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.
Patterson-Kane JC, Parry DA, Birch HL, Goodship AE, Firth EC.The superficial digital flexor tendon is the most commonly injured tendon in the racing Thoroughbred. Despite the clinical significance of this structure, only limited data exist regarding normal age-related morphology of the tensile units, the collagen fibrils. The age at which these collagen fibrils become mature in composition and structure may be of importance. Consequently, the association of age and collagen fibril crosslink composition, diameter distribution and crimp morphology in the superficial and deep digital flexor tendons of Thoroughbreds up to and including three years of age ha...
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...
Crevier N, Pourcelot P, Denoix JM, Geiger D, Bortolussi C, Ribot X, Sanaa M.To determine the local variations of mechanical properties of the equine superficial digital flexor tendon (SDFT). Methods: 10 SDFT of adult horses, selected for absence of abnormality. Methods: Needles (with a dark marker at both ends) pinned perpendicularly through each tendon to delimit 7 segments. Each tendon was tested in traction until rupture; test was filmed, using an 8-mm video camera. For each image, the coordinates of the center of mass of each marker and the corresponding force were registered. The third-degree polynomial that best fits the stress-strain curve thus obtained was cal...
Riley CB, Archer FJ, Bailey JV.To compare the effects of different commercial nutrient media and sera on protein synthesis and maintenance of cellular density in cultures of the equine superficial digital flexor tendon (SDFT). Methods: 8 healthy 2- to 4-year-old horses. Methods: First Dulbecco's modified Eagle's medium, Ham's F12 nutrient mixture, RPMI 1640 medium, minimum essential medium with Earle's salts, minimum essential medium with Hanks' salts, and a Dulbecco's modified Eagle's medium/Ham's F12 nutrient mixture with 10% fetal bovine serum (FBS) were compared. Then FBS, fetal equine serum, and donor horse serum, each...
Valdés-Vázquez MA, McClure JR, Oliver JL, Ramirez S, Seahorn TL, Haynes PF.A sutured tenorrhaphy technique that incorporated an autologous tendon graft was compared mechanically and histologically with a sutured tenorrhaphy at 6, 12, and 24 weeks after repair. Tenorrhaphy was performed in the forelimb tendon of the deep digital flexor muscle and the graft was taken from the hindlimb tendon of the lateral digital extensor muscle; one forelimb site included the graft, whereas the other forelimb site was not grafted. Tenotomies were made immediately proximal to the insertion of the accessory ligament into the tendon of the deep digital flexor muscle. Grafted and nongraf...
Miles CA.Ultrasound velocity, attenuation, and backscattering were measured in vitro in samples of equine digital flexor tendon sandwiched between plane, parallel rexolite buffer rods. The buffer rods were coupled to transmitting and receiving transducers (nominally 10 MHz) mounted in-line and facing one another on the jaws of a digital caliper. Six superficial digital flexor (SDF) tendons and six deep digital flexor (DDF) tendons were measured in three orthogonal directions: along the long axis of the tendon (D), and across the tendon in the dorsal-volar (C), and lateral (L) directions. Substantial an...
Riemersma DJ, van den Bogert AJ, Jansen MO, Schamhardt HC.Strains in the tendons of the m. flexor digitalis superficialis (superficial digital flexor, SDFT) and m. flexor digitalis profundus (deep digital flexor, DDFT) tendons, the accessory ligament of the deep digital flexor muscle (inferior check ligament, ICL) and the m. interosseus medius (suspensory ligament, SL) of 5 ponies were recorded at the walk and trot using mercury-in-silastic strain gauges (MISS), on a hard surface (brick pavement) and on sand. The horses were shod with normal, flat shoes. On pavement, strain in the SDFT, DDFT and SL increased significantly from the walk (2.19%, 1.15% ...
Riemersma DJ, van den Bogert AJ, Jansen MO, Schamhardt HC.Strains in the superficial digital flexor tendon (SDFT), deep digital flexor tendon (DDFT), accessory ligament of the deep digital flexor muscle (inferior check ligament [ICL]) and the interosseus medius muscle (suspensory ligament [SL]) in the right forelimb of 5 ponies were measured using mercury-in-silastic strain gauges a few hours after implantation. Tendon strains were recorded at the walk with normal flat shoes, egg-bar shoes, a 7 degrees increased hoof angle accomplished by application of a heel-wedge and a 7 degrees decreased hoof angle using a toe-wedge, consecutively. Ground reactio...
