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.
Berner D, Brehm W, Gerlach K, Offhaus J, Scharner D, Burk J.Signal intensity (SI) of equine tendinopathies in MRI differs between the superficial digital flexor tendon (SDFT) and the deep digital flexor tendon (DDFT). In DDFT lesions, short tau inversion recovery (STIR) SI decreases earlier than T2-weighted (T2w) SI, while the latter decreases earlier in SDFT lesions, but long-term results using STIR sequences are lacking. Methods: Standing MRI of eight horses with naturally occurring SDFT lesions was performed at the day of treatment as well as 2, 6 and 12 months after treatment. Results: After 12 months, six horses were sound and showed complete reso...
Verkade ME, Hazeleger E, van de Lest CHA, Back W.Throughout the ages, humans have selected different horse breeds for their locomotor capacities. Consequently, the properties of equine locomotor tissues could have diversified because of the specific requirements of different disciplines. Therefore, this study aimed to compare biochemical properties of tendons in different equine breeds traditionally selected for racing or sports performance. We hypothesised that tendons in racing breeds would have biochemical properties that would increase strength, whereas those in sporting breeds would have more elastic properties. An ex vivo tendon tissue...
Marr N, Hopkinson M, Hibbert AP, Pitsillides AA, Thorpe CT.Three-dimensional imaging modalities for optically dense connective tissues such as tendons are limited and typically have a single imaging methodological endpoint. Here, we have developed a bimodal procedure utilising fluorescence-based confocal microscopy and x-ray micro-computed tomography for the imaging of adult tendons to visualise and analyse extracellular sub-structure and cellular composition in small and large animal species. Results: Using fluorescent immunolabelling and optical clearing, we visualised the expression of the novel cross-species marker of tendon basement membrane, lam...
Mostafa MB, Elemmawy YM.There is limited knowledge about causes of musculoskeletal injury in jumping Thoroughbred horses. The objective of this study was to describe the relationships between musculoskeletal disorders and linear and angular limb measurements acquired from photographs of horses with markers at specific reference points. The diagnosed musculoskeletal disorders in either fore or hind limbs were flexor tendonitis, suspensory ligaments desmitis, and osteoarthritis of the distal intertarsal and tarso-metatarsal and carpometacarpal joints. Lengths and angles in 17 clinically normal jumping Thoroughbred hors...
Giantsis IA, Diakakis NE, Avdi M.Tendinopathies constitute a very common category of musculoskeletal disorders, causing economic losses in the equine industry and animal welfare issues in horse populations. Sport and racehorses are in general sensitive to tendinopathies, whereas local indigenous horse populations are often more tolerant to various disorders. Particularly, indigenous Greek horse breeds have evolved and adapted in the rough topographic features of mountainous and semimountainous Greek terrain and are less prone to develop tendinopathies. Susceptibility to tendinopathy has been proposed to be associated with thr...
Metzger J, Distl O.Orthopedic diseases are a common cause for limited exercise capacity in the horse. They often underlie genetic risk factors, which can affect bone, articular cartilage, tendons, ligaments, and adnexal structures among others. The genetic effects can directly interfere with tissue development and skeletal growth or can trigger degenerative or inflammatory processes. Many of these diseases of the locomotor system like osteochondrosis are complex and can be affected by multifactorial influences. For this reason, it is important for those performing diagnostic procedures to have a comprehensive kn...
Haussler KK, Wilde SR, Davis MS, Hess AM, McIlwraith CW.Rehabilitation of tendon injuries in horses often involves cryotherapy to reduce inflammation and occasionally tissue heating to increase collagen extensibility. The application of alternating cold and hot (ie contrast therapy) is widely used in human physical therapy; however, its utility in equine rehabilitation is largely unknown. Objective: The objectives of this study were to (a) assess if the equipment could achieve therapeutic tissue temperatures (40°C) at different tissue depths relative to the digital flexor tendons and (b) evaluate the time-temperature profiles during serial heating...
