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.
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 ...
Caldwell FJ, Waguespack RW.To develop a tenoscopic approach for desmotomy of the accessory ligament of the deep digital flexor tendon (AL-DDFT) in horses. Methods: Experimental. Methods: Cadaveric forelimbs (n=10) and 4 forelimbs from 2 horses anesthetized for terminal teaching procedures, and 12 forelimbs of 6 experimental horses. Methods: Saline distention of the carpal flexor sheath facilitated insertion of an arthroscope into the distal medial aspect of the sheath between the AL-DDFT and deep digital flexor tendon (DDFT). Location of an instrument portal on the lateral aspect of the metacarpus was identified with a ...
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...
Plaas A, Sandy JD, Liu H, Diaz MA, Schenkman D, Magnus RP, Bolam-Bretl C, Kopesky PW, Wang VM, Galante JO.We describe analysis of suspensory ligaments from horses with advanced degenerative suspensory ligament desmitis (DSLD) to identify the major proteoglycans (PGs), ADAMTS-aggrecanases and inter-alpha-trypsin inhibitor (IαI) components associated with ligament degeneration. Specific anatomical regions of suspensory ligaments from two normal horses and four diagnosed with DSLD were analyzed by Western blot and immunohistochemistry for the following: aggrecan, aggrecan fragments, decorin, ADAMTS4, ADAMTS5, and IαI components. When compared to normal, DSLD ligaments showed about a 15-fold increas...
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...
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...
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...
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...
Morrison S.Laminitis is a disease of the suspensory apparatus of the distal phalanx, which can advance to the chronic stage with varying degrees of structural failure. Because the disease may ultimately lead to mechanical failure of the digit, a foot management plan is required to effectively and mechanically treat these cases. Many laminitis cases can be successfully rehabilitated back to athletic soundness, light use, breeding, or pasture soundness, whereas others suffer from permanent instability and never enjoy an acceptable level of comfort. To understand how to minimize damage in the acute laminiti...
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...
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...
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.
Labens R, Schramme MC, Robertson ID, Thrall DE, Redding WR.Sonography is commonly used for diagnosis of desmopathy of the proximal part of the suspensory ligament in horses. However, magnetic resonance (MR) imaging has been stated to be superior for detecting disease and localizing lesions. In this retrospective study of 39 horses or 46 hind limbs with lameness due to proximal plantar metatarsal pain, the clinical and diagnostic findings are discussed and sonography and MR imaging compared for examination of the proximal part of the suspensory ligament. With MR imaging interpreted as the clinical gold standard, desmopathy of the proximal part of the s...
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...
Pauwels FE, Schumacher J, Mayhew IG, Van Sickle DC.Neurectomy of the deep branch of the right lateral plantar nerve was performed on a single healthy mature horse. Six weeks after surgery, the horse was subjected to euthanasia and both hind suspensory ligaments harvested. The cross sectional area of the muscular part of the proximal part of the suspensory ligament was measured and assessed for morphological abnormalities in a blinded fashion. There was a clear difference in cross sectional area of the muscular part between treated and control ligament and there was profound neurogenic atrophy of the muscular fibres in the treated ligament.
Bosch G, de Mos M, van Binsbergen R, van Schie HT, van de Lest CH, van Weeren PR.Extracorporeal shock wave therapy (ESWT) is frequently used in equine practice, but little is known about its biological action. Objective: To study the effects of ESWT on matrix structure and gene expression levels in normal, physiologically loaded tendinous structures in ponies. Methods: Six Shetland ponies, free of lameness and with ultrasonographically normal flexor and extensor tendons and suspensory ligaments (SL), were used. ESWT was applied at the origin of the suspensory ligament and the mid-metacarpal region of the superficial digital flexor tendon (SDFT) 6 weeks prior to sample taki...
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,...
