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.
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...
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 ...
Shikh Alsook MK, Antoine N, Piret J, Moula N, Busoni V, Denoix JM, Gabriel A.The third interosseous muscle (suspensory ligament, TIOM) is composed of connective tissue (CT) with a variable proportion of muscle (MT) and adipose tissue (AT). The aim of our study is to quantify the CT, MT and AT within the body and the branches of right thoracic and pelvic limbs TIOM in sound horses to determine whether there are differences in CT, MT and AT between age, sex, limbs and levels. Right limbs from 11 sound horses were collected. Samples from 6 levels of the TIOM were embedded in paraffin or in Tissue-Tek(®) . Most of the paraffin sections were shredded. Using the cryosection...
Hall MS, Vasey JR, Russell JW, Russell T.To evaluate the racing performance of horses that underwent ultrasound-guided intralesional injection of autologous bone marrow aspirate for treatment of selected forelimb suspensory ligament (body or branch) core lesions. Methods: Retrospective cohort study of 13 Standardbred and 17 Thoroughbred race horses. Methods: Autologous bone marrow aspirated from the sternebrae was injected, under ultrasound guidance, into suspensory ligament core lesions (body or branch). Racing records were reviewed for a comparison of performance before and after surgery. Results: Of the 13 Standardbreds, 9 (69%) h...
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.
Gaschen L, Burba DJ.Adaptive and nonadaptive stress remodeling in Thoroughbred racehorses leads to most of their musculoskeletal injuries, and imaging plays an important role in its detection. Bone scintigraphy is important for detecting stress remodeling and stress fractures and aids in decision making when more than one lesion is present on MRI or radiographic examinations. MRI likely represents the best modality for the assessment of osteoarthritis of the metacarpophalangeal and metatarsophalangeal joints. Ultrasonography remains important as the first modality for the assessment of tendon and ligamentous inju...
Walker VA, Walters JM, Griffith L, Murray RC.A recent epidemiological study indicated that various factors may be related to injury in dressage horses, but the mechanism by which these injuries occur has yet to be determined. The suspensory ligament (SL) is a frequent site of injury, and it is assumed that greatest strain is placed on this structure in collected trot; this has yet to be proved conclusively. The study aimed to investigate the effect of collected and extended trot on the hindlimb movement pattern. Four dressage horses were fitted with markers and inertial motion sensors (IMS). High-speed video was obtained for 2 strides on...
Zauscher JM, Estrada R, Edinger J, Lischer CJ.To evaluate intra- and interobserver variability in ultrasonographic measurements of the proximal aspect of the suspensory ligament (PSL) in the horse. Objective: A minimum difference of ≥20% is required to differentiate reliably between physiological and pathological alterations related to dimensions. Methods: Two operators examined the PSL in all 4 limbs of 14 horses twice using different techniques and different probes with and without standoff pads. Measurements were taken from the longitudinal and transverse images. Inter- and intraoperator variability was evaluated using agreement indi...
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...
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...
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...
Schramme M, Josson A, Linder K.The suspensory ligament is difficult to image accurately, partly because it contains ligamentous fibers, as well as noncollagenous adipose and muscle tissue in the normal horse. Our hypothesis was that magnetic resonance (MR) imaging would be more accurate than ultrasonography in identifying the size of the suspensory ligament and the presence and size of noncollagenous tissues within the ligament. Eleven horses were used for ultrasonographic and MR imaging and histologic evaluation of the rear suspensory ligament. The origin and body of the normal suspensory ligament had a heterogenous appear...
Seabaugh KA, Selberg KT, Valdés-Martínez A, Rao S, Baxter GM.To investigate tissue diffusion of anesthetic agent following administration of low palmar nerve blocks (LPBs) in horses. Methods: Randomized clinical trial. Methods: 12 adult horses. Methods: In 9 horses, mepivacaine hydrochloride-iohexol (50:50 dilution) injections were administered bilaterally (2 or 4 mL/site) to affect the medial and lateral palmar and palmar metacarpal nerves (4 sites). Lateral radiographic views of both metacarpal regions were obtained before and at 5, 15, 30, 60, 90, and 120 minutes after block administration; proximal and distal extents of contrast medium (and presumab...
