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.
Hofberger SC, Gauff F, Thaller D, Morgan R, Keen JA, Licka TF.OBJECTIVE To identify signs of tissue-specific cortisol activity in samples of suspensory ligament (SL) and neck skin tissue from horses with and without pituitary pars intermedia dysfunction (PPID). SAMPLE Suspensory ligament and neck skin tissue samples obtained from 26 euthanized horses with and without PPID. PROCEDURES Tissue samples were collected from 12 horses with and 14 horses without PPID (controls). Two control horses had received treatment with dexamethasone; data from those horses were not used in statistical analyses. The other 12 control horses were classified as old horses (≥...
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...
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 ...
Barrett MF, Manchon PT, Hersman J, Kawcak CE.Injury to the proximal suspensory ligament is a common cause of lameness in cutting horses. Radiographic and ultrasonographic imaging of lesions responsible for lameness can provide ambiguous results. MRI provides the most comprehensive diagnostic imaging evaluation of lesions specifically affecting cutting horses. Objective: To describe the distribution and severity of bone and soft tissue lesions present in the proximal metacarpus of Quarter Horse cutting horses and to assess the impact of these lesions on return to competition. Methods: Retrospective case series. Methods: Retrospective anal...
Mizobe F, Nomura M, Kato T, Nambo Y, Yamada K.Problems associated with the proximal metacarpal region, such as an osseous injury associated with tearing of Sharpey's fibers or an avulsion fracture of the origin of the suspensory ligament (OISL), are important causes of lameness in racehorses. In the present study, four Thoroughbred racehorses (age range, 2-4 years) were diagnosed as having forelimb OISL and assessed over time by using standing magnetic resonance imaging (sMRI). At the first sMRI examination, all horses had 3 characteristic findings, including low signal intensity within the trabecular bone of the third metacarpus on T1-we...
Dyson S, Pinilla MJ, Bolas N, Murray R.There have been no previous studies correlating high-field magnetic resonance imaging (MRI) findings with gross and histological post-mortem examination in horses with hindlimb proximal suspensory desmopathy (PSD). Objective: To determine if adhesions between the suspensory ligament (SL) and adjacent tissues could be detected using high-field MRI and if collagen, adipose tissue and muscle pathology could be differentiated. Methods: Retrospective study. Methods: Nineteen horses with hindlimb PSD were humanely destroyed; 12 limbs of 11 horses with PSD underwent high-field MRI. All lame limbs wer...
Lopez-Navarro G, Trigo-Tavera FJ, Rodriguez-Monterde A, Gutierrez-Ospina G, Arechavaleta-Velasco M, Schumacher J, Schumacher J.Proximal suspensory desmitis (PSD) is a common cause of lameness in the pelvic limb, but could also affect the thoracic limb of competing and non-competing horses. Most horses diagnosed with PSD in a thoracic limb respond to rest followed by controlled exercise, but in a small percentage of affected horses, lameness persists. In one study, four horses chronically lame because of PSD in a thoracic limb became sound after neurectomy of the deep branch of the lateral palmar nerve (DBLPaN), which innervates the proximal aspect of the suspensory ligament (SL; Guasco et al., 2013). Whether neurectom...
Luo W, Sandy J, Trella K, Gorski D, Gao S, Li J, Brounts S, Galante J, Plaas A.Equine degenerative suspensory ligament desmitis (DSLD) in Peruvian Paso horses typically presents at 7-15 years and is characterized by lameness, focal disorganization of collagen fibrils, and chondroid deposition in the body of the ligament. With the aim of developing a test for disease risk (that can be used to screen horses before breeding) we have quantified the expression of 76 TGFβ-signaling target genes in adipose-derived stromal fibroblasts (ADSCs) from six DSLD-affected and five unaffected Paso horses. Remarkably, 35 of the genes showed lower expression (p<0.05) in cells from DSL...
Nazem MN, Sajjadian SM.Palmar region of metacarpus in the horses and donkeys is an important region because of its tendons and ligaments which contribute to stay apparatus. This study was done on forelimbs of 6 healthy Miniature donkeys to detect the tendons, ligaments and their accessories on the palmar surface of metacarpus in this animal. Methods: Based on that magnetic resonance imaging (MRI) is a good technique to evaluate the soft tissues such as tendons and ligaments, palmar aspects of metacarpus in 6 euthanatised Miniature donkeys were prepared for anatomical and trans-sectional MRI studies to determine the ...