Buchner HH, Savelberg HH, Becker CK.An analysis of joint moments was used to study the biomechanical implications, load redistribution and kinematic pattern following desmotomy of the accessory ligament of the deep digital flexor tendon (AL) in adult horses. Recordings of 6 sound horses were made before and 10 days after desmotomy of the AL of the right forelimb at the walk and the trot. Kinematic recordings of the right forelimb and the left distal forelimb were made using the CODA-3 system. Kinetic recordings of the ground reaction forces in both forelimbs were made using a Kistler force plate simultaneously with the kinematic...
Miles CA, Fursey GA, Birch HL, Young RD.The velocity, attenuation and apparent backscattering coefficient of 6-11-MHz ultrasound were measured in three orthogonal directions in equine deep digital flexor (DDF) and superficial digital flexor (SDF) tendons at 0 degree C. Ultrasonic measurements were examined for correlation with tendon water, collagen, DNA and glycosaminoglycans contents, determined by chemical analyses and with structure observed by scanning electron microscopy. The SDF tendon contained more water, more DNA (i.e., more cells), less collagen and less glycosaminoglycans and exhibited lower velocities and attenuations t...
Matthews GL, Keegan KG, Graham HL.To determine effects of tendon grip technique on in vitro surface strain measurements of equine deep digital flexor tendon (DDFT) when loaded in tension. Methods: 12 hind limb DDFT from 8 adult horses (mean age, 9.8 years [range, 4.5 to 17 years]; mean body weight, 472 kg [range, 450 to 509 kg]), with no clinical evidence of hind limb lameness. Methods: After calibration, liquid mercury strain gauges were sutured to plantar surfaces of the tendons at distal (position 1), middle (position 2), and proximal (position 3) metatarsal regions. Each tendon was affixed to a materials testing machine (d...
Davankar SP, Deane NJ, Davies AS, Firth EC, Hodge H, Parry DA.Since horses bred for the racing industry are subject to rigorous training procedures there is a real need to understand how the stresses experienced by their tendons and ligaments in vivo relate to the major load-bearing elements-the collagen fibrils. Consequently, an age-related study has been made of the collagen fibril diameter distributions of nine ligaments in and around the equine carpus. This is the first stage of a larger study aimed at understanding the ultrastructural changes that occur as a result of exercise. Most of the ligaments showed a bimodal diameter distribution at maturity...
Keg PR, Schamhardt HC, van Weeren PR, Barneveld A.Controversy exists with respect to the innervation of the suspensory ligament (SL) in the fore limb of the horse. It is uncertain whether this structure is exclusively innervated by branches of the ulnar nerve or also to some extent by median nerve branches. Ground Reaction Forces (GRF) were determined in horses before and after the induction of a tendonitis in the lateral branch of the SL by the injection of collagenase, and before and after a high palmar and an ulnar block respectively. The high palmar block succeeded in bringing all GRF variables back to their original values which the ulna...
Denoix JM, Jacot S, Bousseau B, Perrot P.This paper describes normal ultrasound images of the soft tissues of the dorsal and abaxial aspects of the equine fetlock. The palmar aspect of the fetlock is not discussed because it is related to the suspensory apparatus and flexor tendon anatomy which has been previously described. Ultrasound scanning was performed with 7.5 MHz linear or 10 MHz sector probes and recorded on 7.5 cm U-matic videocassettes allowing further retrospective data analysis, computer manipulation and good image reproducibility. Sagittal, parasagittal, frontal and transverse ultrasound scans of 13 lameness free mature...
Gibson KT, Burbidge HM.Three horses were presented for treatment of chronic infections of the digital flexor tendon sheath. Clinical signs included severe lameness, and heat, pain and swelling of the digital flexor tendon sheath. The horses were treated with surgical lavage of the tendon sheath, systemic and local antibiotics, and analgesics. In each case, resolution of the lameness occurred over weeks to months. Only one horse returned to athletic activity, while the other two became comfortable at pasture. Response to treatment in cases of chronic tenosynovitis may not be as rapid or complete as that reported for ...