Hontoir F, Paques F, Simon V, Balau B, Nicaise C, Clegg P, Dugdale A, Vandeweerd JM.Foot pain is a frequent cause of lameness in horses and can involve multiple structures within the hoof. The T-ligament (an anatomical structure connecting the synovium of the distal interphalangeal joint, the digital flexor tendon sheath and the navicular bursa) is poorly described. Five pairs of equine cadaver distal forelimbs were collected from a slaughterhouse. Sagittal sections (medial, middle and lateral) were obtained and processed with Haematoxylin Eosin Safran, Unna's Orcein, and Picrosirius red stains. Histological assessment revealed that the T-ligament was covered by the surroundi...
Paterson YZ, Cribbs A, Espenel M, Smith EJ, Henson FMD, Guest DJ.Tendon injuries occur frequently in human and equine athletes. Treatment options are limited, and the prognosis is often poor with functionally deficient scar tissue resulting. Fetal tendon injuries in contrast are capable of healing without forming scar tissue. Embryonic stem cells (ESCs) may provide a potential cellular therapeutic to improve adult tendon regeneration; however, whether they can mimic the properties of fetal tenocytes is unknown. To this end, understanding the unique expression profile of normal adult and fetal tenocytes is crucial to allow validation of ESC-derived tenocytes...
Bastos CM, Rocha F, Cerqueira Â, Terroso D, Sequeira C, Tilley P.Clays are natural ingredients used to prepare therapeutic cataplasms suitable for topical application. The knowledge about these formulations and their preparations to be applied on humans and animals has been orally transmitted since ancient times. Several empirical methods using clays have demonstrated fast and effective results in the reduction of the inflammatory response and the formation of edemas in horse limbs. The use of traditional and alternative medicine, such as pelotherapy, is now becoming more popular in veterinarian medical practice, alone or combined with other therapies in ho...
Durgam S, Singh B, Cole SL, Brokken MT, Stewart M.Histological evaluation of healing tendons is primarily focused on monitoring restoration of longitudinal collagen alignment, although the elastic property of energy-storing flexor tendons is largely attributed to interfascicular sliding facilitated by the interfascicular matrix (IFM). The objectives of this study were to explore the utility of second harmonic generation (SHG) imaging to objectively assess cross-sectional tendon fascicle architecture, to combine SHG microscopy with elastin immunofluorescence to assess the ultrastructure of collagen and elastin in longitudinal and transverse se...
Casillas JM, Jacobs CC, Manfredi JM.To identify radiographic locations of soft tissue attachments in the tarsal region of horses and describe any variability in the gross anatomy of those attachments. Methods: 15 cadaveric limbs from 8 adult horses. Methods: 8 limbs were used for dissection and radiography of soft tissue structures, with metallic markers used to identify radiographic locations of soft tissue attachments. The remaining 7 limbs were used to evaluate anatomic variations in the insertion of the tendon of the fibularis tertius muscle. A consensus list of preferred radiographic views for evaluating each soft tissue at...
Rajpar I, Barrett JG.Tendon injury is a significant clinical problem due to poor healing and a high reinjury rate; successful treatment is limited by our poor understanding of endogenous tendon stem cells. Recent evidence suggests that adult stem cells are phenotypically diverse, even when comparing stem cells isolated from the same tissue from the same individual, and may in fact exist on a spectrum of proliferation and differentiation capacities. Additionally, the relationships between and clinical relevance of this phenotypic variation are poorly understood. In particular, tenogenic capacity has not been studie...
Atkinson F, Evans R, Guest JE, Bavin EP, Cacador D, Holland C, Guest DJ.Tendon injuries are a common cause of morbidity in humans. They also occur frequently in horses, and the horse provides a relevant, large animal model in which to test novel therapies. To develop novel cell therapies that can aid tendon regeneration and reduce subsequent reinjury rates, the mechanisms that control tendon tissue regeneration and matrix remodelling need to be better understood. Although a range of chemical cues have been explored (growth factors, media etc.), the influence of the mechanical environment on tendon cell culture has yet to be fully elucidated. To mimic the in vivo e...
