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Topic:Tendons

Tendons in horses are fibrous connective tissues that attach muscles to bones, facilitating movement and providing stability to the musculoskeletal system. They are composed primarily of collagen fibers, which confer strength and flexibility, allowing horses to perform various physical activities. Equine tendons are subject to significant mechanical stress during locomotion, making them susceptible to injury, particularly in performance horses. Common tendon injuries include strains, tears, and tendinitis, which can impact a horse's mobility and performance. This page compiles peer-reviewed research studies and scholarly articles that explore the structure, function, and pathology of tendons in horses, as well as advancements in diagnostic and therapeutic approaches for tendon injuries.
Clinical insights: Musculoskeletal disorders of the sports horse.
Equine veterinary journal    August 6, 2025   Volume 57, Issue 5 1152-1160 doi: 10.1111/evj.14553
Morgan R, Ortved K, Clayton HM, Oosterlinck M.No abstract available
Does Low-Field MRI Tenography Improve the Detection of Naturally Occurring Manica Flexoria Tears in Horses?
Animals : an open access journal from MDPI    July 31, 2025   Volume 15, Issue 15 2250 doi: 10.3390/ani15152250
Aßmann AD, Sànchez-Andrade JS, Argüelles D, Bischofberger AS.Diagnosing digital flexor tendon sheath (DFTS) pathologies, particularly manica flexoria (MF) tears, can be challenging with standard imaging modalities. Standing low-field MRI tenography (MRIt) may improve the detection rate of MF tears. This study aimed to compare ultrasonography, contrast radiography, pre-contrast MRI, and MRIt to detect naturally occurring MF lesions in horses undergoing tenoscopy. Ten horses with a positive DFTS block, which underwent contrast radiography, ultrasonography, MRI, MRIt, and tenoscopy were included. Two radiologists evaluated the images and recorded whether a...
Clinical Updates on Superficial Digital Flexor Tendon Injuries: Insights on Diagnostic and Therapeutic Advancements.
The Veterinary clinics of North America. Equine practice    July 25, 2025   Volume 41, Issue 2 279-298 doi: 10.1016/j.cveq.2025.04.003
Smith RKW, Schramme MC.Superficial digital flexor tendinopathy is one of the most common orthopedic soft tissue injuries in horses. The veterinary challenge for this condition is less related to identifying the presence of the injury (as it is usually readily evident clinically) but more related to improving the healing process so that the healed tendon is more like normal tendon in biology and function in order to reduce reinjury, which is the key adverse consequence of the injury. Diagnostic imaging has improved in recent years to aid with treatment choices and monitoring the healing process.
Tendon/Ligaments: Structure and Composition.
The Veterinary clinics of North America. Equine practice    July 25, 2025   Volume 41, Issue 2 227-238 doi: 10.1016/j.cveq.2025.05.004
Durgam S.The mid-metacarpal SDFT, intrasynovial DDFT and suspensory ligament are frequently injured soft tissues in the equine athlete. The mid-metacarpal SDFT exhibits a hierarchical structure and encounters repetitive strains at its functional limit. The intrasynovial DDFT possesses fibrocartilage where opposing bony surfaces to facilitate resistance-free gliding and contains chondrocyte-like cells embedded in a proteoglycan-rich ECM. While suspensory ligament enthesis injuries are common, collagen and non-collagen ECM structure-function specializations at the bone-ligament interface are understudied...
Normal MRI features of the manica flexoria in horses and evaluation of the anatomic variability between forelimbs and hindlimbs.
PloS one    July 21, 2025   Volume 20, Issue 7 e0327880 doi: 10.1371/journal.pone.0327880
Miles S, McCauley C, Carossino M, Del Piero F, Liu CC, Gaschen L.Manica flexoria tears are increasingly recognized as a cause of lameness in horses resulting in a need for improved pre-operative diagnosis. Partial tears are difficult to pre-operatively diagnose and thus research for diagnostics of manica flexoria tears has been seen in increasing frequency over the past decade, though a deficit of information exists for the features of this structure on MRI, which is best suited for evaluation of soft tissues. The goal is to perform an observational study on the morphometry of the normal manica flexoria prospectively and describe it retrospectively on MRI. ...