Back W, Schamhardt HC, Hartman W, Barneveld A.In literature, it has been hypothesized that the concussion at impact in the equine forelimb is larger than that in the hind limb, and therefore, eventually more clinical lameness may develop in the distal portion of the forelimbs. As the functional anatomy of the distal forelimb and hind limb segments is similar, a study was undertaken to compare the kinematics of hoof and fetlock in the forelimbs and hind limbs. For this purpose, the trot of 24 clinically normal (sound) horses on a treadmill (4 m/s) was recorded, using modern gait analysis equipment. It appeared that vertical hoof velocity a...
Gillis C, Sharkey N, Stover SM, Pool RR, Meagher DM, Willits N.Results of studies in human beings and other species have indicated that aging significantly influences the strength, modulus of elasticity, and energy storage ability of tendon. We wanted to determine the effects of aging on the material and ultrasonographic properties of equine superficial digital flexor (SDF) tendon. Ultrasonographic measurements of left forelimb SDF tendon cross-sectional area and mean echogenicity were made in 23 standing horses ranging in age from 2 to 23 years. All horses had not been in work for a minimum of 6 months prior to the study. After euthanasia, left forelimb ...
Gillis C, Meagher DM, Cloninger A, Locatelli L, Willits N.Fifty Thoroughbred horses were examined. All horses had been in race training for a minimum of 4 months before examination and had worked at racing speed; 24 horses had raced. All horses were clinically sound at the time of examination. Ultrasonography was performed, using a 7.5-MHz transducer with built-in fluid offset. Videotaped images of the palmar soft tissue structures were obtained at 4, 8, 12, 16, 20 and 24 cm distal to the base of the accessory carpal bone (DACB). Images were digitized, and each image was calibrated. Values for cross-sectional area (CSA) and mean echogenicity (ME) wer...
Gillis C, Sharkey N, Stover SM, Pool RR, Meagher DM, Willits N.Ultrasonographic cross sectional area (CSA) measurements of equine superficial digital flexor (SDF) tendon were obtained to determine the feasibility of ultrasonography for CSA measurement of tendon in vivo and in vitro. Ultrasonographic measurements were compared with a more traditional CSA measurement method, ink-blot analysis. In addition, values for ultrasonographic SDF tendon mean echogenicity were obtained in vivo and in vitro. The left forelimb SDF tendons of 23 horses were evaluated ultrasonographically. Cross sectional images were acquired at 4-cm intervals distal to the base of the a...
Barr AR, Dyson SJ, Barr FJ, O'Brien JK.Twenty-four horses with ultrasonographic evidence of tendonitis of the deep digital flexor tendon in the metacarpal/metatarsal region were seen over a 7 year period. Most horses had mild to moderate lameness and distension of the digital flexor tendon sheath in the affected limb. Intrasynovial analgesia of the digital flexor tendon sheath consistently improved the degree of lameness. Ultrasonography most commonly revealed small, distinct, often circular, focal hypoechoic areas within the deep digital flexor tendon which usually extended less than 1 cm proximodistally. The degree of lameness an...
Dik KJ, Dyson SJ, Vail TB.The anatomy of the digital flexor tendon sheath and related tendons and ligaments is described. Diagnosis and management of acute tenosynovitis and long-term tenosynovitis and associated tendon injuries are discussed, as well as the syndrome of stenosis of the fetlock canal (or fetlock annular ligament constriction) and palmar annular ligament constriction. Desmitis of the palmar annular ligament is also described.
Dyson SJ, Denoix JM.The palmar (plantar) aspect of the pastern is an anatomically complex area and an understanding of this is a prerequisite for accurate diagnosis of injuries in this area. The gross and normal ultrasonographic anatomy are described, and injuries of the superficial and deep digital flexor tendons and the digital flexor tendon sheath, the distal sesamoidean ligaments, and the palmar ligaments of the proximal interphalangeal joint are discussed.
Dyson SJ, Dik KJ.The use of diagnostic ultrasonography has greatly enhances our ability to diagnose injuries of tendons and tendon sheaths that were previously either unrecognized or poorly understood. For may of these injuries, there is currently only a small amount of follow-up data. This article considers injuries of the deep digital flexor tendon and its accessory ligament, the carpal tunnel syndrome soft tissue swellings on the dorsal aspect of the carpus, intertubercular (bicipital) bursitis and bicipital tendinitis, injuries of the gastrocnemius tendon, common calcaneal tendinitis, rupture of peroneus (...
