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.
Taguchi T, Lopez MJ, Aoun R, Helber L.Over the last few decades, cell and cell-based therapies emerged as treatment options for equine tendinopathy and desmopathy. The objective of this study was to critically evaluate outcomes following treatment of equine tendinopathy or desmopathy with adult multipotent stromal/stem cells (MSCs). Unassigned: The PubMed and Web of Science databases were searched for "equine/horse," "tendon/tendinopathy/tendonitis/ligament/ligamentopathy/desmopathy/desmitis," "stem/stromal/mesenchymal/multipotent," and "cell" from January 2001 to June 2025. Studies were identified according to PRISMA guidelines, ...
Mazzucco L, Marcatili M, Withers J, Cantatore F.Superficial digital flexor tendinopathy is a common cause of forelimb lameness in Thoroughbred racehorses and sports horses; however, this condition is rarely observed in the hindlimb. A 16-year-old Irish sports horse gelding was presented with bilateral swelling in the plantar metatarsal region and severe bilateral hindlimb lameness visible at the walk. The lameness occurred after the cross-country phase of an eventing competition. The clinical suspicion of superficial digital flexor tendon (SDFT) injury was confirmed after ultrasonographic examination, which revealed an extensive core lesion...
Bosman LM, Logan MG, Miszewski A, Pepper MS.Translational regenerative medicine, integrating human and veterinary approaches within the "One Health" framework, increasingly uses horses as models for human musculoskeletal conditions due to shared anatomical and functional features. Osteoarthritis and tendon disorders affect both species, often resulting from high-impact or repetitive strain activities. Regenerative medicine offers therapeutic opportunities by promoting tissue repair and modulating inflammation. Cellular orthobiologics such as mesenchymal stromal/stem cells (MSCs) show promise for treating osteoarthritis and tendon injuri...
Eren G, López-Albors O, López Corbalán M, Latorre R.Digital technologies have improved the visualization of anatomical structures for veterinary education and clinical practice. In this study, a detailed three-dimensional anatomical model of the equine palmar metacarpal region was generated using E12-based epoxy sheet plastination combined with digital reconstruction in Amira V5.6 software. Serial cross-sections of the metacarpal region provided high-resolution visualization of bones, tendons, ligaments, nerves, vessels, fasciae, and synovial structures, with minimal shrinkage or deformation, ensuring improved anatomical accuracy. These section...
Qiu Z, Wang J, Zhang Y, Liu X, Wei C, Ma T.Musculoskeletal injuries represent a primary cause of suboptimal performance and early retirement in equine athletes. To address this challenge, the veterinary community has long endeavored to develop safer and more effective therapeutic strategies. Extracorporeal shock wave therapy (ESWT), as a treatment for equine musculoskeletal injuries, has garnered substantial attention among equine veterinarians. Focused on the theme ESWT Therapy for Equine Musculoskeletal Disorders: From biological mechanisms to clinical applications, this article systematically reviews existing literature on the biolo...
Guadalupi M, Girelli CR, Della Tommasa S, Corte FD, Crovace AM, Fanizzi FP, Brehm W, Lacitignola L.Joint and tendon sheath diseases are a major cause of lameness and reduced performance in horses. Synovial fluid composition changes in response to pathological processes and metabolomic profiling offers a promising approach to detect these alterations. While equine joint metabolomics has been explored, little is known about the metabolomic profile of tendon sheaths. This study aimed to characterize and compare the synovial fluid metabolomic profiles of healthy and pathological joints and tendon sheaths in horses using high-resolution H Nuclear Magnetic Resonance spectroscopy, and to identify ...
Honnas DH, Fiske-Jackson AR, Fulkerson CV, Wilhite DR.An injury of a tendon or ligament of the equine foot is frequently a cause of lameness. The optimal radiographic projections delineating the entheses of five commonly injured tendons and ligaments of the foot should be described. Methods: The entheses of the collateral ligaments of the distal interphalangeal joint, the collateral sesamoidean ligaments of the navicular bone, the deep digital flexor tendon, the common digital extensor tendon and the distal sesamoidean impar ligament were isolated from a thoracic foot of three cadavers. Three standard radiographic projections (60-degree, dorsopro...