Guidelines for Formulating Rehabilitation Strategies for Equine Tendon and Ligament Injuries.
The Veterinary clinics of North America. Equine practice    June 14, 2025   S0749-0739(25)00028-8 doi: 10.1016/j.cveq.2025.04.010
Ellis KL, Giancola S.Rehabilitation for tendon/ligament injury requires a multimodal approach to reduce pain, restore range of motion, improve proprioception/neuromotor control, and improve strength/endurance. Multiple tools are available to accomplish these goals. The rehabilitation program must be tailored to the individual patient regardless of injury type in order to return the horse to full athletic activity and reduce the risk of reinjury.
Cellular and Matrix Dynamics of the Equine Tendon.
The Veterinary clinics of North America. Equine practice    June 14, 2025   S0749-0739(25)00025-2 doi: 10.1016/j.cveq.2025.04.007
Koch DW.Our understanding of tendon homeostasis and repair following injury has made great strides through basic science, clinical veterinary medicine, and preclinical translational research. We have now gleaned a greater understanding of the cellular and matrix dynamics that are being orchestrated within the tendon, which provide therapeutic opportunities. This article will focus on how utilizing the horse and equine tissues have advanced our understanding of tendinopathy and the cellular and matrix dynamics at play while also identifying continued gaps in our knowledge where the horse as a veterinar...
Suspensory Ligament Injuries: Diagnosis and Treatment.
The Veterinary clinics of North America. Equine practice    June 14, 2025   S0749-0739(25)00023-9 doi: 10.1016/j.cveq.2025.04.005
Horne CR, Redding WR.The location of a suspensory ligament (SL) injury heavily influences the clinical presentation, prognosis, and treatment options. Diagnostic imaging is necessary to provide an accurate diagnosis and is critical to ensure the institution of the most appropriate treatment. The hindlimb proximal SL in particular can be challenging to diagnosis, carries a guarded prognosis, and typically requires aggressive treatment to achieve soundness.
Adjunct Therapies for Tendon/Ligament Healing: Therapeutic Laser and Extracorporeal Shockwave Therapy.
The Veterinary clinics of North America. Equine practice    June 14, 2025   Volume 41, Issue 2 391-401 doi: 10.1016/j.cveq.2025.04.009
Pluim M, Reynolds A, McClure S.High-power laser therapy and extracorporeal shock wave therapy (ESWT) can be safely used to treat tendon and ligament injuries in horses, and the potential beneficial effects have been described. The power of low level lasers is not sufficient for treatment of tendon and ligament injuries in horses. ESWT is used more often to treat tendon and ligament injuries than it is for any other type of condition in horses, but there is limited supporting scientific evidence. Further research should focus on establishing dosage and treatment protocols for both laser therapy and ESWT in horses with clinic...
Current and Emerging Biologic Therapies for Equine Tendon and Ligament Injuries.
The Veterinary clinics of North America. Equine practice    June 14, 2025   Volume 41, Issue 2 371-389 doi: 10.1016/j.cveq.2025.04.008
Connard SS, Schnabel LV.This review explores the use of biologics in the treatment of tendon and ligament injuries in horses, focusing on current and emerging therapies aimed at enhancing tissue repair and regeneration. It discusses the role of scaffold-based therapies, growth factors, blood-derived and tissue-derived biologics, and gene therapy as biologic regenerative therapies for improving healing outcomes. The review evaluates the mechanisms, efficacy, and challenges of biologics in clinical applications, highlighting recent advances and clinical studies. It provides an overview of current trends and future dire...
Techniques for Equine Tendon Tenorrhaphy.
The Veterinary clinics of North America. Equine practice    June 14, 2025   Volume 41, Issue 2 341-355 doi: 10.1016/j.cveq.2025.04.002
Tay A, McMaster M.Equine tendon lacerations are not uncommon secondary to traumatic wounds and degloving lacerations. These wounds are often contaminated and, therefore, basic principles of wound assessment and management are critical to identify the extent of an injury. Ancillary tools to aid physical examination include radiography, ultrasonography, and synoviocentesis (eg, if involving a joint and/or tendon sheath). Prolonged convalescence period, continued external coaptation, and controlled exercise are mainstays of treatment following tenorrhaphy. A poor prognosis for return to full athletic function is e...