Dik KJ, Leitch M.Contrast radiography provides a clear survey of the size, shape, and location of extratendovaginal fluid-filled cavities, distended bursa, and tendon sheaths and demonstrates intersynovial communication. Ultrasonography effectively demonstrates Achilles tendon injury, slippage of the SDFT off the summit of the calcaneus, assorted ligamentous injuries, and cystic or solid extratendovaginal masses. It will also demonstrate distended bursae and tendon sheaths, but it is not as effective in demonstrating a synovial herniation, or a narrow synovial fistula. Contrast radiography may prove to be the ...
Breit S, König HE.20 extremities of horses were used to investigate the synovial membrane of the distal interphalangeal joint and the navicular bursa. From each extremity five specimens were taken from the distal interphalangeal joint capsule, two further from the navicular bursa. Synovial villi were found near the articular cartilage as well as everywhere where the joint capsule did not form a tight periostal cover or was not connected with ligaments or tendons. Some lay between the articular surfaces of the phalanx media and phalanx distalis. Besides synovial villi and synovial folds "trabecular-like" cords o...
Kraus BL, Kirker-Head CA, Kraus KH, Jakowski RM, Steckel RR.The vascular and microvascular anatomy of the equine deep digital flexor tendon (DDFT) within the digital sheath was studied by injecting the vasculature with either colored latex or barium sulphate for radiographic, microangiographic, histologic, and computed tomographic (CT) evaluation. Consecutive 4-mm thick two-dimensional CT slice data were reconstructed to 3-dimensional volumetric images to enhance spatial evaluation of the blood supply. Gross dissection and angiographic studies identified three major vascular sources. Above the fetlock, the DDFT was supplied by either a branch of the me...
Hawkins JF, Ross MW.Medical records of 40 racing Standardbreds with superficial digital flexor tendinitis that underwent transection of the accessory ligament of the superficial digital flexor (SDF) muscle (superior check desmotomy) were reviewed. Surgery was performed bilaterally in 32 horses and unilaterally in 8. Concurrent palmar annular desmotomy was performed in 8 horses in which tendinitis involved the distal metacarpal region and confinement of the deep and SDF tendons by the annular ligament was suspected. Follow-up information was obtained for 32 horses, by telephone, and racing results were available f...
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...
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...
Yeung CC, Svensson RB, Mogensen NMB, Merkel MFR, Schjerling P, Jokipii-Utzon A, Zhang C, Carstensen H, Buhl R, Kjaer M.Physical activity can activate extracellular matrix (ECM) protein synthesis and influence the size and mechanical properties of tendon. In this study, we aimed to investigate whether different training histories of horses would influence the synthesis of collagen and other matrix proteins and alter the mechanical properties of tendon. Samples from superficial digital flexor tendon (SDFT) from horses that were either (a) currently race trained (n = 5), (b) previously race trained (n = 5) or (c) untrained (n = 4) were analysed for matrix protein abundance (mass spectrometry), collage...
Means K, Hayden L, Kramer J, McCracken MJ, Reed SK, Wilson DA, Keegan KG.Compensatory vertical head and pelvis movement asymmetry may occur in trotting horses with a primary cause of lameness in one end of the body due to the weight shifting between limbs, leading to apparent combined forelimb and hindlimb lameness (CFHL). Little is known about CFHL patterns observed with body-mounted inertial sensors (BMIS) and regardless of their underlying mechanisms, compensatory and secondary lameness may complicate the definitive identification of the primary causes of lameness. Objective: Determine associations between vertical pelvic movement asymmetry and location of prima...
Bierau J, Rott P, Röcken M, Staszyk C.This study aimed to delineate the detailed anatomy of the metacarpophalangeal (MCP) and metatarsophalangeal (MTP) joints in healthy horses using cone beam computed tomography (CBCT). The fetlock region of 15 cadaveric forelimbs and 14 cadaveric hindlimbs from nine adult horses without orthopaedic disease underwent CBCT scanning. Additionally, arthrography CBCT scans were conducted following intra-articular injection of a radiopaque contrast medium containing blue epoxy resin dye. Subsequently, limbs were frozen and sectioned to visualize anatomical structures in sectional planes corresponding ...
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...
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 ...
Local anaesthetics (LAs) can have detrimental effects on rat, bovine, canine, and human tendon tissues and cells. Currently, there has been no available data on the impact of these drugs on equine tenocytes. Even if LA injection for managing painful tendon conditions in horses is limited, it is usually used via intra-articular, intrasynovial, perineural, and intrathecal as well as for lameness examinations. In this in vitro study, the cytotoxic effects of LAs, including lidocaine, mepivacaine, and bupivacaine on equine tenocytes, in the presence and absence of platelet rich plasma (PRP), were ...