Stäubli T, Theiss F, Bischofberger A.A total of 48 horses with unilateral (n = 44) or bilateral (n = 4) overstrain-induced complete rupture of the superficial digital flexor tendon (SDFT) in the forelimbs were retrospectively analysed. A telephone questionnaire, carried out an average of 5,9 years post-injury, served as a long-term follow-up in 25 horses. The mortality rate associated with SDF tendonitis was 12,0 % (3/25). Superficial digital flexor tendonitis did not recur in 76,0 % (19/25) of the horses, but at least one subsequent episode occurred in 24,0 % (6/25). The results of this study indicate that it is reasonable...
McDonald S, Verheyen KLP, Chang YM, Allen SE.Race-related injuries in horse racing, especially those requiring extended recovery, are a welfare concern and threaten the sport's social licence. Previous studies predominantly report on fatalities; however, serious non-fatal musculoskeletal injuries often end horses' racing careers or have a high recurrence risk. No recent studies have described or quantified long-term injuries (LTIs) in racing Thoroughbreds, which is essential to inform targeted risk prevention strategies. Objective: To describe the types, frequencies and incidences of LTIs in British jump racing. Methods: Retrospective co...
Pilger F, Aurich C, Aurich JE.The early career start of racehorses, the pretraining of two-year-old Warmblood stallions for licensing, and individual housing of young horses increasingly raise animal welfare concerns. Objective: Assess pretraining practices and the opinion of trainers on housing of young horses, minimum age to commence training and pretraining injuries. Methods: Qualitative interviews with trainers of Warmblood stallions and Thoroughbred and Trotter racehorses (n = 10 each). Results: Pretraining of Thoroughbreds and Trotters began at 18 months, whereas licensing preparation of Warmblood stallions began at ...
Racine J, Ungermann A, Blatter M, von Plato G, Rijkenhuizen ABM.To describe a modified two-portal tenoscopic technique for proximal manica flexoria (MF) resection designed to preserve the mesotendons (MTs) of the deep digital flexor tendon (DDFT). Methods: Prospective clinical study. Methods: Client-owned horses (n = 30). Methods: MF resection was performed in four steps: (1) Transection of the lateral attachment of the MF to the superficial digital flexor tendon (SDFT), staying abaxial to the lateral MT; (2) transection of the medial attachment of the MF to the SDFT between the flexor tendons from distal to proximal until reaching the level of the med...
Woods T, Dixon J, Melvaine C, Fraser B.To determine the ideal location of a medial tenoscopic portal in the equine carpal flexor tendon sheath (CFTS) using contrast computed tomography (CT). Methods: Experimental cadaver study. Methods: A total of 20 entire forelimbs from adult Standardbred horses. Methods: Contrast media diluted in saline was injected into the CFTS from a lateral approach before manually flexing and extending the limb 20 times to disperse the contrast solution. The limbs were placed in lateral recumbency and a capped 21-gauge 1.5 inch needle was placed approximately 5 mm proximal and 32 mm caudal to the palpab...
Beaumont RE, Flood C, Guest DJ.Interleukin 1 beta (IL-1β) is upregulated following a tendon injury and in vitro studies have shown that it leads to numerous negative effects on tendon cell function and gene expression. IL-1β activates nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) and we hypothesised that inhibiting NF-κB activation would mediate the negative effects of IL-1β on equine tendon cells in 3-dimensional (3D) cultures. Results: Here, we tested three inhibitors of NF-κB signalling (Bortezomib, BAY11-7082 and Wedelolactone) along withTJ-M2010-5, an inhibitor of MyD88, which is a critic...
Shaw KA, Brounts SH.To evaluate the effect of heel elevation on measurement of stiffness gradients by means of acoustoelastography in the digital flexor tendons of clinically normal horses. Unassigned: 15 clinically normal horses. Unassigned: For each horse, stiffness gradient index (SGI) for superficial digital flexor tendons (SDFT) and deep digital flexor tendons (DDFT) were evaluated in both forelimbs at 0, 4 and 8 degrees of heel elevation. Acoustoelastography (AEG) was used for data acquisition at three sites, approximately 6, 12, and 18 cm distal to the accessory carpal bone in the metacarpal region. Lif...