Metabolic heterogeneity exists across equine distal limb tendons and ligaments in healthy, metabolically normal horses.
American journal of veterinary research    June 13, 2025   1-12 doi: 10.2460/ajvr.25.01.0015
Ellis K, Van Zeeland EM, Ashton L, Wist S, Broeckling C, Harris M, Frisbie DD, Sikes KJ.To (1) identify tissue-specific metabolic profiles of the superficial digital flexor tendon (SDFT), deep digital flexor tendon (DDFT), and suspensory ligament (SL) and (2) evaluate metabolic profile differences in the SDFT, DDFT, and SL between the equine forelimb and hindlimb. Unassigned: 2 SDFT, DDFT, and SL specimens were collected from the forelimbs and hindlimbs of 10 horses of mixed breed, age, and sex that were euthanized for other reasons. One specimen was processed for histology to confirm that there were no underlying soft-tissue pathologies. One specimen was processed for 2 forms of...
The cross-sectional area of normal superficial digital flexor tendon of young French Trotters increases during the first months of training.
American journal of veterinary research    June 12, 2025   Volume 86, Issue 8 doi: 10.2460/ajvr.24.09.0249
Beaumont A, Emond AL, Pourcelot P, Fayaubot L, Ravary-Plumioen B, Dupays AG, Desquilbet L, Denoix JM, Crevier-Denoix N.To quantify changes in the cross-sectional area (CSA) of the midmetacarpal superficial digital flexor tendon (SDFT) in young Trotters during training. Unassigned: In this experimental study, 12 healthy 3-year-old French Trotters, assigned to either a soft-track or a hard-track group, were trained for 4 months (June through September of 2012 and 2013). Both groups followed the same exercise program of increasing intensity. Ultrasonographic examinations of both forelimb SDFTs of each horse were performed before the beginning of training (D0), after 2 months of training (M2), and after 4 months o...
Proteomic profiling reveals the potential role of allogenic equine platelet-rich plasma and extracellular vesicles in modulating tendon inflammation and repair.
American journal of veterinary research    June 11, 2025   1-13 doi: 10.2460/ajvr.24.08.0241
Clarke EJ, Jensen A, Gillen AM, Bardell D, Senior M, Anderson JR, Peffers MJ.To determine the protein composition of equine platelet-rich plasma (PRP) and PRP-derived extracellular vesicles (EVs) and evaluate their effects on tendon inflammation in vitro. As tendon injuries are common in horses and treatment with PRP derived from the horse's own blood shows promise, but outcomes vary due to inconsistent composition. PRP contains EVs that facilitate cell communication. Unassigned: From December 2022 through May 2023, equine plasma (n = 3, adult) was isolated via double centrifugation and PRP produced using a commercial kit. Extracellular vesicles were isolated using dif...
Tenogenic potential of tendon-derived mesenchymal stem cells isolated post-mortem: Impact of cryopreservation.
Research in veterinary science    May 29, 2025   Volume 193 105722 doi: 10.1016/j.rvsc.2025.105722
Marine L, Wilfried P, Joëlle P, Justine J, Axel D, Vinciane T, Benoît V, Laurent G, Luc G, Jean-François K, Nadine A.In situ injection of mesenchymal stem cells appears as a promising treatment of tendinopathies. Tendon-derived mesenchymal stem cells (TDSCs) are widely studied and show a lot of interesting characteristics for clinical use. The aim of this study is to confirm the tenogenic potential of cryopreserved TDSCs and to confirm their ability to produce type I and/or type III collagens fibers in culture. Tendon-derived mesenchymal stem cells are harvested from the tendon no later than 72 h post-mortem. Their tenogenic potential has been assessed by quantitative reverse transcriptase polymerase chain ...
