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.
Fraser BS, Bladon BM.Lacerations to the digital flexor tendon sheath (DFTS) are a common injury in the horse, but little information is available in the literature regarding prognostic indicators. Objective: To ascertain whether laceration of the DFTS carried a better prognosis if treated by tenoscopic lavage, debridement and repair within 36 h of the original injury. Methods: A retrospective analysis of 39 horses treated surgically for lacerations to the DFTS was performed over a 3 year period. The injury-to-surgery interval was recorded as <36 or >36 h. The structures damaged by the injury were also recorded, as...
Watanabe T, Hosaka Y, Yamamoto E, Ueda H, Tangkawattana P, Takehana K.The Golgi tendon organ (GTO) is an encapsulated fusiform mechanoreceptor siding in the musculo-tendinous junction of many animal species. Inhibitory function of afferent nerve fibers distributed from nearby motor units, the organ responds to active tension exerted onto the muscle. The morphological features of the equine GTO have not yet been elucidated. Additionally, there is some controversy regarding to the existence of the GTO in the equine superficial digital flexor tendon (SDFT). Therefore, immunohistochemistry and immunoelectron microscopy using alcian blue (pH 2.5) staining and the sil...
Kidd JA, Voute LC, Hewetson M.A 12-year-old hunter gelding became severely lame as a result of a laceration to the sheath of the digital flexor tendons of its left hindlimb, but there was no apparent damage to the tendons. The injury became chronically infected with Pseudomonas and Streptococcus species and Escherichia coli which did not respond to antibiotic treatment, and the horse remained lame. A postmortem examination revealed that the tendons had ruptured.
Busoni V, Snaps F, Trenteseaux J, Dondelinger RF.The purpose of this study was to describe the normal magnetic resonance (MR) imaging characteristics of the palmar structures of the equine podotrochlear apparatus by means of retrospective evaluation of MR imaging studies of 16 cadaver limbs. The articular aspect of the distal sesamoid bone was not evaluated in this study. Equine digits were imaged with a human knee radiofrequency coil in a 1.5 T magnetic field, using spin echo (SE) T1-weighted, turbo spin echo proton density (TSE PD)-weighted with and without fat saturation (FS), and FS TSE T2-weighted sequences. The limbs were dissected aft...
Yoon JH, Brooks RL, Khan A, Pan H, Bryan J, Zhang J, Budsberg SC, Mueller PO, Halper J.Fluoroquinolone antibiotics have been used widely in humans and domestic animals, including horses, because of their broad-spectrum bactericidal activity, and relative safety. The use of fluoroquinolones, however, is not without risk. Tendonitis and spontaneous tendon rupture have been reported in people during or following therapy with fluoroquinolones. We have studied the effects of enrofloxacin, a fluoroquinolone antibiotic used commonly in domestic animals, on tendon cell cultures established from equine superficial digital flexor tendons. Effects on cell proliferation and morphology were ...
Arnoczky SP, Lavagnino M, Gardner KL, Tian T, Vaupel ZM, Stick JA.To determine the effects of oxytetracycline on matrix metalloproteinase-1 (MMP-1) mRNA expression and collagen gel contraction by equine myofibroblasts in an effort to explain the mechanistic basis for the pharmacologic treatment of flexural deformities in foals. Methods: Cultured myofibroblasts from the accessory ligament (distal check ligament) of 6 foals. Methods: Collagen gel scaffolds seeded with equine myofibroblasts were cultured in individual culture dishes containing complete media (Dulbecco's modified Eagle medium with 10% fetal bovine serum) and oxytetracycline (0, 12.5, 25, or 75 m...
Crowson CL, Jann HW, Stein LE, Claypool LP, Moll HD, Blaik MA.To compare effects of the locking-loop suture pattern (LLP) and 3-loop pulley (3LP) suture pattern for tenorrhaphy on the intrinsic vasculature of the superficial digital flexor tendon (SDFT) of horses in vitro after surgery. Methods: 16 forelimbs obtained from 8 mature horses. Methods: Tenotomy and subsequent tenorrhaphy was performed in anesthetized horses. Following systemic administration of heparin, horses were euthanatized and the limbs were removed and placed under tension to load the flexor tendons. The intrinsic vasculature was then perfused with a mixture of barium sulfate and water....