Woodman MJ, Thomas MA, Colville MJ, Durgam S, McDonough SP, Reesink HL.To describe proteoglycan 4 (PRG4) expression, lubricin tissue distribution, and lubricin synovial fluid concentrations in healthy and injured equine flexor tendons and tenosynovial structures. Unassigned: Synovial fluid and tissues were collected over the span of 1 year. Proteoglycan 4 expression was quantified using quantitative real-time PCR, lubricin synovial fluid concentrations were measured using ELISAs, and lubricin tissue distribution was evaluated with immunohistochemistry. Histology and quantitative real-time PCR data for healthy samples were analyzed using paired t tests, repeated-m...
Nelson B.Complications of equine musculoskeletal procedures and surgery are an inevitable occurrence. This article summarizes complications principally encountered by primary equine veterinarians who perform and manage musculoskeletal procedures and surgeries. Topics discussed include complications of musculoskeletal diagnostic procedures, angular/flexural limb deformities, and muscle, tendon, and ligament surgery; surgery of the foot, orthopedic and arthroscopic surgery, and cast management. Each section lists complications encountered and includes diagnostic and treatment considerations. Awareness of...
Wood AD, Parker RA.To describe a tenoscopically guided technique for desmotomy of the proximal digital annular ligament (PDAL). Methods: Ex vivo study and clinical case series. Methods: A total of 10 normal cadaver equine hindlimbs and five clinical cases of PDAL desmitis. Methods: The digital flexor tendon sheath (DFTS) was approached via a lateral basisesamoid portal and a palmar/plantar annular ligament (PAL) desmotomy was performed to improve maneuverability in the DFTS. Additional proximolateral and distal midline instrument portals were created to facilitate transection of the proximolateral attachment, th...
Guerri G, Bandera L, Straticò P, Palozzo A, Di Nunzio L, Celani G, Varasano V, Vignoli M, Petrizzi L.Superficial digital flexor tendon (SDFT) injuries cause progressive loss of its mechanical properties. Two-dimensional shear wave elastography (2D-SWE) provides information about tissue stiffness. Objective: To determine the feasibility, repeatability, and reproducibility of 2D-SWE of healthy and pathological forelimb SDFT. Methods: Prospective observational cohort study. Methods: Horses were divided into a noninjured Group (H) and a Group with tendinopathy of the SDFT (P). 2D-SWE of both fore SDFTs was performed at three metacarpal levels (A, B, and C, from proximal to distal). Qualitative an...
Freeman KD, Adams MN, Salinger AE, White NA, Barrett JG.Suspensory desmopathy is a frequently documented cause of lameness in performance horses; proximal suspensory desmopathy is the most frequent site of injury in dressage horses [...].
Tommasa SD, Raspe S, Farí G, Imperante A, Brehm W.Tendon and ligament injuries in equine athletes pose significant challenges, often leading to prolonged recovery, reduced performance, and increased risk of reinjury. Current treatment strategies, including conservative and surgical approaches, have shown limited success in fully restoring tendon integrity. Autologous blood derivatives, such as autologous conditioned serum (ACS), have emerged as potential regenerative therapies. However, the clinical efficacy of ACS in the treatment of equine tendinopathies remains under investigation. Unassigned: This study aimed to compare the clinical outco...
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...
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.
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...
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. ...
Beggan CP, Panizzi L, Oliver LJ.To measure microsphere recovery following needle-through-and-through lavage (NTAT) of the metacarpo-/metatarsophalangeal joint (fetlock) and digital flexor tendon sheath (DFTS) compared to endoscopic lavage (EL). Methods: Ex vivo experimental study. Methods: Adult equine cadavers immediately following euthanasia (n = 10). Methods: Colored 15 μm microspheres (2 million) were injected into fetlock joints and DFTS. Synovial structures were assigned to NTAT or EL groups. Each lavage was performed using 5 L of 0.9% NaCl, sequentially collecting egress fluid for microsphere quantification. Re...
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.
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...
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.
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...