Castelijns G, Crawford A, Schaffer J, Ortolano GA, Beauregard T, Smith RK.Platelet preparations have become a treatment for soft tissue injuries in horses. This study evaluated a novel filter-based system to concentrate platelets and assesses its value in the treatment of suspensory ligament branch desmitis. Methods: Filtered platelet concentrate was prepared from 55 ml of venous blood obtained from 21 normal horses. Platelets and white blood cells in whole blood and filtered platelet concentrate were measured, as was platelet activating factor (PAF)-induced platelet-derived growth factor-BB (PDGF-BB) release. Eleven horses with 18 focal acute suspensory ligament br...
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 ...
Dyson S, Murray R.Neurectomy of the deep branch of the lateral plantar nerve and plantar fasciotomy have become accepted as methods of treatment of proximal suspensory desmopathy (PSD), but there are limited long-term studies documenting the outcome. Objective: To describe long-term follow-up in horses with PSD alone or with other injuries contributing to lameness and poor performance, including complications, following neurectomy and fasciotomy. Methods: Follow-up information was acquired for 155 horses that had undergone neurectomy and fasciotomy for treatment of PSD between 2003 and 2008. Success was classif...
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...
Noble P, Lejeune JP, Caudron I, Lejeune P, Collin B, Denoix JM, Serteyn D.Whereas the effect of heel configuration on the tension of the suspensory apparatus is well documented in the literature, there are few reports of joint contact force components in the equine distal forelimb. Objective: To improve understanding of the effect of heel configuration on equine digit joint loading, a sensitivity analysis was performed to compare the effect of a raised heel on joint contact force components in the coffin and fetlock joints during the stance phase of the trot. Methods: Four Warmblood horses were used. An inverse dynamic analysis was carried out using kinematic and ki...
Torricelli P, Fini M, Filardo G, Tschon M, Pischedda M, Pacorini A, Kon E, Giardino R.Tissue repair in musculoskeletal injuries is often a slow and sometimes incomplete process. Regenerative medicine based on the use of growth factors (GFs) and cell therapy is aimed at improving the quality and speed of tendon and ligament healing. The aim of this study was to evaluate the potential for the administration of a combination of autologous platelet-rich plasma (PRP) and freshly isolated bone marrow mononucleated cells (BMMNCs) in 13 competition horses affected by overuse musculoskeletal injuries (suspensory ligament desmopathy and superficial flexor tendinopathy) and refractory to ...
Dyson SJ, Weekes JS, Murray RC.The aim of the study was to characterize radiopharmaceutical uptake patterns in horses with clinical and ultrasonographic evidence of proximal suspensory desmitis. It was hypothesized that radiopharmaceutical uptake in the proximal palmar (plantar) aspect of the third metacarpal (metatarsal) bone would be greater in lame limbs of horses with proximal suspensory desmitis than in sound limbs and that there would be a positive correlation between the severity of ultrasonographic abnormalities and the degree of radiopharmaceutical uptake. Nuclear scintigraphic evaluation of the proximal metacarpal...
Woodie JB, Ruggles AJ, Bertone AL, Hardy J, Schneider RK.To determine whether fracture fragment dimensions, suspensory ligament damage, and racing status at the time of injury were associated with outcome in Standardbred horses with apical fracture of the proximal sesamoid bone. Methods: Retrospective study. Methods: 43 Standardbred racehorses. Methods: Medical records, racing records, and radiographs were reviewed, and ultrasonographic findings were scored. Measurements of the fractured portion of the proximal sesamoid bone were made. Results: Seventy-four percent (32/43) of horses were pacers, and 26% (11/43) were trotters. Statistical differences...