Fairburn AJ, Busschers E, Barr ARS.Suspensory ligament branch (SLB) desmopathy is a common cause of lameness and an important cause of lost training in the Thoroughbred racing industry. Studies have assessed the impact of insertional injuries of the SLB on the careers of flat racehorses and established the prevalence of subclinical ultrasonographic SLB abnormalities in this population, but little work has investigated SLB injury in National Hunt (NH) racehorses. Objective: To investigate the prevalence of subclinical ultrasonographic SLB abnormalities in NH racehorses with no clinical signs or history of SLB injury and to estab...
Spriet M, Espinosa P, Kyme AZ, Stepanov P, Zavarzin V, Schaeffer S, Katzman SA, Galuppo LD, Beylin D.Positron emission tomography (PET) is a highly sensitive, noninvasive imaging technique for quantifying biological functions of tissues. However, at the time of this study, PET imaging applications had not been reported in the horse. The aim of this exploratory study was to determine whether a portable high-resolution PET scanner could be used to image the equine distal limb. Images of the front feet and fetlocks of three research horses, with known lesions localized to the distal front limbs, were acquired under general anesthesia after administration of 18 F-fluorodeoxyglucose (18 F-FDG), wi...
Brokken MT, Schneider RK, Roberts GD, Holmes SP, Gavin PR, Sampson SN, Farnsworth KD, Dahlgren LA.To evaluate the effects of a new microfracture and ligament splitting procedure on ligament healing and to examine the usefulness of magnetic resonance (MR) imaging for monitoring ligament healing over time using a collagenase model of hind limb proximal suspensory desmitis. Methods: Experimental in vivo study. Methods: Healthy adult horses (n=6). Methods: Horses were free of lameness with normal hind limb proximal suspensory ligaments (PSL). The origin of both hind limb PSL was injected with collagenase and underwent MR imaging 2 weeks later, followed by the microfracture and ligament splitti...
Mizobe F, Okada J, Shinzaki Y, Nomura M, Kato T, Yamada K, Spriet M.Desmitis of the oblique distal sesamoidean ligaments (ODSL) is caused by hyperextension of the metacarpophalangeal/metatarsophalangeal joint and has been described as a significant cause of lameness in racehorses. In this study, three Thoroughbred racehorses (age range: 3-6 years) were diagnosed with desmitis of the forelimb ODSL using standing low-field magnetic resonance imaging (sMRI). Radiography and ultrasonography were inconclusive with regard to a definitive diagnosis. For all horses, the sMRI characteristics included increased signal intensity within the medial ODSL on T1-weighted grad...
Dyson S, Murray R, Pinilla MJ.It has been suggested that ultrasonography is unreliable for the detection of hindlimb proximal suspensory desmopathy (PSD) based on comparisons between ultrasonographic and magnetic resonance images. Objective: To compare ultrasonography with gross and histopathological post mortem examination in horses with PSD diagnosed based on ultrasonography and control horses. Methods: Retrospective descriptive study. Methods: Part 1: 19 horses with hindlimb PSD and 10 control horses were humanely destroyed. Twenty control limbs and 37 lame limbs were examined grossly and 40 suspensory ligaments (SLs) w...
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 ...
Plevin S, McLellan J, O'Keeffe T.Sesamoiditis is a common radiological finding in yearling Thoroughbreds. The condition is believed to be associated with suspensory ligament branch injury (SLBI), which is known to affect racing performance. The presence of subclinical suspensory ligament branch change (SSLBC) in untrained yearlings has not been investigated. Associations between sesamoiditis, SSLBC and subsequent SLBI would allow more accurate prognoses to be made regarding the development of SLBI. They could also provide opportunity for intervention and prevention of SLBI. Objective: To test our hypotheses that untrained yea...
Vandenberghe A, Broeckx SY, Beerts C, Seys B, Zimmerman M, Verweire I, Suls M, Spaas JH.Suspensory ligament injuries are a common injury in sport horses, especially in competing dressage horses. Because of the poor healing of chronic recalcitrant tendon injuries, this represents a major problem in the rehabilitation of sport horses and often compromises the return to the initial performance level. Stem cells are considered as a novel treatment for different pathologies in horses and humans. Autologous mesenchymal stem cells (MSCs) are well known for their use in the treatment of tendinopathies; however, recent studies report a safe use of allogeneic MSCs for different orthopedic ...