Terzi A, Gallo N, Sibillano T, Altamura D, Masi A, Lassandro R, Sannino A, Salvatore L, Bunk O, Giannini C, De Caro L.Type I collagen physiological scaffold for tissue regeneration is considered one of the widely used biomaterials for tissue engineering and medical applications. It is hierarchically organized: five laterally staggered molecules are packed within fibrils, arranged into fascicles and bundles. The structural organization is correlated to the direction and intensity of the forces which can be loaded onto the tissue. For a tissue-specific regeneration, the required macro- and microstructure of a suitable biomaterial has been largely investigated. Conversely, the function of multiscale structural i...
Kidd JA, Dyson SJ, Barr AR.Intratendonous infection in the absence of any clinical evidence of a wound has not, to our knowledge, been described previously in horses. This paper reports the clinical features, diagnostic techniques. treatment and outcome in 5 cases of septic flexor tendon core lesions. This condition is characterised by seven lameness and ultrasonographic evidence of a central intratendonous anechoic core lesion which may enlarge rapidly.
Jaskólska M, Adamiak Z, Zhalniarovich Y, Przyborowska P, Peczyński Z.Deep digital flexor tendinopathy is a common problem in horses of different athletic disciplines. Nowadays, the use of magnetic resonance imaging is considered to be a noninvasive and superior choice for recognizing bone and soft tissue pathologies especially related to difficult to access structures within the hoof capsule.
Littlewood HF.A technique for implanting carbon fibre into sprained flexor tendons in horses is described. Insertion of the fibres through paravertebral needles which passed through the affected region of the tendon was considered to be preferable to direct implantation into the surgically opened tendon. The results of the eight cases treated to date are dealt with briefly, together with a discussion as to how this form of treatment could be further evaluated.
Vaughan LC, Edwards GB, Gerring EL.Implants of carbon fibre, made by plaiting a tow of 10,000 filaments of Grafil type HT-S, were used to treat strains and ruptures of digital flexor tendons in 46 horses. The relevant clinical data, the techniques employed and an analysis of the results are described. Apart from two horses in which the implant was extruded and had to be removed, there were minimal untoward consequences of the surgery. Of the 34 horses with acute or chronic tendinitis, 14 returned to racing, seven were used as hunters and seven as hacks. Among the former group, seven suffered a further strain while racing but th...
Strömberg B.Thermography is the pictorial representation of infra-red (IR) emission from the surface of an object. IR emission from biological surfaces originates from two principal sources, circulation and metabolism, which are interdepen-dent. Changes in IR emission as recorded by thermography were correlated to changes in local blood circulation (BrAnemark & Nilsson 1969) and to changes in '33Xe disappearance rate (Stromberg & Norberg 1971). In 1969 Stromberg & Tufvesson, using microradiography, demonstrated that there were vascular changes in the superficial flexor tendon (SFT) even before clinical si...
Van Wulfen KK, Bowker RM.To describe microanatomic characteristics of the insertion of the aistal sesamoidean impar ligament (DSIL) and deep digital flexor tendon (DDFT) on the distal phalanx in horses. Methods: Healthy feet obtained from 62 horses of various breeds. Methods: Feet from 23 horses were used to histologically examine the insertion of the DSIL and DDFT (n = 7), its vasculature (10), and neural elements (6). In 39 other horses, the insertion zone was examined for proteoglycan. Results: The insertion of the DSIL and dorsal half of the DDFT contained bundles of collagen fibers with intervening loose connecti...
Booth TM, Clegg PD, Singer ER, Cheeseman MT.A four-year-old gelding was lame owing to a chronic septic common digital extensor tendon and sheath. The horse had been treated by open surgical lavage but the sepsis had recurred after three months. Physical, ultrasonographic, cytological and histological examinations confirmed chronic septic tenosynovitis and tendonitis. The entire intrathecal component of the common digital extensor tendon was resected under general anaesthesia and the synovial lining of the sheath was ablated. Postoperatively the horse regained good limb function and became sound.
Alexander RM.This research presents the hypothesis and findings that short muscle fibers in horses and other large mammals may protect bones and tendons from damaging vibrations during running, negating the previous […]