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.
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...
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...
Urion R, Lustgarten M, Hostnik ET.Technological developments in imaging modalities have advanced the diagnostic capabilities for equine tendon and ligament injuries beyond the traditional methods. This review examines elastography techniques in ultrasonography that assess tissue stiffness and strain properties, computed tomography (CT) innovations including PET/CT fusion and dual-energy CT, and emerging applications of diffusion-weighted MRI for evaluating fiber microstructure and functionality. These complementary approaches offer veterinarians improved means to detect early injuries, assess structural integrity, monitor heal...
Moreno C, Rice H.Diagnostic and treatment strategies for infectious equine tendon and ligament disorders are continually evolving where recent progress is focused on advanced imaging and evidence supporting endoscopic lavage and regional antimicrobial therapy.
Beasley B.The overall objective of therapeutic farriery for equine tendon and ligament injuries is to provide a biomechanical environment conducive to healing by limiting excessive strain on the injured structure. With an understanding of equine limb anatomy and the pathophysiology of tendon/ligament injuries, the rationale used in therapeutic farriery for soft tissue injuries of the distal limb is quite logical. Through therapeutic farriery, foot manipulation is used to reduce the tension on the injured tendon(s) or ligament(s).
Zamboulis DE, Thorpe CT.The high stresses and strains experienced by the superficial digital flexor tendon (SDFT) make it prone to age-related injury. The SDFT exhibits cellular and structural specializations, localized to the interfascicular matrix (IFM), enabling it to resist its extreme mechanical environment. With aging, these specializations are lost, impacting the ability of the tendon to withstand repeated loading. Within the IFM, there is loss of mechanical properties and organization accompanying cell senescence and a decreased resolution of inflammation. Developing therapeutics to reverse these changes may,...
García-López JM.Intrathecal and intrasynovial tendon and ligament injuries can result in extrusion of tendon/ligament fibers, granuloma, and adhesion formation that not only impairs healing of the original injury but can create new injuries that negatively affect adequate healing and return to athletic work. In these cases, endoscopic evaluation and debridement, not only of the lesion, but also any other secondary injury present, can enhance the healing of the tendon or ligament and improve the athletic prognosis. Careful planning of the approach, positioning, instrumentation, and thorough knowledge of the an...
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...
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...
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...
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 ...
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...
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...
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...
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...
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...
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 ...
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...
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...
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...
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...
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...
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...
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...
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...
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...
Dörner CA, Vargas V, Castellón CH.The aim of this prospective case-control study was to describe and implement a reliable, accurate, and straightforward ultrasound-guided proximo-medial approach technique for injecting the carpal flexor tendon sheath in horses. The proximo-medial ultrasound-guided approach for intrathecal access to the carpal canal, as described in this study, was firstly developed on ten cadaveric limbs using an undiluted ionic iodinated contrast medium. Landmarks were identified, and the access point was established. Subsequently, the technique was validated in ten horses, and its efficacy was compared with ...
Willette JA, Tsoi M, Frobish D, VanderBroek AR.The objectives of the study were to describe a standing percutaneous adhesion induction model in the digital flexor tendon sheath (DFTS) of horses and to evaluate the effect of intrathecal administration of the angiotensin-converting enzyme (ACE) inhibitor enalapril on tendon healing and adhesion formation. Methods: Randomized, blinded, controlled experimental study. Methods: Eight healthy horses. Methods: A collagenase-induced adhesion model was implemented in the deep digital flexor tendon (DDFT) of both forelimbs under standing ultrasonographic guidance. Daily intrathecal injections of 5 ...
Eren G, López-Albors O, Guilabert Segura R, Jordan Montesinos J, Latorre R.The accessory ligament of the deep digital flexor tendon (AL-DDFT) plays a crucial role in the stay apparatus of the horse. This study aimed to investigate the anatomical relationship between the AL-DDFT, the superficial digital flexor tendon (SDFT), and other structures in the metacarpal region. Sixteen distal forelimbs from eight horses, aged 1 to 6 years, were evaluated through macroscopic, microscopic, and morphometric analyses, utilizing detailed dissection, E12 plastinated sections, and histological analysis. During lateral dissection, a connection was observed between the AL-DDFT and th...