Lavagnino M, Madison J, Williams MR, Arnoczky SP.To determine if regional variations in strain patterns occur within the suspensory ligament under tensile load. Local increases in strain may put certain regions of the suspensory ligament at risk and may explain the poor healing and high recurrence rates associated with suspensory branch injuries. Methods: The suspensory ligament and its bone attachments were isolated from each of 10 adult equine cadaveric forelimbs and radiodense reference beads were inserted throughout the length of the ligament. Specimens were attached to a custom fixture secured to a materials testing system. Radiographs ...
Pollitt CC, Collins SN.The suspensory apparatus of the distal phalanx (SADP) is functionally and clinically important. Objective: To investigate SADP form and function and the microanatomy of its insertion zone. Methods: Descriptive gross and microanatomy. Methods: The feet of 6 normal Standardbred horses were sectioned into blocks along the traditional perpendicular transverse axis and along functional axes of the SADP, decalcified and processed for staining with haematoxylin and eosin, Jones' periodic acid silver methenamine or Masson's trichrome stains. Results: In traditional midline toe transverse plane section...
Hill AE, Blea JA, Arthur RM, McIlwraith CW.Private-practice racetrack veterinarians in southern California recorded non-fatal injuries meeting defined criteria in Thoroughbreds for 1 year. Injury incidence was 2.29 injury events per 100 horse-months, which was lower than other studies where trainer reported injury data were collected. Of 477 injuries recorded, 344 (72.1%) were acute and 133 (27.9%) were chronic. Fractures were common (47.6% of injuries), with stress fractures accounting for 14% of injuries. Superficial digital flexor tendonitis and suspensory ligament desmitis accounted for 15.3 and 11.5% of injuries, respectively. Agr...
Shikh Alsook MK, Gabriel A, Salouci M, Piret J, Alzamel N, Moula N, Denoix JM, Antoine N, Baise E.Suspensory ligament (SL) injuries are an important cause of lameness in horses. The mechanical properties of connective tissue in normal and pathological ligaments are mainly related to fibril morphology, as well as collagen content and types. The purpose of this study was to evaluate, using biochemical and ultrastructural approaches, the alterations in collagen fibrils after injury. Eight Warmblood horses with visible signs of injury in only one forelimb SL were selected and specimens were examined by transmission electron microscope (TEM). Collagen types I, III and V were purified by differe...
Hofberger S, Gauff F, Licka T.In older horses, pituitary pars intermedia dysfunction (PPID) and suspensory ligament (SL) degeneration are common. The aim of the present study was to identify histopathological changes in the SL in horses with PPID. SLs of four horses with clinical signs of PPID (17-26 years of age) were compared with SLs from four old horses (18-31 years of age) and three young horses (4-9 years of age). In horses with PPID, there was reduced longitudinal arrangement of collagen fibres in SLs, along with inclusions of cartilage, extracellular matrix and haemorrhage, as well as significant proteoglycan accum...
Hill AE, Gardner IA, Carpenter TE, Lee CM, Hitchens PL, Stover SM.Knowledge of the site distribution of ligamentous injuries facilitates clinical diagnosis of suspensory apparatus conditions. Objective: To determine if lesions within the suspensory ligament (SL) and distal ligaments of the proximal sesamoid bones (DSLs) were associated with suspensory apparatus failure or metacarpal lateral condylar fracture in California Thoroughbred racehorses. Methods: Cross-sectional study. Methods: Suspensory apparatus specimens from 327 deceased Thoroughbred racehorses were sectioned within the SL body and branches, and oblique and straight DSLs. Purple lesions ≥2 ...
Takahashi T, Mukai K, Ohmura H, Aida H, Hiraga A.The purpose of this study was to create a lower forelimb model of the Thoroughbred horse for measuring the force in the superficial and deep digital flexor tendons (SDFT and DDFT), and the suspensory ligament (SL) during a trot. The mass, centers of gravity, and inertial moments in the metacarpus, pastern, and hoof segments were measured in 4 Thoroughbred horses. The moment arms of the SDFT, DDFT, and SL in the metacarpophalangeal (fetlock) and distal interphalangeal (coffin) joints were measured in 7 Thoroughbred horses. The relationship between the fetlock joint angle and the force in the SL...