Evidence Related to the Effects of Intralesional/Intrasynovial Corticosteroids on Tendon/Ligament Homeostasis and Healing.
The Veterinary clinics of North America. Equine practice    May 26, 2025   S0749-0739(25)00024-0 doi: 10.1016/j.cveq.2025.04.006
Quam V.Inflammation plays a role in acute and chronic equine tendon/ligament injury; anti-inflammatories are often indicated. Local corticosteroids provide consistent and profound short-term effects on pain and inflammation across species. However, there is no demonstrated benefit in the long term, and complications can occur. Alternative biologic anti-inflammatory treatments are available and should be used in horses at risk of complications. Nonetheless, corticosteroids remain an affordable and effective anti-inflammatory that, with continued research, may be indicated on a case-by-case basis as pa...
Pharmacological alternatives to oxytetracycline as potential treatment of flexural limb deformities in foals: a preliminary in vitro cell viability and proliferation study.
Scientific reports    May 6, 2025   Volume 15, Issue 1 15762 doi: 10.1038/s41598-025-00311-z
Cardinaux EM, Oltmanns H, Beineke A, Meißner J, Geburek F.Flexural limb deformities are a widespread condition in foals. Oxytetracycline is a common conservative treatment option with relaxing effects on the muscle-tendon-unit, potentially mediated through a matrix-metalloproteinase (MMP)-inhibitor mechanism. Its high therapeutic dose for this indication, potential negative side effects, and the guidelines for prudent use of antimicrobials make investigating alternatives desirable. In this study, the influence of substances with potentially similar mechanisms of action, however without antimicrobial properties, on viability and proliferation of juven...
Magnetic resonance Imaging for diagnosing and managing deep digital flexor tendinopathy in equine athletes: Insights, advances and future directions.
Equine veterinary journal    May 2, 2025   doi: 10.1111/evj.14508
Scharf A, Acutt E, Bills K, Werpy N.Deep digital flexor (DDF) tendinopathy is a significant cause of lameness and poor performance in equine athletes with substantial implications for their return to athletic performance. Magnetic resonance imaging (MRI) is increasingly integrated into the diagnostic workup of horses with foot pain and has revolutionised the diagnosis and management of these injuries. This review discusses the principles of MRI in the context of deep digital flexor tendon (DDFT) injury, comparing high-field and low-field systems and highlighting the clinical relevance of technical parameters, including field str...
Efficacy of Platelet-Rich Plasma in the Treatment of Equine Tendon and Ligament Injuries: A Systematic Review of Clinical and Experimental Studies.
Veterinary sciences    April 18, 2025   Volume 12, Issue 4 doi: 10.3390/vetsci12040382
Carmona JU, López C.(1) Background: Tendon and ligament injuries are a leading cause of lameness in horses, with significant economic implications. Platelet-rich plasma (PRP) has gained attention for its regenerative potential, but its efficacy remains uncertain due to inconsistent study designs and reporting. (2) Methods: This systematic review, following the PRISMA guidelines, evaluated 22 studies (clinical and experimental) to assess the safety and efficacy of PRP in treating equine tendon and ligament injuries. The risk of bias was analyzed using the ROBINS-I and RoB 2.0 tools. (3) Results: PRP demonstrated a...
Gross anatomy, computed tomographic contrast tenography, and needle endoscopy of the equine medial digital flexor tendon sheath.
Veterinary surgery : VS    April 14, 2025   Volume 54, Issue 6 1133-1144 doi: 10.1111/vsu.14263
Kerbert MP, Delling U, Verhaar N.To investigate the computed tomography (CT) and gross anatomy of the equine medial digital flexor tendon sheath (MDFTS), and the endoscopic anatomy and approach to the MDFTS. Methods: Ex vivo experimental study and one clinical case. Methods: Twelve clinically normal cadaveric hindlimbs. Methods: Dissection, native and contrast CT scans were conducted to evaluate the anatomy of the MDFTS. Based on these findings, the portal locations for the endoscopic approaches were determined. Six hindlimbs were used in the pilot phase and another six limbs were selected for the main study. Endoscopic image...