Yin NH, Parker AW, Matousek P, Birch HL.The lack of clinical detection tools at the molecular level hinders our progression in preventing age-related tendon pathologies. Raman spectroscopy can rapidly and non-invasively detect tissue molecular compositions and has great potential for in vivo applications. In biological tissues, a highly fluorescent background masks the Raman spectral features and is usually removed during data processing, but including this background could help age differentiation since fluorescence level in tendons increases with age. Therefore, we conducted a stepwise analysis of fluorescence and Raman combined s...
Smith R, Önnerfjord P, Holmgren K, di Grado S, Dudhia J.The diagnosis of tendon injury relies on clinical signs and diagnostic imaging but imaging is subjective and does not always correlate with clinical signs. A molecular marker would potentially offer a sensitive and specific diagnostic tool that could also provide objective assessment of healing for the comparison of different treatments. Cartilage Oligomeric Matrix Protein (COMP) has been used as a molecular marker for osteoarthritis in humans and horses but assays for the protein in tendon sheath synovial fluids have shown overlap between horses affected by tendinopathy and controls. We hypot...
Terzi A, Gallo N, Bettini S, Sibillano T, Altamura D, Madaghiele M, De Caro L, Valli L, Salvatore L, Sannino A, Giannini C.Collagen represents one of the most widely used biomaterial for scaffolds fabrication in tissue engineering as it represents the mechanical support of natural tissues. It also provides physical scaffolding for cells and it influences their attachment, growth, and tissue regeneration. Among all fibrillary collagens, type I is considered one of the gold standard for scaffolds fabrication, thanks to its high biocompatibility, biodegradability, and hemostatic properties. It can be extracted by chemical and enzymatic protocols from several collagen-rich tissues, such as tendon and skin, of differen...
Ülke ÇG, Deniz SI, Nureddin Ç.Metacarpal tendon diseases are important problems that may cause a decrease in performance and even may finish sport life in equine athletes. In this study, it was aimed to evaluate the ratio of return to races and the time of staying away from races and also to detect the prognostic value of ultrasonographic findings in Thoroughbred and Arabian racehorses with metacarpal flexor tendon injury or peritendonitis. Of 120 cases, 84 (70.0%) returned to races. Among these, 82.1% had tendonitis (69/84) and 17.9% peritendonitis (15/84). Among the cases being unable to return to races, 91.7% had tendon...
Durgam SS, Altmann NN, Coughlin HE, Rollins A, Hostnik LD.There is increased incidence of tendon disorders and decreased tendon healing capacity in people with diabetes mellitus (DM). Recent studies have also suggested pathological ossification in repair tendon of people with DM. Therefore, the objective of this study is to investigate the effects of insulin supplementation, an important pathophysiologic stimulus of DM, on tendon progenitor cell (TPC) proliferation and in vitro osteogenic capacity. Passage 3 TPCs were isolated from collagenase-digested, equine superficial digital flexor tendons. TPC proliferation was measured via MTT assay after 3 da...
Horstmeier C, Ahrberg AB, Berner D, Burk J, Gittel C, Hillmann A, Offhaus J, Brehm W.The magic angle effect increases the MRI signal of healthy tendon tissue and could be used for more detailed evaluation of tendon structure. Furthermore, it could support the discrimination of hypointense artefacts induced by contrast agents such as superparamagnetic iron oxide used for cell tracking. However, magic angle MRI of the equine superficial digital flexor tendon has not been accomplished in vivo in standing low-field MRI so far. The aim of this in vivo study was to evaluate the practicability of this magic angle technique and its benefit for tracking superparamagnetic iron oxide-lab...
Ribitsch I, Gueltekin S, Keith MF, Minichmair K, Peham C, Jenner F, Egerbacher M.Aging is hypothesized to be associated with changes in tendon matrix composition which may lead to alteration of tendon material properties and hence propensity to injury. Altered gene expression may offer insights into disease pathophysiology and thus open new perspectives toward designing pathophysiology-driven therapeutics. Therefore, the current study aimed at identifying naturally occurring differences in tendon micro-morphology and gene expression of newborn, young and old horses. Age-related differences in the distribution pattern of tendon fibril thickness and in the expression of the ...