Tranquille CA, Chojnacka K, Murray RC.There has been little investigation into the health patterns of the eventing horse population outside veterinary clinics. To target health problems in the eventing horse population, it is important to determine the relative impact of different health problems. The objectives were to describe the prevalence and patterns of lameness/illness in registered British eventing horses. An online survey was released for all horses registered with British eventing in 2018. Data were collated and descriptive analyses undertaken. A total of 1677 surveys were completed, among which 49.4% reported a previous...
Dowling BA, Dart AJ, Hodgson DR, Smith RK.The superficial digital flexor tendon (SDFT) is an elastic structure that during maximal exercise appears to operate close to its functional limits. The biomechanical and biochemical responses to exercise, injury, and healing are still poorly understood but ongoing research is providing valuable new information which is addressed in this review. It appears that the SDFT matures early, after which time it has limited ability to adapt to stress and undergoes progressive degeneration. Focal hypocellularity, collagen fibril degeneration, selective fibril loading and alterations in the noncollageno...
Smith RK.Optimal management of tendon overuse injuries in equine and human athletes should avoid the formation of excessive scar tissue, regenerate normal tendon matrix, and reduce re-injury rates. We hypothesized that the implantation of marrow-derived stromal stem cells (BM-MSCs), in far greater numbers than are present normally within tendon tissue, would synthesize a matrix more closely resembling tendon matrix than scar tissue, and hence increase the capacity to return to performance successfully. This article reviews the technique used clinically in the horse and the current outcome data for hors...
Dahlgren LA, van der Meulen MC, Bertram JE, Starrak GS, Nixon AJ.Flexor tendinitis is a common and debilitating injury of elite and recreational athletes. Healing may be improved through intratendinous injection of insulin-like growth factor-I (IGF-I), which has been shown in vitro to stimulate mitogenesis and enhance tendon matrix production. This study investigated the effects of intratendinous injection of IGF-I on tendon healing in an equine model of flexor tendinitis. Collagenase-induced lesions were created in the tensile region of theflexor digitorum superficialis tendon of both forelimbs of eight horses. Treated tendons were injected with 2 microg r...
Guest DJ, Smith MR, Allen WR.Injury to the superficial digital flexor tendon (SDFT) is common in racing and sport horses and poor tendon regeneration leads to high reinjury rates. Autologous mesenchymal stromal cells (MSCs) are being used clinically to improve tendon regeneration but they have some practical limitations. Embryonic stem cells (ESCs) may overcome these limitations but their fate following injection into the damaged SDFT is unknown. Objective: To inject MSCs and ESCs into distinct areas of damage in the SDFT and monitor their survival over a 3 month period. Methods: MSCs and ESCs expressing different reporte...
Smith RK, Birch HL, Goodman S, Heinegård D, Goodship AE.Strain-induced tendinopathy is a common injury in both human and equine athletes, with increasing incidence associated with greater involvement in sport and an increasingly aged population. This paper reviews our studies on the abundant non-collagenous protein, cartilage oligomeric matrix protein (COMP), in equine tendons. Its variation between tendon type and site, age and exercise has provided an insight into how age and exercise influence tendon growth and maturation. Tendons can be broadly divided into two types, reflecting their different matrix composition and function: the energy-storin...
Peffers MJ, Thorpe CT, Collins JA, Eong R, Wei TK, Screen HR, Clegg PD.Energy storing tendons, such as the human Achilles and equine superficial digital flexor tendon (SDFT), are highly prone to injury, the incidence of which increases with aging. The cellular and molecular mechanisms that result in increased injury in aged tendons are not well established but are thought to result in altered matrix turnover. However, little attempt has been made to fully characterize the tendon proteome nor determine how the abundance of specific tendon proteins changes with aging and/or injury. The aim of this study was, therefore, to assess the protein profile of normal SDFTs ...
Marędziak M, Marycz K, Lewandowski D, Siudzińska A, Śmieszek A.The aim of this work study was to evaluate the cytophysiological activity of equine adipose-derived stem cells (ASCs) cultured under conditions of static magnetic field. Investigated cells were exposed to a static magnetic field (MF) with the intensity of 0.5 T. In order to investigate the effects of magnetic field on stem cell signaling, the localization and density and content of microvesicles (MVs) as well as morphology, ultrastructure, and proliferation rate of equine ASCs were evaluated. Results showed that potential of equine adipose-derived mesenchymal stem cells was accelerated when ma...