Swanstrom MD, Stover SM, Hubbard M, Hawkins DA.To determine the relative contributions of the muscles, tendons, and accessory ligaments to the passive force-length properties of the superficial (SDF) and deep digital flexor (DDF) myotendinous complexes. Methods: 8 cadaveric forelimbs from 6 adult Thoroughbreds. Methods: In vitro, limb configurations during slack position and myotendinous lengths during subsequent axial loading of forelimbs were recorded before and after transection of accessory ligaments. Expressions were derived to describe the force-length behavior of each muscle, tendon, and accessory ligament-tendon unit; linear stiffn...
Garcia T, Hornof WJ, Insana MF.The strong dependence of tendon echogenicity on insonation angle is explored by analyzing echo spectra. Combining echo spectra with high-resolution images from several modalities reveals that fluid spaces surrounding fascicles and bundles are likely sources of ultrasonic scatter. Mathematical models of tendon structure are proposed to explain how the anisotropic microstructure of tendon gives rise to angle-dependent echogenicity. Echo spectra from spontaneously damaged equine tendon samples were compared with normal equine tendon and found to exhibit a dramatic decrease in anisotropic properti...
Pinchbeck GL, Clegg PD, Proudman CJ, Stirk A, Morgan KL, French NP.A prospective cohort study was conducted on horses starting in hurdle and steeplechase races on six UK racecourses in 2000 and 2001. Trainers or carers were questioned on the horses' pre-race routine and observational data were collected in the stables and parade ring. Some practices were common to many starters, such as withholding food and water before racing whereas other practices, such as schooling frequency, were more variable. There was a total of 2879 starts and a total of 83 injuries or medical events (28.8/1000 starts). The commonest types of injury were tendon/suspensory injuries an...
The Journal of physiologyOctober 24, 2003
Volume 554, Issue Pt 3 791-801 doi: 10.1113/jphysiol.2003.054809
Kostyuk O, Birch HL, Mudera V, Brown RA.This study aimed to investigate the preferential collagen fibril alignment in unloaded and loaded tendons using elastic scattering spectroscopy. The device consisted of an optical probe, a pulsed light source (320-860 nm), a spectrometer and a PC. Two probes with either 2.75 mm or 300 microm source-detector separations were used to monitor deep and superficial layers, respectively. Equine superficial digital flexor tendons were subjected to ex vivo progressive tensional loading. Seven times more backscattered light was detected parallel rather than perpendicular to the tendon axis with the 2.7...
Jann H, Blaik M, Emerson R, Tomioka M, Stein L, Moll D.To describe the healing characteristics of deep digital flexor tenorrhaphy within the digital sheath. Methods: Experimental study. Methods: Five mature horses. Methods: Right thoracic limb, deep digital flexor tenorrhaphy was performed within the digital sheath. Limbs were cast in partial flexion using a short limb cast for 6 weeks. Next, extended heel shoes were used for limb support for 14 weeks. Healing was evaluated by sequential ultrasonographic examinations, and limb use was evaluated by force plate analysis. At 26 weeks, mechanical strength and morphologic characteristics of the repair ...
Brown NA, Kawcak CE, McIlwraith CW, Pandy MG.Articular injuries in athletic horses are associated with large forces from ground impact and from muscular contraction. To accurately and noninvasively predict muscle and joint contact forces, a detailed model of musculoskeletal geometry and muscle architecture is required. Moreover, muscle architectural data can increase our understanding of the relationship between muscle structure and function in the equine distal forelimb. Muscle architectural data were collected from seven limbs obtained from five thoroughbred and thoroughbred-cross horses. Muscle belly rest length, tendon rest length, m...