Recent advances in tendinopathy research have focused on tendon vascularization detected with Color Doppler (CD) ultrasound. The use of CD has also been described in horses in a study on chronic lesions of superficial digital flexor tendon and suspensory ligament. The aim of this study was to investigate the occurrence and distribution of power Doppler (PD) signal in horses with superficial digital flexor tendinopathy. Twenty-five horses with tendinopathy were included and 10 healthy horses with no lameness and no ultrasonographic abnormalities were used for comparison. In all horses with tend...
Roth SP, Brehm W, Groß C, Scheibe P, Schubert S, Burk J.Transforming growth factor beta 3 (TGFβ3) promotes tenogenic differentiation and may enhance tendon regeneration in vivo. This study aimed to apply TGFβ3 absorbed in decellularized equine superficial digital flexor tendon scaffolds, and to investigate the bioactivity of scaffold-associated TGFβ3 in an in vitro model. TGFβ3 could effectively be loaded onto tendon scaffolds so that at least 88% of the applied TGFβ3 were not detected in the rinsing fluid of the TGFβ3-loaded scaffolds. Equine adipose tissue-derived multipotent mesenchymal stromal cells (MSC) were then seeded on scaffolds loa...
Noguera Cender A, Mählman K, Lischer CJ.To describe and evaluate an alternative technique for tenoscopic resection of the manica flexoria (MF). Methods: Descriptive study. Methods: Equine cadaver forelimbs and hind limbs (n = 36). Methods: Three surgeons varying in experience resected the MF in 12 limbs. The procedure was divided into six steps, including resection of the lateral/medial borders of the MF with a hook knife and resection of the proximal border with a micro scalpel. Outcomes compared between surgeons included completeness of resection, appearance of the margins of resection, appearance of the resected MF, collateral da...
Isgren CM, Salem SE, Singer ER, Wylie CE, Lipreri G, Graham RJTY, Bladon B, Boswell JC, Fiske-Jackson AR, Mair TS, Rubio-Martínez LM.Previous studies investigating factors associated with survival following endoscopic treatment of contamination/sepsis of the calcaneal bursa are limited. Objective: To investigate the factors associated with survival in horses with contamination/sepsis of the calcaneal bursae treated endoscopically and to describe the bacterial isolates involved in the synovial infections. Methods: Retrospective analysis of clinical records. Methods: Medical records from 128 horses with contamination/sepsis of the calcaneal bursae treated by endoscopic lavage at seven equine hospitals were reviewed. A follow-...
McClellan A, Paterson YZ, Paillot R, Guest DJ.In horses and humans, tendon injuries are a significant problem. Not only can they occur in both athletes and nonathletes, they require lengthy periods of recuperation and undergo poor natural regeneration, which leads to high reinjury rates. Embryonic stem cells (ESCs) may provide a renewable source of allogeneic cells to use in clinical applications to aid tissue regeneration. Equine ESCs can undergo tenocyte differentiation in vivo and in vitro, but the immune properties of tenocytes isolated from either ESCs or tissues have not previously been characterized. Here, we demonstrate that equin...
Turlo AJ, Mueller-Breckenridge AJ, Zamboulis DE, Tew SR, Canty-Laird EG, Clegg PD.The main challenge in tendon injury management is suboptimal tissue healing that fails to re-establish original tendon function. Tissue bioengineering is a promising approach for tendon therapy, with potential to improve its functional outcomes. However, evaluation criteria for tissue-engineered tendon are unclear due to the lack of specific markers of differentiated tendon. The study aim was to identify a panel of genes that characterised tendons in comparison to cartilage or muscles and validate those genes, both in human and key species used as models for tendon diseases. Gene expression pr...
Verkade ME, Back W, Birch HL.Throughout the ages, human subjects have selected horse breeds for their locomotor capacities. Concurrently, tissue properties may have diversified because of specific requirements of different disciplines. Objective: The aim of this study was to compare the biomechanical properties of tendons with different functions between equine breeds traditionally selected for racing or sport. Methods: This study used ex vivo tendons and compared the mechanical properties of the common digital extensor tendon (CDET) and superficial digital flexor tendon (SDFT) between racehorses (Thoroughbred [TB]) and s...