Risk factors for superficial digital flexor tendinopathy in Thoroughbred racehorses in South Korea (2015-2019).
Equine veterinary journal    March 19, 2025   doi: 10.1111/evj.14493
Choi Y, Parkin T.Superficial digital flexor (SDF) tendinopathy is one of the most common musculoskeletal diseases in Thoroughbreds and a major cause of retirement from racing among racehorses in South Korea. However, there are no previous epidemiological studies on SDF tendinopathy-related risk factors for racehorses in South Korea. The interventions derived from such a study could reduce the occurrence of SDF tendinopathy and, therefore, extend horses' racing careers. Objective: To identify the risk factors associated with SDF tendinopathy for Thoroughbreds in South Korea. Methods: Retrospective case-control ...
Computed Tomographic Tenography of the Equine Carpal Flexor Tendon Sheath. Woods TDC, Dixon J, Fraser BSL, Melvaine C.Exploratory tenoscopy is considered the gold standard technique to identify intrathecal pathology of the equine carpal flexor tendon sheath (CFTS). Preoperative diagnosis allows for more precise prognostication and surgical planning, potentially associated with improved surgical outcomes. This prospective, descriptive, anatomical study aimed to describe the anatomy of the equine CFTS using noncontrast and contrast CT in clinically normal cadaver limbs. Ten pairs of equine forelimbs free of gross external abnormalities were examined from mid-antebrachium to distal metacarpus. Specimens initiall...
Casting techniques of equine hand and foot synovial cavities for the development of teaching models.
Frontiers in veterinary science    March 4, 2025   Volume 12 1524549 doi: 10.3389/fvets.2025.1524549
Velásquez JM, Tamayo-Arango L, Santos-Silva T, Miglino MA.Horse joints are common sites of injury, orthopedic issues, and surgical and clinical interventions. For this reason, a thorough understanding of joint anatomy, including the boundaries of their recesses and their relationships with other structures of the locomotor apparatus, is essential. This study aimed to develop cast anatomical models of the synovial structures of the equine hand and foot, compare different casting materials and visualization methods, and identify the most suitable technique for enhancing the understanding of equine limb arthrology. Additionally, an anatomical descriptio...
Equine Distal Limb Wounds: Economic Impact and Short-Term Prognosis of Non-Synovial Versus Synovial Lesions in Southern Germany.
Veterinary sciences    March 1, 2025   Volume 12, Issue 3 doi: 10.3390/vetsci12030205
Albanese V, Straticò P, Fischer H, Petrizzi L.Injuries to the distal limb are common in horses. The clinical aspect of the lesions is variable based on the structures that are involved. Synovial structures as well as tendons and/or ligaments may be involved in such injuries, affecting treatment modalities and costs, and prognosis. This retrospective study compares wounds involving synovial structures to wounds without such involvement in terms of treatment duration and costs, and prognosis. Synovial wounds were much more expensive to treat and carried a lower prognosis. Involvement of tendons and/or ligaments in the wounds resulted in mor...
In vivo effects of cold therapy and bandaging on core temperatures of equine superficial and deep digital flexor tendons.
Veterinary surgery : VS    February 25, 2025   Volume 54, Issue 3 470-477 doi: 10.1111/vsu.14235
McCarthy RD, Ordóñez HJ, Semevolos SA.To compare core temperatures of superficial and deep digital flexor tendons (SDFT, DDFT) during application of a compression cooling system versus ice boots and during subsequent lower limb bandaging. Methods: Experimental study. Methods: Paired forelimbs of six sedated horses. Methods: Thermocouples were placed in the core of SDFT and DDFT of both front limbs of each horse. A compression cooling system was applied to one front limb and an ice boot was applied to the other front limb for 60 min and then removed for 60 min. Standing bandages were then applied to both front limbs for 60 mi...
Tenoscopic-guided resection of the manica flexoria utilizing radiofrequency energy. A proof of concept study.