Brown NA, Pandy MG, Kawcak CE, McIlwraith CW.A detailed musculoskeletal model of the distal equine forelimb was developed to study the influence of musculoskeletal geometry (i.e. muscle paths) and muscle physiology (i.e. force-length properties) on the force- and moment-generating capacities of muscles crossing the carpal and metacarpophalangeal joints. The distal forelimb skeleton was represented as a five degree-of-freedom kinematic linkage comprised of eight bones (humerus, radius and ulna combined, proximal carpus, distal carpus, metacarpus, proximal phalanx, intermediate phalanx and distal phalanx) and seven joints (elbow, radiocarp...
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...
Wilderjans H, Boussauw B, Madder K, Simon O.Inflammation of the digital flexor tendon sheaths is a chronic and nebulous condition often unresponsive to medical and surgical treatment. Objective: To evaluate the incidence of longitudinal tears (LT) as the underlying cause of chronic tenosynovitis and annular ligament constriction syndrome (ALCS) in warmblood horses. Methods: The records of 25 horses with chronic tenosynovitis and ALCS in which tenoscopical inspection of the digital flexor tendon sheath (DFTS) was performed between 1999-2000 were reviewed. Of 25 horses, 17 were diagnosed with an LT in the deep digital flexor tendon (DDFT)...
Brown NA, Pandy MG, Buford WL, Kawcak CE, McIlwraith CW.To determine whether muscle moment arms at the carpal and metacarpophalangeal joints can be modeled as fixed-radius pulleys for the range of motion associated with the stance phase of the gait in equine forelimbs. Methods: 4 cadaveric forelimbs from 2 healthy Thoroughbreds. Methods: Thin wire cables were sutured at the musculotendinous junction of 9 forelimb muscles. The cables passed through eyelets at each muscle's origin, wrapped around single-turn potentiometers, and were loaded. Tendon excursions, measured as the changes in lengths of the cables, were recorded during manual rotation of th...
van Schie HT, Bakker EM, Jonker AM, van Weeren PR.To describe a method of computerized ultrasonographic tissue characterization that includes structures below the size limits of resolution in equine superficial digital flexor tendons. Methods: 2 damaged and 2 structurally normal superficial digital flexor tendons. Methods: Transverse ultrasonographic images were collected along the tendon long axis. Stability of echo pattern was quantified by means of variation in gray levels of each pixel in contiguous images and expressed as correlation, entropy, and waviness ratios. Results: Normal young and normal old tissues were characterized by high co...
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...
Kohama M, Nio J, Hashimoto Y, Iwanaga T.The intimal lining cells of the synovium in joints have been studied morphologically and histochemically and shown to consist of macrophagic cells (type A) and fibroblast-like cells (type B). It is believed that the structure of the synovium in the tendon sheath is similar to that in the joint, but there have been only a few morphological studies of the tendon sheath. The present study revealed the cellular architecture of synovium in the tendon sheath of horses by histochemistry and scanning electron microscopy (SEM). Like the joint, the inner surface of the tendon sheath was covered with a c...
Zekas LJ, Forrest LJ.The purpose of this study was to describe ultrasonographic changes of the equine palmar metacarpal area attributed to the infiltration of local anesthetic solution and to determine whether these changes were noted immediately or at 24 h. The palmar metacarpal region of one forelimb in each of six horses was examined ultrasonographically with a 10-MHz linear array transducer and a 7.5-MHz curvilinear transducer. Transverse and longitudinal images were recorded at 5-cm intervals distal to the accessory carpal bone. High and low palmar and palmar metacarpal nerve blocks were performed with a 2% m...
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...
Smith RK, McGuigan MP, Hyde JT, Daly AS, Pardoe CH, Lock AN, Wilson AM.Metacarpophalangeal (MCP) joint extension is primarily resisted by the digital flexor tendons and suspensory ligament. A variety of external support techniques are used to protect these supporting structures from or after injury by resisting MCP joint extension, although not all are effective and/or practical for use in an exercising horse. In this study, 7 forelimbs were loaded in vitro to determine the effect of a simple gamgee bandage, a 3-layered bandage with and without a contoured palmar splint, a neoprene exercise boot, and an innovative carbon fibre composite exercise boot (Dalmar tend...