Muñoz A, Saitua A, Becero M, Riber C, Satué K, de Medina AS, Argüelles D, Castejón-Riber C.In recent years, exercise on a water treadmill has come to have great relevance in rehabilitation and training centres for sport horses. Its use exploits certain physical properties of water, related to the fundamental principles of hydrodynamics, such as buoyancy, viscosity, hydrostatic pressure, and water temperature. These properties together with deliberate specification of the depth of the water and the velocity of the treadmill provide a combination of parameters that can be varied according to the purpose of the rehabilitation or training programme, the disease to rehabilitate, or the h...
Watson JC, Wilson AM.Three muscles from the proximal equine forelimb were dissected in order to investigate their potential to contribute to proximal limb mechanics. Muscle mass, fibre length, tendon mass and tendon length were measured from biceps brachii, triceps brachii, supraspinatus and lacertus fibrosus (biceps lateral head mass 171-343.4 g and fibre length 0.5-0.8 cm; biceps medial head mass 283-500 g and fibre length 2.2-4 cm; biceps tendon mass 121.8-260 g and tendon length 35-44 cm; triceps long head mass 3200-6663 g and fibre length 19-26.3 cm; triceps lateral head mass 513.8-1240 g and fibre length 17....
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 ...
amnion-derived stem cells are considered a promising alternative source for tendon tissue regeneration. Objective: aims of this paper were to illustrate the ultrasound and histological outcomes following the treatment of acute and chronic superficial digital flexor tendon spontaneous lesions in horses with ovine amniotic epithelial cells xenotransplantation. Methods: six adult horses suffering from unilateral acute (4 cases) and chronic (2 cases) tendinopathy (clinical and ultrasound diagnosis) were enrolled. At baseline, ovine amniotic epithelial cells were grafted, in sterile conditions and ...
Bavin EP, Atkinson F, Barsby T, Guest DJ.The transcription factor scleraxis is required for tendon development and is upregulated during embryonic stem cell (ESC) differentiation into tenocytes. However, its role beyond early embryonic development is not defined. We utilized a short hairpin RNA to knock down scleraxis expression in ESCs and adult and fetal tenocytes. No effect on growth or morphology was observed in two-dimensional cultures. However, scleraxis knockdown in fetal tenocytes significantly reduced COL1A1, COMP, and SOX9 gene expression. Scleraxis knockdown in adult tenocytes had no effect on the expression of these genes...
Gomiero C, Bertolutti G, Martinello T, Van Bruaene N, Broeckx SY, Patruno M, Spaas JH.Tendons regenerate poorly due to a dense extracellular matrix and low cellularity. Cellular therapies aim to improve tendon repair using mesenchymal stem cells and tenocytes; however, a current limitation is the low proliferative potential of tenocytes in cases of severe trauma. The purpose of this study was to develop a method useful in veterinary medicine to improve the differentiation of Peripheral Blood equine mesenchymal stem cells (PB-MSCs) into tenocytes. PB-MSCs were used to study the effects of the addition of some growth factors (GFs) as TGFβ3 (transforming growth factor), EGF2 (Epi...
Hanson RR.Complications of wounds and cosmetic surgery can be accurately managed with a combination of timely surgical and medical intervention to ensure the best possible outcome. The lack of soft tissue protection and a large quantity of susceptible synovial, tendon, ligament, and neurovascular structures make early and meticulous evaluation of limb wounds critical. Skin grafting is usually used following a period of open wound management and after healthy granulation tissue formation. Penetrating wounds of the abdomen or thorax have a guarded prognosis resulting from the ensuing potential for infecti...
Mouser VHM, Dautzenberg NMM, Levato R, van Rijen MHP, Dhert WJA, Malda J, Gawlitta D.The implantation of chondrocyte-laden hydrogels is a promising cartilage repair strategy. Chondrocytes can be spatially positioned in hydrogels and thus in defects, while current clinical cell therapies introduce chondrocytes in the defect depth. The main aim of this study was to evaluate the effect of spatial chondrocyte distribution on the reparative process. To reduce animal experiments, an ex vivo osteochondral plug model was used and evaluated. The role of the delivered and endogenous cells in the repair process was investigated. Full thickness cartilage defects were created in equine ost...