Veterinary surgery : VS    February 13, 2025   doi: 10.1111/vsu.14209
Barton CK, Nelson BB, Winther TM, Maker TC, Goodrich LR.To develop and optimize a tenoscopic technique for resection of the manica flexoria utilizing a radiofrequency probe. Methods: Experimental study. Methods: Eighteen cadaver limbs and two experimental horses. Methods: Tenoscopic-guided resection of the manica flexoria using radiofrequency energy proceeded sequentially by transection of the medial, lateral and proximal borders. The technique was performed in ex vivo limbs and then in vivo to replicate clinical scenarios. Time to complete resection of the manica flexoria (mean ± SD) and complications was recorded. Limbs were dissected and sc...
Equine adult, fetal and ESC-tenocytes have differential migratory, proliferative and gene expression responses to factors upregulated in the injured tendon.
Cells & development    February 8, 2025   Volume 181 204003 doi: 10.1016/j.cdev.2025.204003
Beaumont RE, Smith EJ, David C, Paterson YZ, Faull E, Guest DJ.Tendon injuries are a common problem in humans and horses. There is a high re-injury rate in both species due to the poor regeneration of adult tendon and the resulting formation of scar tissue. In contrast, fetal tendon injuries undergo scarless regeneration, but the mechanisms which underpin this are poorly defined. It is also unclear if tendon cells derived from embryonic stem cells (ESCs) would aid tendon regeneration. In this study we determined the responses of adult, fetal and ESC-derived equine tenocytes to a range of cytokines, chemokines and growth factors that are upregulated follow...
Needle tenoscopy of the digital flexor tendon sheath in a standing equine cadaver model using a novel approach and guided palmar/plantar annular ligament desmotomy.
Veterinary surgery : VS    February 6, 2025   doi: 10.1111/vsu.14213
Breen LJ, Stack JD, Gillen AM, Baldwin CM.(1) To evaluate the feasibility of needle tenoscopy of the digital flexor tendon sheath (DFTS) using basisesamoid (BS) and proximolateral (PL) approaches in a standing equine cadaver model. (2) To report visualization of intrathecal DFTS anatomy via both approaches. (3) To determine the efficacy of needle scope-guided palmar/plantar annular ligament (PAL) desmotomy. (4) To report any iatrogenic damage associated with the procedure. Methods: Ex vivo experimental. Methods: Ten equine cadaver limbs. Methods: Limbs were placed in a Kimzey leg-saver splint and needle tenoscopy was performed using t...
Biomechanical Assessment of the Collateral Ligament of the Distal Interphalangeal Joint of the Horse Following Alterations to the Palmar Angle-A Cadaveric Study.
Animals : an open access journal from MDPI    February 1, 2025   Volume 15, Issue 3 406 doi: 10.3390/ani15030406
Colla S, Johnson JW, McGilvray KC, Zanotto GM, Seabaugh KA.Therapeutic shoeing for horses is used to affect the palmar angle (PA) of the distal phalanx. These changes may influence the strain on the distal interphalangeal joint collateral ligaments (DIJCLs). This cadaveric study aimed to assess DIJCL strain under varying loads and PA adjustments. Using 26 cadaver forelimbs, eight optical markers were placed on one DIJCL for strain measurement under five different loads (1000-5000 newtons) at a neutral PA, followed by PA increases of 2°, 4°, and 6° and decreases of -2° and -4°. The results indicate that increases in PA corresponded to significantl...
Distribution of race and training-related musculoskeletal injuries by track and location in Thoroughbred and Arabian racehorses.
Equine veterinary journal    January 7, 2025   doi: 10.1111/evj.14457
Yildirim İG, Karaarslan S, Erkan A.Musculoskeletal injuries (MSI) are a major concern in the horse racing industry, often leading to career-ending outcomes. Contributing factors include conformation, limb and joint defects, hoof structure, age, and hard track surfaces. Objective: This study aimed to evaluate the distribution of MSI in Thoroughbred and Arabian racehorses during racing and training, categorised by breed and track surface. Methods: Retrospective cohort study. Methods: The data from 2018 to 2023 were collected at the Turkish Jockey Club's Şirinyer Hippodrome (38°23'03.7″ N 27°09'01.0″ E), covering 553 MSI ca...
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