Hosaka Y, Kirisawa R, Yamamoto E, Ueda H, Iwai H, Takehana K.Although inflammatory activation of cytokines have been analyzed in various tissues, there have only been a few and as-yet-inconclusive studies on cytokines in equine tendons. In this study, the localizations of 4 cytokines (IL-1alpha, IL-1beta, TNFalpha and IFNgamma) in tendinocytes of the equine superficial digital flexor tendon (SDFT) were analyzed by the use of an immunohistochemical method. In inflamed tendons positive staining for all 4 cytokines antibodies were detected in endotedinieum cells and vascular epithelial cells. In contrast, negative or trace immunoreactions were obtained in ...
Birch HL, Smith TJ, Poulton C, Peiffer D, Goodship AE.Partial rupture occurs most often to the superficial digital flexor tendon (SDFT) of the forelimb at the mid-metacarpal level. In this study, we tested the hypothesis that the mid-metacarpal region of the SDFT has the smallest cross sectional area (CSA) and a similar collagen content to other regions and, therefore, represents a weak point in the tendon. The SDFT was collected from the forelimbs of 9 horses. Each tendon was marked at 7 different levels from the origin of the accessory ligament to the phalangeal region. The CSA, water content and collagen content was measured at each level. The...
Takahashi T, Kai M, Hada T, Eto D, Muka K, Ishida N.It has been reported that a small decrease in the strain in the superficial digital flexor tendon (SDFT) occurs if the toe is raised during walking. Although walking on a slope appears similar to raising the toe, it is unclear whether uphill exercise decreases the strain in the SDFT. Because the force or strain on tendons is one of the important factors leading to tendon stress injury, we hypothesised that reducing the force in the SDFT during exercise may prevent tendinitis. The purpose of this study was to determine the effects of treadmill inclination on the force in the SDFT in the walking...
Dow SM, Wilson AM, Goodship AE.Horses with acute injuries of the superficial digital flexor tendon were treated with a course of seven intramuscular injections of 500 mg of polysulphated glycosaminoglycan at four-day intervals. Clinical assessments of the lesions were made by a veterinary surgeon at the time of each injection and 14 and 28 days after the last injection. A total of 150 courses of the drug were administered and adequately completed assessment forms were returned for 80 cases. Long-term follow-up data were obtained for 19 cases. The subjective assessments by the veterinary surgeons showed that in 80 per cent o...
Jann HW, Good JK, Morgan SJ, Berry A.Healing of transected superficial digital flexor tendons was evaluated mechanically and histologically in eight horses. Tendons sutured with polyglyconate had higher loads at failure than nonsutured tendons at weeks 5 and 9. The tendon stress at failure (force per unit area) was higher in the sutured tendons at week 5 but not at week 9, reflecting the increased size of the scar at week 9. Histologically, scars after tenorrhaphy were consistently more mature than nonsutured tenotomy scars. The mean maturity score for sutured tendons was higher than for nonsutured tendons at weeks 5 and 9. Overa...
Adams SB, Fessler JF, Thacker HL.FIBROMAS arise from connective tissue and occur in all domestic animals (Smith, Jones and Hunt 1972; Stannard and Pulley 1978). They are most frequently noted in the dermis or subcutis, but may be present wherever connective tissue occurs. In the dermis and subcutis of the horse fibromas are grossly similar to sarcoids and may be difficult to differentiate (Baker and Leyland 1975). Fibromas have been described as tumours of the tendon sheath or tendon proper in man (Flynn 1975), but have not been described in this location in the horse.
Bowker RM, Linder K, Sonea IM, Holland RE.The sensory innervation of the navicular bone (os sesamoideum distale) and its suspensory ligaments [ligamenta sesamoidea collateralia (CSL) and ligamentum sesamoideum distale impar or distal sesamoidean impar (DS-impar) ligament] and the navicular bursa (podotrochlearis) was examined in the neonatal foal using immunocytochemistry. With antisera raised to substance P (SP) and human calcitonin gene-related peptide (CGRP), immunoreactive nerves were demonstrated to innervate the CSL and navicular bursa. Within CSL, and SP- and CGRP-like nerves were present in the synovial lining of the navicular...