Birch HL, Wilson AM, Goodship AE.This study explores the hypothesis that high-intensity exercise induces degenerative changes in the injury-prone equine superficial digital flexor tendon (SDFT), but not in the rarely injured common digital extensor tendon (CDET). The horse represents a large-animal model that is applicable to human tendon and ligament physiology and pathology. Twelve age-matched female horses undertook galloping exercise three times a week with trotting exercise on alternative days (high-intensity group, n = 6) or only walking exercise (low-intensity group, n = 6) for 18 mo. The SDFT, suspensory ligament, dee...
Tóth F, Schumacher J, Schramme M, Holder T, Adair HS, Donnell RL.To describe pathologic changes in the deep branch of the lateral plantar nerve (DBLPN) of horses determined to be lame because of proximal suspensory desmitis (PSD), and to report the outcome after treatment by excision of a segment of the horses' DBLPN. Methods: Retrospective case series. Methods: Adult horses (n=16). Methods: Horses determined to be lame on one or both pelvic limbs because of PSD were treated by excision of a segment of the DBLPN, and 30 nerves were examined histologically. Owners were contacted to obtain information about the horses >or=6 months after surgery. Results: H...
Waselau M, Sutter WW, Genovese RL, Bertone AL.To determine outcome of Standardbred racehorses with moderate to severe midbody suspensory ligament desmitis (MSD) treated by means of ultrasound-guided intralesional injection of a single dose of platelet-rich plasma (PRP) followed by a program of gradually increased exercise. Methods: Nonrandomized clinical trial. Methods: 9 Standardbred racehorses. Methods: Following injection of PRP, horses were allowed a controlled, gradual return to exercise. Race records for the year prior to injury and for 3 consecutive years after horses returned to racing were reviewed. For comparison purposes, race ...
Carpenter RS, Galuppo LD, Simpson EL, Dowd JP.To report use of a locking compression plate (LCP) for fetlock arthrodesis in Thoroughbred racehorses after catastrophic disruption of the suspensory apparatus. Methods: Retrospective case study. Methods: Racing Thoroughbreds (n=6) with a catastrophic breakdown injury of the suspensory apparatus. Methods: Medical records (2004-2006) of horses that had fetlock arthrodesis using an LCP were reviewed. Preoperative recorded variables were: age, gender, affected limb, injury type and occurrence, limb support used and time to surgery. Recorded surgical variables were: implants used and cost, surgery...
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...
Imboden I, Waldern NM, Wiestner T, Lischer CJ, Ueltschi G, Weishaupt MA.Extracorporeal shock wave therapy (ESWT) is an accepted form of treatment for chronic cases of proximal suspensory desmitis (PSD). Subjective evaluation of horses shortly after being treated with ESWT has led clinicians to comment on an immediate reduction in lameness. This study aimed to evaluate the analgesic effect of ESWT on 16 horses with PSD or PSD-like pain in a fore- or hindlimb. To objectively assess lameness, gait analysis was performed on an instrumented treadmill before and 6, 24, 48 and 72h after ESWT of the origin of the suspensory ligament and the results compared to the effects...
Argüelles D, Carmona JU, Climent F, Muñoz E, Prades M.Two horses with acute tendinopathy of a superficial digital flexor tendon (SDFT) and three horses with chronic proximal desmitis of the suspensory ligament (PDSL) were treated by injecting autologous concentrates of their platelets into the lesions. The lesions were monitored ultrasonographically and clinically. There were significant ultrasonographic and clinical improvements in the two horses with SDFT, but no ultrasonographic improvements in the horses with PDSL; however, they improved clinically and became less lame. All the horses had returned to their pre-injury level of performance by s...
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...
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...
Brokken MT, Schneider RK, Sampson SN, Tucker RL, Gavin PR, Ho CP.Magnetic resonance (MR) imaging abnormalities in horses with lameness localized to the proximal metacarpal or metatarsal region have not been described. To accomplish that, the medical records of 45 horses evaluated with MR imaging that had lameness localized to either the proximal metacarpal or metatarsal region were reviewed. Abnormalities observed in the proximal suspensory ligament or the accessory ligament of the deep digital flexor tendon included abnormal high signal, enlargement, or alteration in shape. Twenty-three horses had proximal suspensory ligament desmitis (13 hindlimb, 10 fore...