Carvalho Ade M, Badial PR, Álvarez LE, Yamada AL, Borges AS, Deffune E, Hussni CA, Garcia Alves AL.Tendon injury is a major cause of lameness and decreased performance in athletic equines. Various therapies for tendonitis have been described; however, none of these therapies results in complete tissue regeneration, and the injury recurrence rate is high even after long recovery periods involving rest and physiotherapy. Methods: A lesion was induced with collagenase gel in the superficial digital flexor tendon in the center portion of the metacarpal region of eight equines of mixed breed. After two weeks, the lesions of the animals in the treated and control groups were treated through the i...
Thorpe CT, Klemt C, Riley GP, Birch HL, Clegg PD, Screen HR.The predominant function of tendons is to position the limb during locomotion. Specific tendons also act as energy stores. Energy-storing (ES) tendons are prone to injury, the incidence of which increases with age. This is likely related to their function; ES tendons are exposed to higher strains and require a greater ability to recoil than positional tendons. The specialized properties of ES tendons are thought to be achieved through structural and compositional differences. However, little is known about structure-function relationships in tendons. This study uses fascicles from the equine s...
Taylor SE, Vaughan-Thomas A, Clements DN, Pinchbeck G, Macrory LC, Smith RK, Clegg PD.There is a paucity of data regarding molecular markers that identify the phenotype of the tendon cell. This study aims to quantify gene expression markers that distinguish between tendon fibroblasts and other mesenchymal cells which may be used to investigate tenogenesis. Methods: Expression levels for 12 genes representative of musculoskeletal tissues, including the proposed tendon progenitor marker scleraxis, relative to validated reference genes, were evaluated in matched samples of equine tendon (harvested from the superficial digital flexor tendon), cartilage and bone using quantitative P...
Richardson LE, Dudhia J, Clegg PD, Smith R.Stem cells have evoked considerable excitement in the animal-owning public because of the promise that stem cell technology could deliver tissue regeneration for injuries for which natural repair mechanisms do not deliver functional recovery and for which current therapeutic strategies have minimal effectiveness. This review focuses on the current use of stem cells within veterinary medicine, whose practitioners have used mesenchymal stem cells (MSCs), recovered from either bone marrow or adipose tissue, in clinical cases primarily to treat strain-induced tendon injury in the horse. The backgr...
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 ...
Bosch G, Moleman M, Barneveld A, van Weeren PR, van Schie HT.The repair process of tendon injuries, which are common in both human and equine athletes, is slow and the quality of the repair tissue is often inferior to the original tendon tissue, which frequently leads to re-injury. The relatively poor vascularization of tendons is considered to be one of the reasons for their limited healing potential. Recently, platelet-rich plasma (PRP), an autologous concentrate of platelets, rich in growth factors, has been shown to enhance the repair process of injured tendons. This effect has been ascribed to the high levels of growth factors in PRP, several of wh...
Watts AE, Yeager AE, Kopyov OV, Nixon AJ.Tendon injury is a common problem in athletes, with poor tissue regeneration and a high rate of re-injury. Stem cell therapy is an attractive treatment modality as it may induce tissue regeneration rather than tissue repair. Currently, there are no reports on the use of pluripotent cells in a large animal tendon model in vivo. We report the use of intra-lesional injection of male, fetal derived embryonic-like stem cells (fdESC) that express Oct-4, Nanog, SSEA4, Tra 1-60, Tra 1-81 and telomerase. Methods: Tendon injury was induced using a collagenase gel-physical defect model in the mid-metacar...
Lange-Consiglio A, Rossi D, Tassan S, Perego R, Cremonesi F, Parolini O.We have recently demonstrated that heterologous transplantation of horse amniotic membrane-derived mesenchymal cells (AMCs) can be useful for cell therapy applications in tendon diseases, and hypothesized that these cells may promote tendon repair via paracrine-acting molecules targeting inflammatory processes. To test this hypothesis, here we examined the immunomodulatory characteristics of AMCs and of their conditioned medium (AMC-CM) in vitro, and studied the potential therapeutic effect of AMC-CM in thirteen different spontaneous horse tendon and ligament injuries in vivo. Our results demo...
Abrahams M.The mechanical behaviour of horse and human tendon, as characterised by the stress-strain curve, has been examined with respect to load-strain cycling and strain rate. It was found that the tendon stress-strain curve for successive cycles was reporducible provided that strain on the specimen did not exceed 2·0–4·0%. If this strain level was exceeded, a permanent deformation occurred. This phenomenon was verified by histological studies on strained tendon which showed that some of the collagen fibres did not return to their original orientation. Variation in the rate of strain was found to ...