Riemersma DJ, Schamhardt HC.The mechanical properties of the deep digital flexor tendon (DDFT), the superficial digital flexor tendon (SDFT) and the suspensory ligament (SL) of the hindlimb of the horse were studied in vitro. The tendons were observed at several morphologically distinct sites. The loaded tendon is homogeneously strained, in spite of large variations in cross-sectional area. Consequently the modulus of elasticity was inversely proportional to the corresponding cross-sectional area and ranged from 738 MPa (megaPascal, N mm-2) to 1398 MPa within the DDFT, from 1000 MPa to 1282 MPa within the SDFT and from 5...
Reed SA, Leahy ER.Tendon injuries affect all levels of athletic horses and represent a significant loss to the equine industry. Accumulation of microdamage within the tendon architecture leads to formation of core lesions. Traditional approaches to tendon repair are based on an initial period of rest to limit the inflammatory process followed by a controlled reloading program designed to promote the maturation and linear arrangement of scar tissue within the lesion. However, these treatment protocols are inefficient, resulting in prolonged recovery periods and frequent recurrence. Current alternative therapies ...
Smith RKW, McIlwraith CW.Tendinopathy remains one of the most common musculoskeletal disorders affecting both human and equine athletes and presents a considerable therapeutic challenge. The following workshop report comes from the third Dorothy Havemeyer Symposium of Tendinopathy which provided a unique overview of our current understanding of both the basic science and the clinical challenges for diagnosing and treating tendinopathy in both species. Pathologically, tendon demonstrates alterations in both cellular, molecular, structural, and biomechanical features, leading to a spectrum of pathological endotypes. To ...
Kasashima Y, Smith RK, Birch HL, Takahashi T, Kusano K, Goodship AE.Most skeletal tissues are thought to adapt to the mechanical environment they experience. While this has been demonstrated for muscle and bone, previous studies in the mature horse have failed to demonstrate adaptation in the superficial digital flexor tendon (SDFT), which suffers a high frequency of injury. This study tested the hypothesis that imposed exercise during growth would result in an increase in SDFT cross-sectional area (CSA). Fourteen Thoroughbred foals were divided into 2 sex-matched groups. A control group received 4 h pasture exercise and an exercise group had the same amount o...
Vandenberghe A, Broeckx SY, Beerts C, Seys B, Zimmerman M, Verweire I, Suls M, Spaas JH.Suspensory ligament injuries are a common injury in sport horses, especially in competing dressage horses. Because of the poor healing of chronic recalcitrant tendon injuries, this represents a major problem in the rehabilitation of sport horses and often compromises the return to the initial performance level. Stem cells are considered as a novel treatment for different pathologies in horses and humans. Autologous mesenchymal stem cells (MSCs) are well known for their use in the treatment of tendinopathies; however, recent studies report a safe use of allogeneic MSCs for different orthopedic ...
Birch HL, Wilson AM, Goodship AE.Tendons that store energy during locomotion, such as the equine superficial digital flexor tendon (SDFT) and human Achilles tendon, suffer a high incidence of central core degeneration which is thought to precede tendon rupture. Although energy storage contributes to the efficiency of locomotion, tendons are not perfectly elastic and some energy is lost in the form of heat. Recent studies have shown that the central core of equine SDFT reaches temperatures as high as 45 degrees C during high-speed locomotion. In this study, we test the hypothesis that hyperthermia causes tendon cell death and ...
Young NJ, Becker DL, Fleck RA, Goodship AE, Patterson-Kane JC.Energy-storing tendons including the equine superficial digital flexor tendon (SDFT) contribute to energetic efficiency of locomotion at high-speed gaits, but consequently operate close to their physiological strain limits. Significant evidence of exercise-induced microdamage has been found in the SDFT which appears not to exhibit functional adaptation; the degenerative changes have not been repaired by the tendon fibroblasts (tenocytes), and are proposed to accumulate and predispose the tendon to rupture during normal athletic activity. The anatomically opposing common digital extensor tendon...