Shikh Alsook MK, Antoine N, Piret J, Moula N, Busoni V, Denoix JM, Gabriel A.The third interosseous muscle (suspensory ligament, TIOM) is composed of connective tissue (CT) with a variable proportion of muscle (MT) and adipose tissue (AT). The aim of our study is to quantify the CT, MT and AT within the body and the branches of right thoracic and pelvic limbs TIOM in sound horses to determine whether there are differences in CT, MT and AT between age, sex, limbs and levels. Right limbs from 11 sound horses were collected. Samples from 6 levels of the TIOM were embedded in paraffin or in Tissue-Tek(®) . Most of the paraffin sections were shredded. Using the cryosection...
Boehart S, Arndt G, Rindermann G, Gmachl M, Carstanjen B.To obtain morphometric values for the superficial digital flexor tendon, deep digital flexor tendon, accessory ligament of the deep digital flexor muscle, and suspensory ligament in the palmar metacarpal region of Icelandic Horses. Methods: 50 nonlame Icelandic Horses in training. Methods: Horses included 2 stallions, 30 geldings, and 18 mares from 4 to 20 years of age with a body mass index from 149.1 to 250.11 kg/m2. Transverse ultrasonographic images were obtained with an 8- to 10-MHz linear transducer and a standoff pad. In both forelimbs, the cross-sectional area, circumference, dorsopalm...
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...
Wright IM, Phillips TJ, Walmsley JP.A technique for evaluation of the navicular bursa using a 4 mm 25 degrees inclined view arthroscope is described. This allows examination of the palmar/plantar surface of the navicular bone, the insertions of the navicular suspensory, T and impar ligaments, the bursal synovium and the dorsal surface of the deep digital flexor tendon. The technique was used in 16 horses with punctures of the navicular bursa. Procedures facilitated by the technique were bursal lavage, removal of pannus, synovial resection and debridement of lesions on the palmar/plantar surface of the bone and in the deep digita...
Bukowiecki CF, Bramlage LR, Gabel AA.Forty-eight limbs of 12 freshly euthanized horses were used to generate data on the strength of the equine suspensory apparatus. The point of failure of the suspensory apparatus of each limb was determined. Immediately before euthanasia, 6 of the 12 horses (thoroughbreds and standardbreds) had been engaged in active training or racing, and six horses in stall and/or pasture activity. In the actively training or racing horses, the point of acute failure of the suspensory apparatus was within the proximal sesamoid bones in 20 (83%) limbs (resulting in 17 apical fractures, 2 basilar fractures, an...
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...
Jordana M, Wilderjans H, Boswell J, Dewulf J, Smith RK, Martens A.To report outcome after the surgical treatment of lacerations of the superficial digital flexor tendon (SDFT), deep digital flexor tendon (DDFT), suspensory ligament (SL), and/or distal sesamoidean ligaments (DSL) in horses. Methods: Case series. Methods: Horses (n=106) with lacerations of the SDFT, DDFT, SL, and/or DSL. Methods: Medical records (1988-2002) were reviewed for signalment, limb and tendon/ligament involvement (location and extent of injury, tendon sheath involvement), method of repair, and outcome. Results: The median age of horses was 7 years and the follow-up time ranged from 1...
Wood AK, Sehgal CM, Polansky M.Sonographic observations were made of the image mean gray scale (MGS) of the flexor tendons and ligaments in the left and right metacarpal regions of each of 10 clinically normal horses. In images made in the dorsal and sagittal planes, the MGS was measured at multiple sites in the superficial digital flexor tendon (SDFT), deep digital flexor tendon (DDFT), accessory ligament (AL), and suspensory ligament (SL), and at single sites in the medial and lateral limbs of the SL, and the palmar ligament. Relative sonographic brightness of each tendon and ligament was calculated by dividing the value ...
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...