Contino EK, King MR, Valdés-Martínez A, McIlwraith CW.Hindlimb proximal suspensory desmopathy is a common injury of sport horses but diagnosis can be difficult because diagnostic analgesia of the region lacks specificity. Perineural analgesia of the deep branch of the lateral plantar nerve (DBLPN) has been proposed as a more specific method of isolating pain of the proximal aspect of the suspensory ligament but the technique has not been evaluated in vivo. Objective: To determine the extent of diffusion of contrast medium and mepivacaine following DBLPN analgesia using a single-needle injection technique and to determine if there is inadvertent i...
Ortved KF, Stewart AW, Fubini SL, Hackett RP.To report surgical management of 4 horses with cryptorchidism caused by failure of regression of the cranial suspensory ligament (CSL). Methods: Retrospective case series. Methods: Cryptorchid horses (n = 4). Methods: Horses with unilateral or bilateral cryptorchidism caused by failure of regression of the CSL were treated by removing the retained testes through a standing laparoscopic approach (2), flank laparotomy (1), or paramedian celiotomy (1). After identification of the retained testis attached to the caudal pole of the kidney by the CSL, the vascular pedicle and ductus deferens were li...
Williams MR, Arnoczky SP, Pease AP, Stick JA.To determine the microvascular anatomy of the suspensory ligament of the forelimb of horses. Methods: 17 cadaveric forelimbs from 9 adult horses with no known history of forelimb lameness. Methods: The median artery of the forelimb was cannulated proximal to the antebrachiocarpal joint and injected with contrast medium for CT evaluation of the gross vasculature (n = 2) or India ink to evaluate the microvasculature (12). Routine histologic evaluation was performed on an additional 3 forelimbs to confirm the microvascular anatomy. Results: The vascular supply of the suspensory ligament of the fo...
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 ...
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...
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...
Xie L, Spencer ND, Beadle RE, Gaschen L, Buchert MR, Lopez MJ.Equine degenerative suspensory ligament desmitis (DSLD) is a debilitating condition that has limited response to rest and stall confinement. This study was designed to test the hypothesis that mild to moderate DSLD is not worsened by consistent exercise. Paso Fino and Peruvian Paso horses (two normal horses and four horses with DSLD) were exercised for 30 min every other day for 8 weeks and then pasture rested for 4 months. Gait analysis, radiographs, ultrasound and serum insulin and glucose concentrations were performed prior to the exercise trial and at each time point. Vertical impulse incr...
Luo W, Sandy J, Trella K, Gorski D, Gao S, Li J, Brounts S, Galante J, Plaas A.Equine degenerative suspensory ligament desmitis (DSLD) in Peruvian Paso horses typically presents at 7-15 years and is characterized by lameness, focal disorganization of collagen fibrils, and chondroid deposition in the body of the ligament. With the aim of developing a test for disease risk (that can be used to screen horses before breeding) we have quantified the expression of 76 TGFβ-signaling target genes in adipose-derived stromal fibroblasts (ADSCs) from six DSLD-affected and five unaffected Paso horses. Remarkably, 35 of the genes showed lower expression (p<0.05) in cells from DSL...
Dyson S, Pinilla MJ, Bolas N, Murray R.There have been no previous studies correlating high-field magnetic resonance imaging (MRI) findings with gross and histological post-mortem examination in horses with hindlimb proximal suspensory desmopathy (PSD). Objective: To determine if adhesions between the suspensory ligament (SL) and adjacent tissues could be detected using high-field MRI and if collagen, adipose tissue and muscle pathology could be differentiated. Methods: Retrospective study. Methods: Nineteen horses with hindlimb PSD were humanely destroyed; 12 limbs of 11 horses with PSD underwent high-field MRI. All lame limbs wer...