Godwin EE, Young NJ, Dudhia J, Beamish IC, Smith RK.Mesenchymal stem (progenitor; stromal) cell (MSC) therapy has gained popularity for the treatment of equine tendon injuries but without reports of long-term follow-up. Objective: To evaluate the safety and reinjury rate of racehorses after intralesional MSC injection in a large study of naturally occurring superficial digital flexor tendinopathy and to compare these data with those published for other treatments. Methods: Safety was assessed clinically, ultrasonographically, scintigraphically and histologically in a cohort of treated cases: 141 client-owned treated racehorses followed-up for a...
McCarrel TM, Minas T, Fortier LA.Numerous methods are available for platelet-rich plasma (PRP) generation, but evidence defining the optimum composition is lacking. We hypothesized that leukocyte-reduced PRP would result in lower inflammatory cytokine expression compared with concentrated-leukocyte PRP and that maintaining the platelet:white blood cell (WBC) ratio would compensate for the effect of increased WBC concentration. Methods: Blood and flexor digitorum superficialis tendons were collected from young adult horses. Three PRP groups were generated with the same platelet concentration but different WBC concentrations: i...
Schnabel LV, Mohammed HO, Miller BJ, McDermott WG, Jacobson MS, Santangelo KS, Fortier LA.Platelet rich plasma (PRP) has recently been investigated for use in tissue regeneration studies that seek to utilize the numerous growth factors released from platelet alpha-granules. This study examined gene expression patterns, DNA, and collagen content of equine flexor digitorum superficialis tendon (SDFT) explants cultured in media consisting of PRP and other blood products. Blood and bone marrow aspirate (BMA) were collected from horses and processed to obtain plasma, PRP, and platelet poor plasma (PPP). IGF-I, TGF-beta1, and PDGF-BB were quantified in all blood products using ELISA. Ten...
Thorpe CT, Udeze CP, Birch HL, Clegg PD, Screen HR.Tendons transfer force from muscle to bone. Specific tendons, including the equine superficial digital flexor tendon (SDFT), also store and return energy. For efficient function, energy-storing tendons need to be more extensible than positional tendons such as the common digital extensor tendon (CDET), and when tested in vitro have a lower modulus and failure stress, but a higher failure strain. It is not known how differences in matrix organization contribute to distinct mechanical properties in functionally different tendons. We investigated the properties of whole tendons, tendon fascicles ...
Caliari SR, Harley BA.Current surgical and tissue engineering approaches for treating tendon injuries have shown limited success, suggesting the need for new biomaterial strategies. Here we describe the development of an anisotropic collagen-glycosaminoglycan (CG) scaffold and use of growth factor supplementation strategies to create a 3D platform for tendon tissue engineering. We fabricated cylindrical CG scaffolds with aligned tracks of ellipsoidal pores that mimic the native physiology of tendon by incorporating a directional solidification step into a conventional lyophilization strategy. By modifying the freez...
Smith RK, Werling NJ, Dakin SG, Alam R, Goodship AE, Dudhia J.Tendon injuries are a common age-related degenerative condition where current treatment strategies fail to restore functionality and normal quality of life. This disease also occurs naturally in horses, with many similarities to human tendinopathy making it an ideal large animal model for human disease. Regenerative approaches are increasingly used to improve outcome involving mesenchymal stem cells (MSCs), supported by clinical data where injection of autologous bone marrow derived MSCs (BM-MSCs) suspended in marrow supernatant into injured tendons has halved the re-injury rate in racehorses....
Schnabel LV, Lynch ME, van der Meulen MC, Yeager AE, Kornatowski MA, Nixon AJ.Tendinitis remains a catastrophic injury among athletes. Mesenchymal stem cells (MSCs) have recently been investigated for use in the treatment of tendinitis. Previous work has demonstrated the value of insulin-like growth factor-I (IGF-I) to stimulate cellular proliferation and tendon fiber deposition in the core lesion of tendinitis. This study examined the effects of MSCs, as well as IGF-I gene-enhanced MSCs (AdIGF-MSCs) on tendon healing in vivo. Collagenase-induced bilateral tendinitis lesions were created in equine flexor digitorum superficialis tendons (SDFT). Tendons were treated with ...