Schramme M, Josson A, Linder K.The suspensory ligament is difficult to image accurately, partly because it contains ligamentous fibers, as well as noncollagenous adipose and muscle tissue in the normal horse. Our hypothesis was that magnetic resonance (MR) imaging would be more accurate than ultrasonography in identifying the size of the suspensory ligament and the presence and size of noncollagenous tissues within the ligament. Eleven horses were used for ultrasonographic and MR imaging and histologic evaluation of the rear suspensory ligament. The origin and body of the normal suspensory ligament had a heterogenous appear...
Jansen MO, van Buiten A, van den Bogert AJ, Schamhardt HC.The in vivo strains of the musculus interosseus medius (suspensory ligament) and its rami extensorii (extensor branches) in the forelimb of the horse were determined from angular changes of the metacarpophalangeal and the distal interphalangeal joints. For this purpose, regression models were fitted to strains and joint angle combinations measured in in vitro limb loading experiments. The in vivo strains were computed from the kinematics of 8 horses at the walk, the trot and the canter. It was found that the extensor branches were strained about 1.0% at hoof impact, which indicates that they p...
Hansen SH, Bramlage LR, Moore GE.Suspensory ligament branch desmitis (SLBD) is a common injury in Thoroughbred racehorses. Orthobiologic treatment of these injuries is a relatively new approach, and there is limited information available on post injury racing performance in racehorses treated with mesenchymal stem cells (MSCs). To assess racing performance post injury in Thoroughbred racehorses with SLBD treated with MSCs.
Roberts JH, Zhang J, David F, McLean A, Blumenshine K, Müller-Alander E, Halper J.Degenerative Suspensory Ligament Desmitis (DSLD) negatively impacts connective tissues in horses, which often leads to progressive chronic pain and lameness. DSLD has been shown to be a systemic disorder that affects multiple body systems, including tendons, sclerae, and the aorta. Currently, the diagnosis is confirmed by post mortem histological examination of a tendon or suspensory ligament. Histology reveals inappropriate accumulations of proteoglycans in the tendons and other tissues in DSLD-affected horses. Unfortunately, there is no reliable method to diagnose DSLD in living horses. Rece...
Gaschen L, Burba DJ.Adaptive and nonadaptive stress remodeling in Thoroughbred racehorses leads to most of their musculoskeletal injuries, and imaging plays an important role in its detection. Bone scintigraphy is important for detecting stress remodeling and stress fractures and aids in decision making when more than one lesion is present on MRI or radiographic examinations. MRI likely represents the best modality for the assessment of osteoarthritis of the metacarpophalangeal and metatarsophalangeal joints. Ultrasonography remains important as the first modality for the assessment of tendon and ligamentous inju...
Barrett E, Arkins S.Few studies are available concerning prevalences of abnormalities in the Thoroughbred horse population. Objective: Determine the prevalence of commonly observed abnormalities in a National Hunt Thoroughbred population using results of pre-purchase examinations conducted at Thoroughbred sales venues. Methods: Retrospective cross-sectional study. Methods: Veterinary pre-purchase examination certificates for 13,603 3- and 4-year-old Thoroughbred National Hunt horses from Tattersalls Ireland, Goffs Ireland and Doncaster Bloodstock Sales Ltd. (DBS) Sales were analysed. All conditions noted by the v...
Tnibar MA.To describe a surgical technique for splitting the proximal third of the medial patellar ligament (MPL) in horses and ponies with upward fixation of the patella (UFP), and to report outcome. Methods: Prospective clinical study. Methods: Four horses and 3 Shetland ponies. Methods: With ultrasound guidance, the proximal third of the MPL was split by percutaneous use of a no. 15 scalpel blade. The rationale for this surgical procedure was to induce a localized desmitis with subsequent ligament thickening. No anti-inflammatory drugs were administered, and horses and ponies were exercised the day a...
