Topic:Suspensory Ligament
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.
Scintigraphic evaluation of the proximal metacarpal and metatarsal regions of horses with proximal suspensory desmitis. 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...
Injuries in the event horse: training versus competition. Two related studies on injuries sustained by event horses during competition and during training are reported. During the cross-country phase of competition, the most common injuries were lacerations and abrasions to the carpus and stifle. Superficial digital flexor tendonitis and exertional rhabdomyolysis were significantly more common during Cours Complete Internationale (CCI) competitions compared to one-day event (ODE) competitions. The difference in injury types at ODEs and CCI competitions probably relates to the increased athletic demands of the CCI and the closer veterinary observation...
Magnetic resonance imaging, ultrasonography and histology of the suspensory ligament origin: a comparative study of normal anatomy of warmblood horses. The diagnosis of lameness caused by proximal metacarpal and metatarsal pain can be challenging. Magnetic resonance imaging (MRI) offers the possibility for further diagnosis but there have been no studies on the normal MRI appearance of the origin of the suspensory ligament (OSL) in conjunction with ultrasonography and histology. Objective: To describe the MRI appearance of the OSL in fore- and hindlimbs of sound horses and compare it to the ultrasonographic and histological appearance. The findings can be used as reference values to recognise pathology in the OSL. Methods: The OSL in the fore...
Treatment of chronic proximal suspensory desmitis in horses using focused electrohydraulic shockwave therapy. The objective of the present clinical report was to investigate the short- and long-term outcomes of chronic proximal suspensory desmitis (PSD) treated with Extracorporeal Shockwave Treatment (ESWT). Fifty-two horses with chronic PSD in the forelimb (34 cases) or hindlimb (22 cases) were included in the study. Three horses had lesions in both hindlimbs and one in both forelimbs. The origin of the suspensory ligament was treated every three weeks for a total of three treatments using 2000 impulses applied by a focused ESWT device (Equitron) at an energy flux density of 0.15 mJ/ mm2. This treatm...
Racing performance after arthroscopic removal of apical sesamoid fracture fragments in Thoroughbred horses age > or = 2 years: 84 cases (1989-2002). 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...
Outcome of desmoplasty and fasciotomy for desmitis involving the origin of the suspensory ligament in horses: 27 cases (1995-2004). 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%)...
Degenerative suspensory ligament desmitis as a systemic disorder characterized by proteoglycan accumulation. Degenerative suspensory ligament desmitis (DSLD) is a debilitating disorder thought to be limited to suspensory ligaments of Peruvian Pasos, Peruvian Paso crosses, Arabians, American Saddlebreds, American Quarter Horses, Thoroughbreds, and some European breeds. It frequently leads to persistent, incurable lameness and need to euthanize affected horses. The pathogenesis remains unclear, though the disease appears to run in families. Treatment and prevention are empirical and supportive, and not effective in halting the progression of the disease. Presently, the presumptive diagnosis of DSLD is ...
Anabolic effects of acellular bone marrow, platelet rich plasma, and serum on equine suspensory ligament fibroblasts in vitro. The purpose of this study was to investigate the response of suspensory ligament fibroblasts (SLF) to in vitro stimulation using acellular bone marrow (ABM), platelet rich plasma (in vitro PRP), and serum as potential treatment modalities for suspensory desmitis. Blood, bone marrow, and suspensory ligaments were collected from five horses. SLF were harvested, grown until confluent, and stimulated with various concentrations of ABM, PRP, equine serum, foetal bovine serum, and medium (control). The responses to the treatments were assessed using a combination of radio-labeling for total protein ...
Histomorphologic evaluation of extracorporeal shock wave therapy of the fourth metatarsal bone and the origin of the suspensory ligament in horses without lameness. To determine via histologic examination and scintigraphy the effect of focused extracorporeal shock wave therapy (ESWT) on normal bone and the bone-ligament interface in horses. Methods: 6 horses without lameness. Methods: Origins of the suspensory ligament at the metacarpus (35-mm probe depth) and fourth metatarsal bone (5-mm probe depth) were treated twice (days 0 and 16) with 2,000 shocks (energy flux density, 0.15 mJ/mm2). One forelimb and 1 hind limb were randomly treated, and the contralateral limbs served as nontreated controls. Bone scans were performed on days -1 (before ESWT), 3, 16,...
[Disorders of the origin of the suspensory ligament in the horse: a diagnostic challenge]. Lameness in horses due to pain originating from the proximal metacarpal/metatarsal region remains a diagnostic challenge. In cases of obvious lameness the pain can be localised to this region by diagnostic anaesthesia. Because a variety of disorders can cause lameness in this region different imaging modalities including radiography, ultrasonography and scintigraphy should be used to arrive at an accurate diagnosis. Even though a precise anatomic-pathologic diagnosis can still be an enigma, because not only bone and joints, but also soft tissue structures including the proximal suspensory liga...
