, Badertscher RR.Suspensory ligaments (SL) from 32 Thoroughbreds and 32 Standardbreds were collected to evaluate the variation in muscle content with respect to age, breed, sex, limb, and use. Six transverse sections, each 3 to 5 mm thick, were obtained from each SL. Four sections were taken from the body of the SL and 1 from the midportion of each branch. Sections were stained with van Gieson picric acid-fuchsin solution, then photographed, and black-and-white slides were made from the processed negatives. The transverse-sectional area of the SL and the contained muscle were determined by use of a computer wi...
Haythorn A, Young M, Stanton J, Zhang J, Mueller POE, Halper J.Equine degenerative suspensory ligament desmitis (DSLD) is a systemic connective tissue disorder first identified in Peruvian Paso horses but afflicting other horse breeds as well. Inappropriate accumulation of proteoglycans in connective tissues, most prominently in tendons and ligaments, leads to progressive and debilitating lameness and pain. It is largely unknown what drives the overproduction of proteoglycans, but our previous studies suggest involvement of bone morphogenetic protein 2 (BMP2), a member of the transforming growth factor-β (TGFβ) family, impacting synthesis of proteoglyca...