Léveillé R, Lindsay WA, Biller DS.Ultrasonography was a valuable diagnostic tool for examination of a ruptured peroneus tertius in a horse, because it allowed visualization of the extent of the injury and evaluation of healing prior to return of the horse to athletic activity.
Lyons ET, Tolliver SC, Drudge JH, Swerczek TW, Crowe MW.Examination of the ligamentum nuchae for Onchocerca spp was completed in 523 Thoroughbreds (1 to 29 years old) at necropsy in Kentucky during a 13-month period (1984 to 1985). Onchocerca spp were found in 306 (59%) of the horses. Frequencies of this parasite were 3%, 17%, 40%, 43%, and 42% in 1-, 2-, 3-, 4-, and 5-year-old horses, respectively. For 6- to 29-year-old horses, frequency varied from 71% to 100%, except for 26-year-old horses (50%); 87% of the 304 horses examined in the 6- to 29-year-old age groups was infected. The suspensory ligaments and flexor tendons from fetlocks (thoracic li...
Taylor DS, Pascoe JR, Meagher DM, Honnas CM.The medical records of 50 horses examined because of lacerations of the tendon of the superficial or deep digital flexor muscle were reviewed to determine whether any injury or treatment factors could be associated with outcome. Median age of horses treated was 4.5 years (range, 1.5 years to 15 years), and the median follow-up time was 5 years (range, 1.5 to 16 years) after injury. Horses were considered to have survived if they were alive more than 1 year after injury. Twelve of 16 horses that had 1 or the other tendon transected survived; 13 of 16 horses that had both tendons transected surv...
Verschooten F, Gasthuys F, De Moor A.An experimental and clinical study to investigate the aetiology of distal splint bone fractures is described. In vitro, extension of the fetlock did not appear to alter the position of the distal ends of the splint bones, although tension in the interosseous tendons increased. Flexion of the fetlock resulted in slight outward displacement of the distal ends of the splint bones. It is suggested that concurrent desmitis of the suspensory ligament can cause movement of the ends of the splint bones thus predisposing to a fatigue fracture. In a clinical study of 87 horses, 114 splint bone fractures...
McDiarmid A.Five cases of acquired flexural deformity of the metacarpophalangeal joint (MCPJ) in older horses and ponies were studied. The mean age of affected horses was 14-8 years. Four deformities developed following desmitis of the accessory ligament of the deep digital flexor tendon (ALDDFT) and superficial digital flexor tendon (SDFT) and one following tendonitis of the SDFT alone. All cases were markedly lame and demonstrated variable degrees of flexural deformity. Ultrasonographic examination was performed on all cases which revealed extensive adhesion formation between the ALDDFT and SDFT and red...
Mizobe F, Okada J, Shinzaki Y, Nomura M, Kato T, Yamada K, Spriet M.Desmitis of the oblique distal sesamoidean ligaments (ODSL) is caused by hyperextension of the metacarpophalangeal/metatarsophalangeal joint and has been described as a significant cause of lameness in racehorses. In this study, three Thoroughbred racehorses (age range: 3-6 years) were diagnosed with desmitis of the forelimb ODSL using standing low-field magnetic resonance imaging (sMRI). Radiography and ultrasonography were inconclusive with regard to a definitive diagnosis. For all horses, the sMRI characteristics included increased signal intensity within the medial ODSL on T1-weighted grad...
Watts AE, Nixon AJ, Reesink HL, Cheetham J, Fubini SL, Looney AL.To investigate the efficacy and safety of a low-volume, single-catheter, continuous peripheral neural blockade (CPNB) technique to locally deliver bupivacaine to alleviate signs of severe forelimb pain resulting from experimentally induced tendonitis in horses. Methods: Randomized controlled experimental trial. Methods: 14 horses and 5 forelimbs from equine cadavers. Methods: Horses underwent collagenase-induced superficial digital flexor tendonitis in the midmetacarpal region of 1 forelimb. To deliver analgesia, a closed-tip catheter was placed from lateral to medial, approximately 12 cm dist...