Arthroscopic diagnosis and treatment of intra-articular insertional injuries of the suspensory ligament branches in 18 horses. Clinical association between the branches of insertion of the suspensory ligament (SL) and metacarpophalangeal (MCP) and metatarsophalangeal (MTP) joints has been reported. However, there has been no assessment of the lengths of the SL branches which are subsynovial with respect to the joints or reports of involvement of the MCP/MTP joints in injuries of the SL branches. Objective: To establish proportions of SL branches subsynovial with respect to the MCP/MTP joints and report clinical and arthroscopic findings in horses with desmitis of SL branches identified as having an articular component...
Assessment of scintigraphic and thermographic changes after focused extracorporeal shock wave therapy on the origin of the suspensory ligament and the fourth metatarsal bone in horses without lameness. To monitor the effect of focused extra-corporeal shock wave therapy (ESWT) on bone and bone-tendon junction of horses without lameness by use of nuclear scintigraphy and thermography. Methods: 6 warmblood horses without lameness. Methods: The origin of the suspensory ligament at the metacarpus (OSL-MC) and the fourth metatarsal bone were treated at 2 time points (days 0 and 16) with 2,000 shocks applied by a focused ESWT device at an energy flux density of 0.15 mJ/mm2. One forelimb and 1 hind limb were treated, and the contralateral limbs served as controls. To document the effect of focused E...
Risk factors for injury to the superficial digital flexor tendon and suspensory apparatus in Thoroughbred racehorses in New Zealand. To investigate risk factors for injury to the superficial digital flexor tendon (SDFT) and suspensory apparatus (SA) of the forelimbs in Thoroughbred racehorses in New Zealand. Methods: Poisson and negative binomial regression, with exposure time represented by cumulative training days for each horse, were used to relate explanatory variables to the incidence rate (IR) of cases of inflammation of the SDFT (n=51), and injuries involving the SA (n=48) in a population of 1,571 commercially- trained racehorses over 554,745 study days. Only the first occurrence of an injury for any one horse was el...
Ultrastructural and immunocytochemical evaluation of the effects of extracorporeal shock wave treatment in the hind limbs of horses with experimentally induced suspensory ligament desmitis. 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 ...
Musculoskeletal responses of 2-year-old Thoroughbred horses to early training. 4. Morphometric, microscopic and biomechanical properties of the digital tendons of the forelimb. 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 ...
Influence of support boots on fetlock joint angle of the forelimb of the horse at walk and trot. 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...
Effects of injury to the suspensory apparatus, exercise, and horseshoe characteristics on the risk of lateral condylar fracture and suspensory apparatus failure in forelimbs of thoroughbred racehorses. To assess concurrently the effects of moderate ligamentous suspensory apparatus injury (MLSAI), racing-speed exercise, and horseshoe characteristics on risk of catastrophic suspensory apparatus failure (SAF) or metacarpal condylar fracture (CDY) in forelimbs of racehorses. Methods: Cadavers of 301 Thoroughbred racehorses (108 with SAF, 33 with CDY and 160 control horses). Methods: A cross-sectional epidemiologic study was used to describe distributions and relationships between MLSAI, exercise, and horseshoe variables. Logistic regression was used to assess potential risk factors for developin...
Use of magnetic resonance imaging identify suspensory desmitis and adhesions between exostoses of the second metacarpal bone and the suspensory ligament in four horses. 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...
Treatment of chronic or recurrent proximal suspensory desmitis using radial pressure wave therapy in the horse. Proximal suspensory desmitis (PSD) is diagnosed with increasing frequency in horses and radial pressure wave therapy (RPWT) is a widely used therapy for painful orthopaedic conditions in man and dogs. There are, however, few published data as to the outcome of its use in PSD. Objective: To evaluate the use of RPWT in the treatment of chronic or recurrent PSD in the horse, an injury which carries a poor prognosis for return to athletic function with conservative management alone. Objective: RPWT and controlled exercise improves the prognosis of chronic or recurrent PSD in the horse when compare...
Prevalence of superficial digital flexor tendonitis and suspensory desmitis in Japanese Thoroughbred flat racehorses in 1999. Overstrain injuries to the superficial digital flexor tendon (SDFT) and suspensory ligament (SI) are among the most common musculoskeletal injuries which contribute to the considerable wastage of racing Thoroughbreds. Many epidemiological studies have demonstrated the prevalence of and risk factors for tendon injury when racing but have not included those injuries sustained during training. However, since tendon injury during training is seen commonly in clinical practice, it is appropriate to determine the overall prevalence of tendon injury sustained during both training and racing. Objectiv...