Spargo KE, Rubio-Martinez LM, Wheeler DP, Fletcher L, Carstens A.The incidence and types of catastrophic musculoskeletal injuries in Thoroughbreds that resulted in euthanasia on selected racetracks in South Africa between 1998 and 2012 were investigated by an observational retrospective investigation. Data from the National Horseracing Authority of Southern Africa for these racetracks were used to calculate incidence rates in Thoroughbreds (n = 114) that sustained catastrophic musculoskeletal injuries during racing that required immediate euthanasia, based on the diagnosis made by the on-site veterinarian as well as on fetlock radiographs and dissections o...
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 ...
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 ...
Meershoek LS, Lanovaz JL, Schamhardt HC, Clayton HM.To calculate forces in the flexor tendons and the influence of heel wedges in affected and contralateral (compensating) forelimbs of horses with experimentally induced unilateral tendinitis of the superficial digital flexor (SDF) tendon. Methods: 5 Warmblood horses. Procedure-Ground reaction force and kinematic data were obtained during a previous study while horses were trotting before and after induction of tendinitis in 1 forelimb SDF and after application of 6 degrees heel wedges to both forehooves. Forces in the SDF, deep digital flexor (DDF), and the suspensory ligament (SL) and strain i...
Souza MV, van Weeren PR, van Schie HT, van de Lest CH.Desmopathies of the suspensory ligament are relatively frequent and vary in prevalence over different anatomical regions. This variation may be because of regional differences in tissue characteristics. Objective: To characterise different regions of healthy forelimb suspensory ligaments (SLs) by means of biochemical, biomechanical and histomorphological techniques. Objective: There is substantial topographical heterogeneity in the SL with respect to structural, compositional and functional characteristics. Methods: SLs were harvested from 38 limbs and used for biochemical (n = 20), biomechani...
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.
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...
van den Belt AJ, Dik KJ, Barneveld A.Over a 2 year-period, the ultrasonographic localization and distribution of flexor tendinous and ligamentous injuries, the long-term follow-up, and the outcome were studied in 101 Dutch Warmblood horses (DW) with a mean age of 8.7 years and in 71 Standardbred racehorses (ST) with a mean age of 5.2 years. The ratio between forelimb and hind limb flexor tendonitis/desmitis in the DW-group was 4:1 and in the ST-group group 4:3. In the DW-group, tendonitis/desmitis of the suspensory ligament (32%), the superficial digital flexor tendon (29%), the distal carpal check ligament (17%) of the forelimb ...
Meershoek LS, Lanovaz JL.To test the sensitivity to measurement and modeling errors of a method for noninvasive calculation of flexor tendon forces in the equine forelimb and to calculate tendon forces for Dutch Warmblood horses during trotting. Methods: A normative set of kinematic and ground-reaction force (GRF) data obtained from horses during trotting in another study. Methods: Forces in the flexor tendons were calculated from the data set before and after addition of fixed relative and absolute errors. Amount of error was based on normal accuracy of the variables. A similar analysis was performed for a measure of...
Hill AE, Gardner IA, Carpenter TE, Lee CM, Hitchens PL, Stover SM.Knowledge of the site distribution of ligamentous injuries facilitates clinical diagnosis of suspensory apparatus conditions. Objective: To determine if lesions within the suspensory ligament (SL) and distal ligaments of the proximal sesamoid bones (DSLs) were associated with suspensory apparatus failure or metacarpal lateral condylar fracture in California Thoroughbred racehorses. Methods: Cross-sectional study. Methods: Suspensory apparatus specimens from 327 deceased Thoroughbred racehorses were sectioned within the SL body and branches, and oblique and straight DSLs. Purple lesions ≥2 ...
Nagy A, Dyson S.Detailed magnetic resonance imaging (MRI) and histological appearances of the proximal aspect of the suspensory ligament (PSL) in the forelimb of nonlame horses have not been previously documented. Objective: 1) to describe detailed anatomy of the PSL, 2) describe high- and low-field MRI and histological appearances of the PSL and surrounding structures in the forelimb of horses with no carpal or proximal metacarpal pain, 3) assess the relationship between age, breed, gender, height, bodyweight and MRI findings and 4) describe the histological appearance of the PSL and compare this with MRI fi...
Zubrod CJ, Schneider RK, Tucker RL.Four horses were examined because of chronic forelimb lameness. In all horses, the cause of the lameness was localized to the metacarpus by means of physical examination and diagnostic anesthesia, and radiography of the affected limb revealed a small exostosis of the second metacarpal bone. Magnetic resonance imaging revealed suspensory desmitis in the region of this exostosis in all 4 horses. In addition, an abnormal area of low signal intensity, suggestive of an adhesion, was seen between the exostosis and the suspensory ligament. In all horses, an adhesion between the suspensory ligament an...