Biewener AA.The stresses acting in muscle-tendon units and ligaments of the forelimb and hindlimb of horses were determined over a range of speed and gait based on recordings of ground reaction forces and limb kinematics. Maximum stresses of 40-50 MPa were calculated to act in several of the principal forelimb (superficial digital flexor (SDF), deep digital flexor (DDF), ulnaris lateralis (UL) and flexor carpi ulnaris/radialis (FCU/R)) and hindlimb tendons (plantaris, DDF) at the fastest galloping speeds recorded (up to 7.4 m s-1). Smaller stresses were found for the gastrocnemius (GAST) tendon (30 MPa) a...
Williams RB, Harkins LS, Hammond CJ, Wood JL.For improvements to the safety and welfare of racehorses to be possible, it is essential to have access to basic descriptive information about the veterinary incidents encountered during horseracing. A 3 year surveillance study (1996-1998) was conducted by The Jockey Club into racing injuries, other postrace clinical problems and fatalities from all 59 British racecourses (mainland Britain only) to identify risk factors. During the survey there were 222,993 racing starts: 106,897 starts in flat races on turf (47.9%), 26,519 starts in flat races on all-weather surfaces (11.9%), 30,932 starts in...
Thorpe CT, Streeter I, Pinchbeck GL, Goodship AE, Clegg PD, Birch HL.Little is known about the rate at which protein turnover occurs in living tendon and whether the rate differs between tendons with different physiological roles. In this study, we have quantified the racemization of aspartic acid to calculate the age of the collagenous and non-collagenous components of the high strain injury-prone superficial digital flexor tendon (SDFT) and low strain rarely injured common digital extensor tendon (CDET) in a group of horses with a wide age range. In addition, the turnover of collagen was assessed indirectly by measuring the levels of collagen degradation mark...
Lomas AJ, Ryan CN, Sorushanova A, Shologu N, Sideri AI, Tsioli V, Fthenakis GC, Tzora A, Skoufos I, Quinlan LR, O'Laighin G, Mullen AM, Kelly JL....Tendon injuries represent a significant clinical burden on healthcare systems worldwide. As the human population ages and the life expectancy increases, tendon injuries will become more prevalent, especially among young individuals with long life ahead of them. Advancements in engineering, chemistry and biology have made available an array of three-dimensional scaffold-based intervention strategies, natural or synthetic in origin. Further, functionalisation strategies, based on biophysical, biochemical and biological cues, offer control over cellular functions; localisation and sustained relea...
Gaspar D, Spanoudes K, Holladay C, Pandit A, Zeugolis D.The last decade has seen significant developments in cell therapies, based on permanently differentiated, reprogrammed or engineered stem cells, for tendon injuries and degenerative conditions. In vitro studies assess the influence of biophysical, biochemical and biological signals on tenogenic phenotype maintenance and/or differentiation towards tenogenic lineage. However, the ideal culture environment has yet to be identified due to the lack of standardised experimental setup and readout system. Bone marrow mesenchymal stem cells and tenocytes/dermal fibroblasts appear to be the cell populat...
Nixon AJ, Dahlgren LA, Haupt JL, Yeager AE, Ward DL.To assess the potential of adipose-derived nucleated cell (ADNC) fractions to improve tendon repair in horses with collagenase-induced tendinitis. Methods: 8 horses. Methods: Collagenase was used to induce tendinitis in the superficial digital flexor tendon of 1 forelimb in each horse. Four horses were treated by injection of autogenous ADNC fractions, and 4 control horses were injected with PBS solution. Healing was compared by weekly ultrasonographic evaluation. Horses were euthanatized at 6 weeks. Gross and histologic evaluation of tendon structure, fiber alignment, and collagen typing were...
Bosch G, van Schie HT, de Groot MW, Cadby JA, van de Lest CH, Barneveld A, van Weeren PR.Tendon injuries are notorious for their slow and functionally inferior healing. Intratendinous application of platelet-rich plasma (PRP) has been reported to stimulate the repair process of tendon injuries, but there is little conclusive evidence for its effectiveness. A placebo-controlled experimental trial was performed to test the hypothesis that a single intratendinous PRP treatment enhances the quality of tendon repair, as evidenced by improved biochemical, biomechanical, and histological tissue properties. In six horses, tendon lesions were created surgically in the Superficial Digital F...