Muylle S, Desmet P, Simoens P, Lauwers H, Vlaminck L.The innervation pattern of the interosseus muscle of the forelimb was studied in two ponies and two horses. The nerves of the suspensory ligament were studied histologically after neurectomy of the ulnar and median nerve branches proximal to the carpal joint. The results demonstrated that the interosseus muscle is innervated by the deep branch of the lateral palmar nerve which emerges at the level of the midcarpal region and contains fibres from the ulnar and the median nerve. These findings provide evidence that an ulnar nerve block proximal to the accessory bone would fail to anaesthetise th...
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...
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...
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...
Hughes TK, Eliashar E, Smith RK.To examine the anatomic relationship of the deep branch of the lateral plantar nerve (DBLPN) with structures of the proximal metatarsal region, and to define the anatomic location of a solution injected using a single injection technique for diagnostic analgesia of the proximal suspensory ligament (PSL). Methods: Descriptive study. Methods: Cadaveric equine pelvic limbs (n=29). Methods: The proximal metatarsal region of both pelvic limbs (n=5 horses, 10 limbs) was dissected and measurements were made of anatomic structures relative to the head of the 4th metatarsal bone (HMT4). A single inject...
Lawson SE, Chateau H, Pourcelot P, Denoix JM, Crevier-Denoix N.As equine musculoskeletal models become common, it is important to determine their sensitivity to the simplifications used. A subject-specific distal forelimb model was created using bones extracted from CT scans to examine movement from in-vivo invasive-marker motion capture. The movements of the sesamoid bones were simulated using the constraints of maintaining an isometric virtual ligament and maintaining contact between the appropriate articular surfaces, creating a variable moment arm for the tendons. The simulation of the proximal sesamoid bones was compared to movement recorded in-vitro...
Schnabel LV, Bramlage LR, Mohammed HO, Embertson RM, Ruggles AJ, Hopper SA.Studies have shown that surgical removal of apical fracture fragments in Standardbred racehorses carries the best prognosis for return to racing performance, but there are no reports involving mature Thoroughbred (TB) racehorses. Objective: To describe the incidence of apical proximal sesamoid fractures in TB racehorses and determine probability and quality of racing performance after arthroscopic removal of such fractures in TB racehorses age > or = 2 years. Methods: Medical records and pre- and post operative race records of TB racehorses age > or = 2 years that underwent arthroscopic surger...
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...
Seghrouchni M, Elkasraoui H, Piro M, Alyakine H, Bouayad H, Chakir J, Tligui N, Elallali K, Azrib R.Tbourida is a traditional Moroccan equestrian sport in which 15 horses gallop 200 m in a line while riders fire into the sky with muskets. The stop is the finale and representative demands of this equestrian event. Such particular sudden stop after a fast gallop requires a hyperextension of the metacarpophalangeal joint. Indeed, it is well known that Tbourida show predisposes horses to different injuries of the hard and soft tissues of the distal forelimbs. Yet, there is a paucity of research that examined such lesions. The aim of the present study was to investigate for the first time the typ...
Kicker CJ, Peham C, Girtler D, Licka T.Support boots are thought to reduce tension on the superficial digital flexor tendon (SDTF) of the horse and are frequently recommended for horses convalescing after tendonitis, but evidence of their effectiveness is conflicting. Objective: To document the effects of 4 different types of support boots on fetlock joint angle in comparison to the unprotected fetlock. Methods: In 26 horses, the kinematics of the forelimb fetlock joint angle was measured at walk and trot on a treadmill when wearing 3 different types of support boots and 1 protective boot, as well as without boots. As outcome param...
Hall MS, Vasey JR, Russell JW, Russell T.To evaluate the racing performance of horses that underwent ultrasound-guided intralesional injection of autologous bone marrow aspirate for treatment of selected forelimb suspensory ligament (body or branch) core lesions. Methods: Retrospective cohort study of 13 Standardbred and 17 Thoroughbred race horses. Methods: Autologous bone marrow aspirated from the sternebrae was injected, under ultrasound guidance, into suspensory ligament core lesions (body or branch). Racing records were reviewed for a comparison of performance before and after surgery. Results: Of the 13 Standardbreds, 9 (69%) h...
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...