Jansen MO, van den Bogert AJ, Riemersma DJ, Schamhardt HC.The load distribution over tendinous structures in the equine forelimb was studied by computing forces from in vivo signals of implanted liquid-metal strain gauges in 5 ponies. For validation, these tendon forces were converted to joint moments, which were summed and compared to the calculated joint moments caused by the ground reaction force. Mean peak forces per kilogram body weight (n = 5) amounted to 5.2 N/kg for the superficial digital flexor tendon, 3.8 N/kg for the deep digital flexor tendon, 7.3 N/kg for the distal accessory (check) ligament and 8.4 N/kg for the third interosseous musc...
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...
Hofberger SC, Gauff F, Thaller D, Morgan R, Keen JA, Licka TF.OBJECTIVE To identify signs of tissue-specific cortisol activity in samples of suspensory ligament (SL) and neck skin tissue from horses with and without pituitary pars intermedia dysfunction (PPID). SAMPLE Suspensory ligament and neck skin tissue samples obtained from 26 euthanized horses with and without PPID. PROCEDURES Tissue samples were collected from 12 horses with and 14 horses without PPID (controls). Two control horses had received treatment with dexamethasone; data from those horses were not used in statistical analyses. The other 12 control horses were classified as old horses (≥...
Carrozzo U, Toniato M, Harrison A.Therapeutic ultrasound is a noninvasive technique, which is well tolerated by horses, does not need sedation, and can easily be performed in a routine clinical setting. Twenty-three client-owned sport horses were recruited at Clinica Equina San Biagio and included in this case study. Treatment of the injured suspensory ligament apparatus was administered using an EQ Pro, low-frequency therapeutic unit (38 kHz). The noninvasive treatment consisted of massaging the injured area in combination with a traditional ultrasound gel while maintaining the head of the device in direct contact with the i...
Launois MT, Vandeweerd JM, Perrin RA, Brogniez L, Desbrosse FG, Clegg PD.3 horses with lameness localized to the proximal aspect of the metacarpus or metatarsus. Results: All horses had evidence of problems that originated from the proximal aspect of the suspensory ligament (PASL), including signs of pain on palpation, positive results of diagnostic nerve blocks, ultrasonographic detection of enlargement and diffuse areas of reduced echogenicity in the proximal region of insertion of the ligament, and radiographic detection of increased mineral opacity in the proximal aspect of the metacarpus or metatarsus. Desmitis of the PASL was diagnosed in each horse; however,...
Nagy A, Dyson S.While low-field magnetic resonance (MR) images can provide useful information in the investigation of proximal metacarpal region pain, an in-depth knowledge of anatomy and comparison with more detailed high-field images are essential to understand the meaning of different signal intensities within tissues. This anatomic description is based on low-field and high-field MR examination of 30 cadaver metacarpal regions of mature horses with no history of carpal or proximal metacarpal pain. Normal MR anatomy is described and is illustrated by high-field and low-field MR images in transverse, sagitt...
Pollitt CC, Collins SN.The suspensory apparatus of the distal phalanx (SADP) is functionally and clinically important. Objective: To investigate SADP form and function and the microanatomy of its insertion zone. Methods: Descriptive gross and microanatomy. Methods: The feet of 6 normal Standardbred horses were sectioned into blocks along the traditional perpendicular transverse axis and along functional axes of the SADP, decalcified and processed for staining with haematoxylin and eosin, Jones' periodic acid silver methenamine or Masson's trichrome stains. Results: In traditional midline toe transverse plane section...
Dyson S.Clinical, ultrasonographic and radiographic features of proximal suspensory desmitis in the forelimb and the hindlimb are described. Acute cases may present with slight, localised, oedematous swelling, heat, distension of the medial palmar (plantar) vein and/or pain, whereas chronic cases or those rested immediately after onset of lameness usually have no detectable clinical signs suggestive of the source of pain. In these cases local analgesia is required to identify pain in the proximal metacarpal (metatarsal) region. Transverse ultrasonographic images of the suspensory ligament usually yiel...