Payne RC, Hutchinson JR, Robilliard JJ, Smith NC, Wilson AM.We provide quantitative anatomical data on the muscle-tendon units of the equine pelvic limb. Specifically, we recorded muscle mass, fascicle length, pennation angle, tendon mass and tendon rest length. Physiological cross sectional area was then determined and maximum isometric force estimated. There was proximal-to-distal reduction in muscle volume and fascicle length. Proximal limb tendons were few and, where present, were relatively short. By contrast, distal limb tendons were numerous and long in comparison to mean muscle fascicle length, increasing potential for elastic energy storage. W...
Violini S, Ramelli P, Pisani LF, Gorni C, Mariani P.Mesenchymal stem cells (MSCs) have been recently investigated for their potential use in regenerative medicine. MSCs, in particular, have great potential, as in various reports they have shown pluripotency for differentiating into many different cell types. However, the ability of MSCs to differentiate into tendon cells in vitro has not been fully investigated. Results: In this study, we show that equine bone marrow mesenchymal stem cells (BM-MSCs), defined by their expression of markers such as Oct4, Sox-2 and Nanog, have the capability to differentiate in tenocytes. These differentiated cell...
Thorpe CT, Clegg PD, Birch HL.Tendon injury is one of the most common causes of wastage in the performance horse; the majority of tendon injuries occur to the superficial digital flexor tendon (SDFT) whereas few occur to the common digital extensor tendon. This review outlines the epidemiology and aetiology of equine tendon injury, reviews the different functions of the tendons in the equine forelimb and suggests possible reasons for the high rate of failure of the SDFT. An understanding of the mechanisms leading to matrix degeneration and subsequent tendon gross failure is the key to developing appropriate treatment and p...
White LM, Sussman MS, Hurtig M, Probyn L, Tomlinson G, Kandel R.To prospectively assess T2 mapping characteristics of normal articular cartilage and of cartilage at sites of arthroscopic repair, including comparison with histologic results and collagen organization assessed at polarized light microscopy (PLM). Methods: Study protocol was compliant with the Canadian Council on Animal Care Guidelines and approved by the institutional animal care committee. Arthroscopic osteochondral autograft transplantation (OAT) and microfracture arthroplasty (MFx) were performed in knees of 10 equine subjects (seven female, three male; age range, 3-5 years). A site of art...
Dakin SG, Dudhia J, Smith RK.Injuries to the superficial digital flexor tendon (SDFT) are an important cause of morbidity and mortality in equine athletes, but the healing response is poorly understood. One important drive for the healing of connective tissues is the inflammatory cascade, but the role of inflammation in tendinopathy has been contentious in the literature. This article reviews the processes involved in the healing of tendon injuries in natural disease and experimental models. The importance of inflammatory processes known to be active in tendon disease is discussed with particular focus on recent findings ...
Thorpe CT, Udeze CP, Birch HL, Clegg PD, Screen HR.Age-related tendinopathy is common in both humans and horses; the initiation and progression of which is similar between species. The majority of tendon injuries occur to high-strain energy storing tendons, such as the human Achilles tendon and equine superficial digital flexor (SDFT). By contrast, the low-strain positional human anterior tibialis tendon and equine common digital extensor (CDET) are rarely injured. It has previously been established that greater extension occurs at the fascicular interface in the SDFT than in the CDET; this may facilitate the large strains experienced during l...
Sivaguru M, Durgam S, Ambekar R, Luedtke D, Fried G, Stewart A, Toussaint KC.Fourier transform-second harmonic generation (FT-SHG) imaging is used as a technique for evaluating collagenase-induced injury in horse tendons. The differences in collagen fiber organization between normal and injured tendon are quantified. Results indicate that the organization of collagen fibers is regularly oriented in normal tendons and randomly organized in injured tendons. This is further supported through the use of additional metrics, in particular, the number of dark (no/minimal signal) and isotropic (no preferred fiber orientation) regions in the images, and the ratio of forward-to-...
Thorpe CT, Peffers MJ, Simpson D, Halliwell E, Screen HR, Clegg PD.Tendon is a simple aligned fibre composite, consisting of collagen-rich fascicles surrounded by a softer interfascicular matrix (IFM). The composition and interactions between these material phases are fundamental in ensuring tissue mechanics meet functional requirements. However the IFM is poorly defined, therefore tendon structure-function relationships are incompletely understood. We hypothesised that the IFM has a more complex proteome, with faster turnover than the fascicular matrix (FM). Using laser-capture microdissection and mass spectrometry, we demonstrate that the IFM contains more ...