Bosch G, Lin YL, van Schie HT, van De Lest CH, Barneveld A, van Weeren PR.Extracorporeal shockwave therapy (ESWT) has recently been introduced as a new therapy for tendon injuries in horses, but little is known about the basic mechanism of action of this therapy. Objective: To study the effect of ESWT on biochemical parameters and tenocyte metabolism of normal tendinous structures in ponies. Methods: Six Shetland ponies, free of lameness and with ultrasonographically normal flexor and extensor tendons and suspensory ligaments (SL), were used. ESWT was applied at the origin of the suspensory ligament and the mid-metacarpal region of the superficial digital flexor ten...
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 ...
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 ...
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...
Pauwels FE, Schumacher J, Mayhew IG, Van Sickle DC.Neurectomy of the deep branch of the right lateral plantar nerve was performed on a single healthy mature horse. Six weeks after surgery, the horse was subjected to euthanasia and both hind suspensory ligaments harvested. The cross sectional area of the muscular part of the proximal part of the suspensory ligament was measured and assessed for morphological abnormalities in a blinded fashion. There was a clear difference in cross sectional area of the muscular part between treated and control ligament and there was profound neurogenic atrophy of the muscular fibres in the treated ligament.
Hewes CA, White NA.To determine outcome of percutaneous ultrasound-guided desmoplasty with simultaneous fasciotomy for proximal suspensory desmitis (ie, desmitis of the origin of the suspensory ligament) in horses that have not responded to stall rest. Methods: Retrospective case series. Methods: 27 horses. Methods: Medical records of horses with proximal suspensory desmitis treated by means of desmoplasty with fasciotomy were reviewed. Follow-up information was obtained through telephone conversations with owners and trainers of the horses or by examination of horses at the hospital. Results: 23 of the 27 (85%)...
Le Jeune SS, Macdonald MH, Stover SM, Taylor KT, Gerdes M.Objective-To determine whether partial transection of the medial branch of the suspensory ligament (MBSL) alters equine third metacarpal bone (MC3) condylar surface strains and forelimb, distal joint angles in a manner consistent with promotion of lateral condylar fracture. Study Design-In vitro biomechanical experiment. Sample Population-Right forelimbs from 7 Thoroughbred horse cadavers. Methods-Lateral and medial MC3 condylar, dorsal and abaxial, bone surface strains and distal joint angles were measured both before and after partial transection of the MBSL during in vitro axial limb compre...
Bowker RM, Linder K, Van Wulfen KK, Sonea IM.The anatomy of the distal interphalangeal (DIP) joint in the adult horse is described in relationship to the suspensory ligaments of the navicular bone, the neurovascular bundle and the sensory nerves to these periarticular regions. Using polymer plastic injections, the synovial cavity of the DIP joint was observed to have a complex relationship to the proximal suspensory or collateral sesamoidean ligament (CSL) of the navicular bone with the cavity forming cranial and caudal compartments around the CSL abaxially. Sensory nerves, as identified by peptide immunocytochemistry and silver/gold chl...
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...
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 ...
Kadic DTN, Minshall GJ, Wright IM.Suspensory ligament branch injuries are common in horses. Most of these injuries are grouped together and considered as a single pathologic entity. Objective: To report a specific injury of the abaxial margin of the suspensory ligament branches and to report its surgical management and outcome. Methods: Retrospective case series. Methods: All horses with suspensory ligament branch injuries over a 9-year period (2007-2015) were identified. Horses with injuries which, on ultrasonographic examination, appeared to have defects in the abaxial margin of the suspensory ligament branch, that were subs...
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...
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...