Boehart S, Arndt G, Carstanjen B.The aim of the study was to determine morphometric values of the superficial and deep digital flexor tendon, the inferior check ligament and the suspensory ligament in the palmar metacarpal region of sound Haflinger horses using ultrasonography and to assess the influence of different factors on them. The findings were compared with the literature. A total of 30 sound Haflinger mares aged 4-20 years were used. Transverse ultrasound images were obtained with an 8-10 linear MHz transducer and the cross-sectional area, the circumference and the dorsopalmar and lateromedial width were determined f...
Bonilla-Gutiérrez AF, Castillo-Franz C, López C, Álvarez ME, Giraldo CE, Carmona JU.The aim of this study was to evaluate the release of pro- and anti-inflammatory as well as anabolic mediators stimulated by a leukocyte-reduced platelet-rich gel supernatant (Lr-PRGS) and a leukocyte-reduced plasma supernatant (Lr-PL) at two concentrations (25 and 50%) on normal equine suspensory ligament explants (SLEs) and tendon explants (TEs). SLEs and TEs from six horses were independently incubated for 48 h with Lr-PRGS and Lr-PL at concentrations of 25 and 50%, respectively. Samples were collected from the incubated tissues at 1 h and 48 h, which were employed for ELISA determinat...
Whitehair KJ, Adams SB, Toombs JP, Parker JE, Prostredny JM, Whitehair JG, Aiken SW.A llama, a miniature horse, and a miniature donkey with severe bilateral congenital flexural deformities of the metacarpophalangeal and metatarsophalangeal joints were treated successfully by arthrodesis with dynamic compression plating or external skeletal fixation. The flexor tendons were more taut than the suspensory ligaments and were transected. In the llama, the suspensory ligament was transected, and overcorrection caused ischemic necrosis of one distal limb and subluxation of the other fetlock joint. In the horse and donkey, the suspensory ligament was preserved and wedge osteotomy was...
Fairburn A, Dyson S, Murray R.Osseous spurs on the dorsoproximal aspect of the third metatarsal bone (MtIII) are common, but their clinical significance is unknown. Objective: To verify the sites of insertion of the dorsal metatarsal ligament and the tendons of tibialis cranialis and fibularis tertius in order to determine if periarticular osteophytes and entheseophytes could be differentiated radiologically; and to determine the frequency of occurrence of osseous spurs on the dorsoproximal aspect of MtIII. Objective: The frequency of osseous spurs on the dorsoproximal aspect of MtIII would be higher in lame than in clinic...
Likon I, Dyson S, Nagy A.Proximal metacarpal injury is common in endurance horses, yet exercise-induced changes in this region have not been described. This study aimed to document objective exercise-induced changes in the proximal palmar cortex of the third metacarpal bone (PcMcIII) and the suspensory ligament (SL). Low-field magnetic resonance (MR) images of both proximal metacarpal regions were obtained from six novice and six experienced horses, before and after six months of endurance training. Measurements were acquired in T1-weighted transverse MR images at four levels and included the thickness of the PcMcIII,...
Spriet M, Wisner ER, Anthenill LA, Buonocore MH.Seven isolated equine front limbs were used to establish the normal T1 relaxation time of equine superficial digital flexor tendon (SDFT), deep digital flexor tendon (DDFT), and suspensory ligament (SL) using magic angle magnetic resonance (MR) imaging. MR imaging of the metacarpi was performed with the limbs positioned at 55° (the magic angle) relative to the main magnetic field. Transverse spin-echo proton density and inversion recovery images were acquired. T1 relaxation time was calculated based on ratios of signal intensity determined from the different pulse sequences. T1 relaxation tim...
Dyson S, Murray R, Pinilla MJ.It has been suggested that ultrasonography is unreliable for the detection of hindlimb proximal suspensory desmopathy (PSD) based on comparisons between ultrasonographic and magnetic resonance images. Objective: To compare ultrasonography with gross and histopathological post mortem examination in horses with PSD diagnosed based on ultrasonography and control horses. Methods: Retrospective descriptive study. Methods: Part 1: 19 horses with hindlimb PSD and 10 control horses were humanely destroyed. Twenty control limbs and 37 lame limbs were examined grossly and 40 suspensory ligaments (SLs) w...