Dakin SG, Werling D, Hibbert A, Abayasekara DR, Young NJ, Smith RK, Dudhia J.Macrophages (Mφ) orchestrate inflammatory and reparatory processes in injured connective tissues but their role during different phases of tendon healing is not known. We investigated the contribution of different Mφ subsets in an equine model of naturally occurring tendon injury. Post mortem tissues were harvested from normal (uninjured), sub-acute (3-6 weeks post injury) and chronically injured (>3 months post injury) superficial digital flexor tendons. To determine if inflammation was present in injured tendons, Mφ sub-populations were quantified based on surface antigen expression of...
Batson EL, Paramour RJ, Smith TJ, Birch HL, Patterson-Kane JC, Goodship AE.Injury to the superficial digital flexor tendon (SDFT) is common in competition horses. The SDFT contributes to locomotory efficiency by storing energy; such tendons have low safety margins. Tendons which merely position the limb, including the opposing common digital extensor tendon (CDET), are rarely injured. The current failure of strategies to prevent or effectively treat injury to the SDFT indicates the importance of understanding how it differs from tendons which are not injury-prone. Objective: That the structural and material properties and matrix composition of the SDFT and CDET diffe...
Lange-Consiglio A, Corradetti B, Bizzaro D, Magatti M, Ressel L, Tassan S, Parolini O, Cremonesi F.The aim of this work was to isolate, for the first time, progenitor-like cells from the epithelial (AECs) and mesenchymal (AMCs) portions of the horse amniotic membrane, and to define the biological properties of these cells. AECs displayed polygonal epithelial morphology, while AMCs were fibroblast-like. Usually, six to eight passages were reached before proliferation decreased, with 13.08 and 26.5 cell population doublings attained after 31 days for AECs and AMCs, respectively. Immunocytochemical studies performed at passage 3 (P3) showed that both cell populations were positive for the expr...
Visser J, Levett PA, te Moller NC, Besems J, Boere KW, van Rijen MH, de Grauw JC, Dhert WJ, van Weeren PR, Malda J.Decellularized tissues have proven to be versatile matrices for the engineering of tissues and organs. These matrices usually consist of collagens, matrix-specific proteins, and a set of largely undefined growth factors and signaling molecules. Although several decellularized tissues have found their way to clinical applications, their use in the engineering of cartilage tissue has only been explored to a limited extent. We set out to generate hydrogels from several tissue-derived matrices, as hydrogels are the current preferred cell carriers for cartilage repair. Equine cartilage, meniscus, a...
Williams IF, McCullagh KG, Silver IA.During tissue response to injury the glycoproteins fibronectin and Type III collagen are synthesized in increased amounts. We have studied the distribution of these molecules in the healing tendon at various times after injury by comparison with that of the major constituent of normal tendon, Type I collagen. Immunofluorescent localization demonstrated the presence of fibronectin throughout the tendon within one week after injury. Staining was found in the matrix, both around capillaries and around fibroblast-like cells. Fibronectin was still apparent in the healing tendon at one month after i...
Romero A, Barrachina L, Ranera B, Remacha AR, Moreno B, de Blas I, Sanz A, Vázquez FJ, Vitoria A, Junquera C, Zaragoza P, Rodellar C.Several therapies have been investigated for equine tendinopathies, but satisfactory long term results have not been achieved consistently and a better understanding of the healing mechanism elicited by regenerative therapies is needed. The aim of this study was to assess the separate effects of autologous bone marrow (BM) and adipose tissue (AT) derived mesenchymal stem cells (MSCs), and platelet rich plasma (PRP), for treating lesions induced in the superficial digital flexor tendon (SDFT) of horses. Lesions were created surgically in both SDFTs of the forelimbs of 12 horses and were treated...
Caliari SR, Harley BA.Biomolecular environments encountered in vivo are complex and dynamic, with combinations of biomolecules presented in both freely diffusible (liquid-phase) and sequestered (bound to the extracellular matrix) states. Strategies for integrating multiple biomolecular signals into a biomimetic scaffold provide a platform to simultaneously control multiple cell activities, such as motility, proliferation, phenotype, and regenerative potential. Here we describe an investigation elucidating the influence of the dose and mode of presentation (soluble, sequestered) of five biomolecules (stromal cell-de...