Dudhia J, Scott CM, Draper ER, Heinegård D, Pitsillides AA, Smith RK.Age-associated and degenerative loss of functional integrity in soft tissues develops from effects of cumulative and subtle changes in their extracellular matrix (ECM). The highly ordered tendon ECM provides the tissue with its tensile strength during loading. As age and exercise collide in the high incidence of tendinopathies, we hypothesized that aged tendons fail due to cumulative damage resulting from a combination of diminished matrix repair and fragmentation of ECM proteins induced by prolonged cyclical loading, and that this is an active cell-mediated process. We developed an equine ten...
Thorpe CT, Godinho MSC, Riley GP, Birch HL, Clegg PD, Screen HRC.While the predominant function of all tendons is to transfer force from muscle to bone and position the limbs, some tendons additionally function as energy stores, reducing the cost of locomotion. Energy storing tendons experience extremely high strains and need to be able to recoil efficiently for maximum energy storage and return. In the equine forelimb, the energy storing superficial digital flexor tendon (SDFT) has much higher failure strains than the positional common digital extensor tendon (CDET). However, we have previously shown that this is not due to differences in the properties of...
Smith RK, Zunino L, Webbon PM, Heinegård D.A protein prominent in guanidine hydrochloride extracts of adult bovine and equine digital flexor tendons was confirmed to be Cartilage Oligomeric Matrix Protein (COMP) by non-reducing and reducing SDS-PAGE, reaction with rabbit anti-COMP polyclonal antiserum on Western blots, trypsin digestion followed by HPLC on a C2/C18 column, and identification of COMP mRNA from tendon on Northern blots. Immunohistochemistry and Western blots of extracts showed COMP to be present in all regions of digital flexor tendons. Equine tendon COMP was purified by ion exchange chromatography and gel filtration and...
Eddy AL, Van Hoogmoed LM, Snyder JR.Equine thermography has increased in popularity recently because of improvements in thermal cameras and advances in image-processing software. The basic principle of thermography involves the transformation of surface heat from an object into a pictorial representation. The colour gradients generated reflect differences in the emitted heat. Variations from normal can be used to detect lameness or regions of inflammation in horses. Units can be so sensitive that flexor tendon injuries can be detected before the horse develops clinical lameness. Thermography has been used to evaluate several dif...
Guest DJ, Smith MR, Allen WR.Autologous mesenchymal progenitor cells (MPCs) purified from bone marrow aspirates are being used in the treatment of superficial digital flexor tendon (SDFT) injuries in the horse with promising results. In this study the fate of autologous and allogeneic MPCs following injection into the SDFT was monitored by stable transfection of MPCs with green fluorescent protein (GFP). Small lesions were created manually in one forelimb SDFT of 2 horses and injected with autologous MPCs, allogeneic MPCs or bone marrow supernatant alone. Post mortem examinations performed after 10 or 34 days revealed GFP...
Wilson AM, McGuigan MP, Su A, van Den Bogert AJ.The muscular work of galloping in horses is halved by storing and returning elastic strain energy in spring-like muscle-tendon units.These make the legs act like a child's pogo stick that is tuned to stretch and recoil at 2.5 strides per second. This mechanism is optimized by unique musculoskeletal adaptations: the digital flexor muscles have extremely short fibres and significant passive properties, whereas the tendons are very long and span several joints. Length change occurs by a stretching of the spring-like digital flexor tendons rather than through energetically expensive length changes...
Patterson-Kane JC, Becker DL, Rich T.The equine superficial digital flexor tendon (SDFT) is a frequently injured structure that is functionally and clinically equivalent to the human Achilles tendon (AT). Both act as critical energy-storage systems during high-speed locomotion and can accumulate exercise- and age-related microdamage that predisposes to rupture during normal activity. Significant advances in understanding of the biology and pathology of exercise-induced tendon injury have occurred through comparative studies of equine digital tendons with varying functions and injury susceptibilities. Due to the limitations of in-...