The effects of extracorporeal shock-wave therapy on the ultrasonographic and histologic appearance of collagenase-induced equine forelimb suspensory ligament desmitis. Extracorporeal shock-wave therapy (ESWT) may stimulate healing of desmitis in multiple species. The objective of this study was to evaluate the ultrasonographic and histologic appearance of collagenase-induced suspensory ligament (SUL) desmitis in untreated ligaments and ligaments treated with ESWT in horses. Four mature horses had SUL desmitis induced in both forelimbs. Beginning 3 weeks after induction of the lesions, one ligament per horse was treated 3 times at 3-week intervals with ESWT. The percent lesion, echogenicity and fiber alignment scores of the SULs were evaluated at 3-week inter...
Biomechanical investigation of the association between suspensory ligament injury and lateral condylar fracture in thoroughbred racehorses. 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...
Force- and moment-generating capacities of muscles in the distal forelimb of the horse. A detailed musculoskeletal model of the distal equine forelimb was developed to study the influence of musculoskeletal geometry (i.e. muscle paths) and muscle physiology (i.e. force-length properties) on the force- and moment-generating capacities of muscles crossing the carpal and metacarpophalangeal joints. The distal forelimb skeleton was represented as a five degree-of-freedom kinematic linkage comprised of eight bones (humerus, radius and ulna combined, proximal carpus, distal carpus, metacarpus, proximal phalanx, intermediate phalanx and distal phalanx) and seven joints (elbow, radiocarp...
Evaluation of a stochastic Markov-chain model for the development of forelimb injuries in Thoroughbred racehorses. To evaluate a Markov-chain model for the development of forelimb injuries in Thoroughbreds and to use the model to determine effects of reducing sprint distance on incidence of metacarpal condylar fracture (CDY) and severe suspensory apparatus injury (SSAI). Methods: Weekly exercise and injury data for 122 Thoroughbreds during racing or training. Methods: Weekly data were used to construct a Markov-chain model with 5 states (uninjured [UNINJ], palpable suspensory apparatus injury [PSAII, SSAI, CDY, and lost to follow-up [LOST]). Transition probabilities between UNINJ and PSAI were estimated as...
Effect of perineural anesthesia on the ultrasonographic appearance of equine palmar metacarpal structures. The purpose of this study was to describe ultrasonographic changes of the equine palmar metacarpal area attributed to the infiltration of local anesthetic solution and to determine whether these changes were noted immediately or at 24 h. The palmar metacarpal region of one forelimb in each of six horses was examined ultrasonographically with a 10-MHz linear array transducer and a 7.5-MHz curvilinear transducer. Transverse and longitudinal images were recorded at 5-cm intervals distal to the accessory carpal bone. High and low palmar and palmar metacarpal nerve blocks were performed with a 2% m...
Medial patellar ligament splitting for the treatment of upward fixation of the patella in 7 equids. 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...
Calculated forelimb flexor tendon forces in horses with experimentally induced superficial digital flexor tendinitis and the effects of application of heel wedges. 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...
Effects of superior check desmotomy on flexor tendon and suspensory ligament strain in equine cadaver limbs. To measure the effects of transection of the accessory ligament of the superficial digital flexor (SDF) muscle (superior check desmotomy) on flexor tendon and suspensory ligament (SL) strain in vitro. Methods: In vitro experimental biomechanical investigation. ANIMALS USED: Ten equine cadaver forelimbs. Methods: The effects of superior check desmotomy were determined using equine cadaver forelimbs secured in a servocontrolled hydraulic testing machine. Strain sensors were used to measure strain on the superficial and deep digital flexor tendons and SL, and a goniometer was used to measure join...
Model formulation and determination of in vitro parameters of a noninvasive method to calculate flexor tendon forces in the equine forelimb. To describe a method to calculate flexor tendon forces on the basis of inverse dynamic analysis and an in vitro model of the equine forelimb and to quantify parameters for the model. Methods: 38 forelimbs of 23 horses that each had an estimated body mass of > or = 500 kg. Methods: Longitudinal limb sections were used to determine the lines of action of the tendons. Additionally, limb and tendon loading experiments were performed to determine mechanical properties of the flexor tendons. Results: The study quantified the parameters for a pulley model to describe the lines of action. Furthermo...
Sensitivity analysis and application to trotting of a noninvasive method to calculate flexor tendon forces in the equine forelimb. 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...