Cadby JA, David F, van de Lest C, Bosch G, van Weeren PR, Snedeker JG, van Schie HT.Injuries in energy-storing tendons are common in both horses and man. The high prevalence of reinjury and the relatively poor prognosis for returning to preinjury performance levels warrant further research, for which well characterised models would be very helpful. Objective: Given the clinical similarities in tendinopathy of energy-storing tendons, we hypothesised that a recently developed experimental model of equine tendon injury would display many of the characteristics of clinical tendinopathy and could therefore be of use for both species, thus providing comparative insight to the human...
Alves AG, Stewart AA, Dudhia J, Kasashima Y, Goodship AE, Smith RK.Tendon and ligament injuries have proved difficult to treat effectively. Cell-based therapies offer the potential to harness the complex protein synthetic machinery of the cell to induce a regenerative response rather than fibrous scarring. This article reviews the current state of play with respect to the clinically used cell preparations for the treatment of tendon and ligaments overstrain injuries.
Kim B, Yoon JH, Zhang J, Eric Mueller PO, Halper J.Defects in glycosylation of decorin can result in systemic hereditary disease. A mutation in the galactosyl transferase I gene is the underlying defect of a progeroid form of Ehlers-Danlos syndrome. We have previously described pathological changes in equine systemic proteoglycan accumulation (ESPA, formerly degenerative suspensory ligament desmitis) as consisting of excessive presence of decorin and other proteoglycans in organs and structures with a high content of connective tissue. Using liquid chromatography/mass spectrometry, and one- and two-dimensional immunoblotting we have determined...
Thorpe CT, Stark RJ, Goodship AE, Birch HL.Damage to the flexor tendons, particularly the superficial digital flexor tendon (SDFT), is one of the most common musculoskeletal injuries sustained by horses competing in all disciplines. Our previous work has shown that SDFTs from different individuals show a wide variation in mechanical strengths; this is important clinically as it may relate to predisposition to injury. The high mechanical strength of tendon relies on the correct orientation of collagen molecules within fibrils and stabilisation by the formation of chemical cross-links between collagen molecules. It is not known whether t...
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...
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...
Evans JH, Barbenel JC.Tendon normally fulfills its primary role as a flexible force transmitting element very effectively and yet failure of this passive tissue leads to great disability. As a connective tissue its structure is relatively simple and the peculiar helical arrangement of collagen fibres confers highly non-linear as well as time-dependent mechanical properties. Functional significance cannot be attributed to any facet of mechanical response until the physiological pattern of loading is established. In particular the rate of deformation and the minimum force experienced by tendon in normal locomotion ha...
Stewart AA, Barrett JG, Byron CR, Yates AC, Durgam SS, Evans RB, Stewart MC.To compare viability and biosynthetic capacities of cells isolated from equine tendon, muscle, and bone marrow grown on autogenous tendon matrix. Methods: Cells from 4 young adult horses. Methods: Cells were isolated, expanded, and cultured on autogenous cell-free tendon matrix for 7 days. Samples were analyzed for cell viability, proteoglycan synthesis, collagen synthesis, and mRNA expression of collagen type I, collagen type III, and cartilage oligomeric matrix protein (COMP). Results: Tendon- and muscle-derived cells required less time to reach confluence (approx 2 weeks) than did bone marr...
Lawson SE, Chateau H, Pourcelot P, Denoix JM, Crevier-Denoix N.The sagittal alteration of hoof balance is a common intervention in horses, with corrective shoeing being one of the most frequently applied methods of managing tendonitis. However, the effect of toe or heel elevation on tendon strains is poorly understood. This study aimed to examine the effect of toe and heel wedges on the superficial digital flexor tendon, deep digital flexor tendon, and the third interosseous muscle or suspensory ligament strains using in vivo data and an accurate subject-specific model. Kinematic data were recorded using invasive markers at the walk and trot. Computerized...