Thorpe CT, Chaudhry S, Lei II, Varone A, Riley GP, Birch HL, Clegg PD, Screen HR.Tendon injury is thought to involve both damage accumulation within the matrix and an accompanying cell response. While several studies have characterized cell and matrix response in chronically injured tendons, few have assessed the initial response of tendon to overload-induced damage. In this study, we assessed cell response to cyclic loading. Fascicle bundles from the equine superficial digital flexor tendon were exposed to cyclic loading in vitro, designed to mimic a bout of high-intensity exercise. Changes in cell morphology and protein-level alterations in markers of matrix inflammation...
McGuigan MP, Wilson AM.A horse's legs are compressed during the stance phase, storing and then returning elastic strain energy in spring-like muscle-tendon units. The arrangement of the muscle-tendon units around the lever-like joints means that as the leg shortens the muscle-tendon units are stretched. The forelimb anatomy means that the leg can be conceptually divided into two springs: the proximal spring, from the scapula to the elbow, and the distal spring, from the elbow to the foot. In this paper we report the results of a series of experiments testing the hypothesis that there is minimal scope for muscle cont...
Crovace A, Lacitignola L, Rossi G, Francioso E.The aim of this study was to compare treatment with cultured bone marrow stromal cells (cBMSCs), bone marrow Mononucleated Cells (BMMNCs), and placebo to repair collagenase-induced tendinitis in horses. In six adult Standardbred horses, 4000 IU of collagenase were injected in the superficial digital flexor tendon (SDFT). Three weeks after collagenase treatment, an average of either 5.5 x 10(6) cBMSCs or 1.2 x 10(8) BMMNCs, fibrin glue, and saline solution was injected intralesionally in random order. In cBMSC- and BMMNCS-treated tendons, a high expression of cartilage oligomeric matrix protein...
Birch HL, Bailey AJ, Goodship AE.Injuries to the superficial digital flexor tendon are common in horses required to gallop and jump at speed. Partial rupture of this tendon usually occurs in the central core of the midmetacarpal region and may be preceded by localised degenerative changes. Post mortem examination of apparently normal equine flexor tendons has revealed an abnormal macroscopic appearance in the central core, characterised by a reddish discolouration. We have previously shown that there is also physical damage to the collagen fibres. In the present study we tested the hypothesis that the abnormal appearance is a...
Watts AE, Millar NL, Platt J, Kitson SM, Akbar M, Rech R, Griffin J, Pool R, Hughes T, McInnes IB, Gilchrist DS.Tendon injuries (tendinopathies) are common in human and equine athletes and characterized by dysregulated collagen matrix, resulting in tendon damage. We have previously demonstrated a functional role for microRNA29a (miR29a) as a post-transcriptional regulator of collagen 3 expression in murine and human tendon injury. Given the translational potential, we designed a randomized, blinded trial to evaluate the potential of a miR29a replacement therapy as a therapeutic option to treat tendinopathy in an equine model that closely mimics human disease. Tendon injury was induced in the superficial...
Brossi PM, Moreira JJ, Machado TS, Baccarin RY.This systematic review aimed to present and critically appraise the available information on the efficacy of platelet rich plasma (PRP) in equine and human orthopedic therapeutics and to verify the influence of study design and methodology on the assumption of PRP's efficacy. We searched Medline, PubMed, Embase, Bireme and Google Scholar without restrictions until July 2013. Randomized trials, human cohort clinical studies or case series with a control group on the use of PRP in tendons, ligaments or articular lesions were included. Equine clinical studies on the same topics were included inde...
Ricco S, Renzi S, Del Bue M, Conti V, Merli E, Ramoni R, Lucarelli E, Gnudi G, Ferrari M, Grolli S.Overstrain tendonitis are common pathologies in the sport horses. Therapeutic approaches to tendon healing do not always result in a satisfactory anatomical and functional repair, and healed tendon is often characterized by functional impairment and high risk of reinjury. Recently, mesenchymal stem cells (MSCs) and platelet rich plasma (PRP) have been proposed as novel therapeutic treatments to improve the tendon repair process. MSCs are multipotent, easy to culture and being originated from adult donors do not pose ethical issues. To date, autologous MSCs have been investigated mainly in the ...