Logan AA, Nielsen BD.Conflicting research and anecdotal evidence have created disagreement among equestrians as to whether two-year-old horses should be trained and raced. The objective of this literature review is to evaluate epidemiological studies, as well as physiological data on equine bone, articular cartilage, and tendons to better determine the impact of training and racing two-year-old horses. The evaluation of numerous studies on the topic provides evidence that a horse which is trained or raced as a two-year-old has a lower risk of injury and better adapted tissues for the rigors of racing. Unfortunatel...
Ribitsch I, Gueltekin S, Keith MF, Minichmair K, Peham C, Jenner F, Egerbacher M.Aging is hypothesized to be associated with changes in tendon matrix composition which may lead to alteration of tendon material properties and hence propensity to injury. Altered gene expression may offer insights into disease pathophysiology and thus open new perspectives toward designing pathophysiology-driven therapeutics. Therefore, the current study aimed at identifying naturally occurring differences in tendon micro-morphology and gene expression of newborn, young and old horses. Age-related differences in the distribution pattern of tendon fibril thickness and in the expression of the ...
Smith EJ, Beaumont RE, McClellan A, Sze C, Palomino Lago E, Hazelgrove L, Dudhia J, Smith RKW, Guest DJ.Tendon injuries occur commonly in both human and equine athletes, and poor tendon regeneration leads to functionally deficient scar tissue and an increased frequency of re-injury. Despite evidence suggesting inadequate resolution of inflammation leads to fibrotic healing, our understanding of the inflammatory pathways implicated in tendinopathy remains poorly understood, meaning successful targeted treatments are lacking. Here, we demonstrate IL-1β, TNFα and IFN-γ work synergistically to induce greater detrimental consequences for equine tenocytes than when used individually. This includes ...
Birch HL, Wilson AM, Goodship AE.This study explores the hypothesis that high-intensity exercise induces degenerative changes in the injury-prone equine superficial digital flexor tendon (SDFT), but not in the rarely injured common digital extensor tendon (CDET). The horse represents a large-animal model that is applicable to human tendon and ligament physiology and pathology. Twelve age-matched female horses undertook galloping exercise three times a week with trotting exercise on alternative days (high-intensity group, n = 6) or only walking exercise (low-intensity group, n = 6) for 18 mo. The SDFT, suspensory ligament, dee...
Watkins JP, Auer JA, Gay S, Morgan SJ.Full-thickness defects were surgically created in the superficial digital flexor tendons of the front limbs of 20 horses. Tissues formed within the defect were evaluated histologically, and the collagen composition of the tissue was determined by immunofluorescence. Transformation occurred from loose fibrillar areas of types I and III collagen and pericellular types IV and V collagen to dense bundles of type I collagen fibers. Loose fibrillar areas of types I and III collagen were present after 24 weeks. Histologically, in horses killed after 2 weeks, the tissue within the defect was a randoml...
King JN, Zubrod CJ, Schneider RK, Sampson SN, Roberts G.Two hundred and thirty-two horses with lameness localized to the metacarpo(tarso)phalangeal (MCP/MTP) region without a radiographic diagnosis were evaluated. All horses had high-field magnetic resonance (MR) imaging of the MCP/MTP region performed for the lame limb and the contralateral limb for comparison. There were 46 horses that had bilateral abnormalities in the forelimbs; 27 of these horses were not lame in the contralateral limb at the time of examination. Bilateral hind limb abnormalities were observed in 37 horses; 22 horses were not lame in the contralateral limb. Soft tissue abnorma...
Smith MR, Wright IM.Until recently, the pathogenesis of noninfected tenosynovitis of the digital flexor tendon sheath (DFTS) has been considered obscure. With the advent of tenoscopy some inciting causes have been described, but to date few cases with a precise diagnosis have been reported. Objective: Tenoscopic surgery enables accurate diagnosis and facilitates treatment of noninfected tenosynovitis of the DFTS. Methods: The case records of all horses with noninfected tenosynovitis of the DFTS admitted to a referral clinic over a 7-year period were evaluated retrospectively. Follow-up information was obtained by...
