Biplanar High-Speed Fluoroscopy of Pony Superficial Digital Flexor Tendon (SDFT)-An In Vivo Pilot Study.
Abstract: The superficial digital flexor tendon (SDFT) is the most frequently injured structure of the musculoskeletal system in sport horses and a common cause for early retirement. This project's aim was to visualize and measure the strain of the sound, injured, and healing SDFTs in a pony during walk and trot. For this purpose, biplanar high-speed fluoroscopic kinematography (FluoKin), as a high precision X-ray movement analysis tool, was used for the first time in vivo with equine tendons. The strain in the metacarpal region of the sound SDFT was 2.86% during walk and 6.78% during trot. When injured, the strain increased to 3.38% during walk and decreased to 5.96% during trot. The baseline strain in the mid-metacarpal region was 3.13% during walk and 6.06% during trot and, when injured, decreased to 2.98% and increased to 7.61%, respectively. Following tendon injury, the mid-metacarpal region contributed less to the overall strain during walk but showed increased contribution during trot. Using this marker-based FluoKin technique, direct, high-precision, and long-term strain measurements in the same individual are possible. We conclude that FluoKin is a powerful tool for gaining deeper insight into equine tendon biomechanics.
Publication Date: 2021-05-27 PubMed ID: 34072030PubMed Central: PMC8228745DOI: 10.3390/vetsci8060092Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Journal Article
Summary
This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.
The research report involves a pioneering in vivo study using high-speed fluoroscopic kinematography (FluoKin) to examine and quantify the strain on the superficial digital flexor tendon (SDFT) of a pony during movement. This tendon is critical for athletic horses, and it’s often linked to premature retirement due to injuries.
Tools and Method
- Researchers used the advanced X-ray movement analysis tool known as biplanar high-speed fluoroscopic kinematography (FluoKin). This was the first time FluoKin had been used in vivo – or within a living organism – on equine tendons.
- FluoKin enabled direct, high-precision, and longitudinal strain measurements in the same individual. This innovative technique differs from past methods which only allowed indirect or less precise measurements.
Findings and Observations
- The strain in the metacarpal region of the healthy SDFT was quantified as 2.86% during walking and 6.78% during trotting.
- When the SDFT was injured, the strain rose to 3.38% during walking and fell to 5.96% during trotting.
- For the mid-metacarpal region of SDFT, the baseline strain was 3.13% during walking and 6.06% during trotting. With an injury, these measurements changed to 2.98% and rose to 7.61%, respectively.
- Peculiarly, following a tendon injury, the mid-metacarpal region was found to contribute less to the total strain during a walk, but its contribution increased during a trot.
Significance and Conclusions
- This pilot study provided evidence for the applicability and efficiency of FluoKin as a potent tool for extensive studies into equine tendon biomechanics.
- This might enhance our knowledge about tendon injuries in horses and could potentially contribute to designing better training or recovery regimes.
- This research also has broader implications, suggesting that similar studies might be conducted on other tendons of veterinary or medical interest.
Cite This Article
APA
Wagner FC, Gerlach K, Geiger SM, Gittel C, Böttcher P, Mülling CKW.
(2021).
Biplanar High-Speed Fluoroscopy of Pony Superficial Digital Flexor Tendon (SDFT)-An In Vivo Pilot Study.
Vet Sci, 8(6), 92.
https://doi.org/10.3390/vetsci8060092 Publication
Researcher Affiliations
- Institute of Veterinary Anatomy, Histology and Embryology, Faculty of Veterinary Medicine, Leipzig University, An den Tierkliniken 43, 04103 Leipzig, Germany.
- Department for Horses, Faculty of Veterinary Medicine, Leipzig University, An den Tierkliniken 43, 04103 Leipzig, Germany.
- Institute of Veterinary Anatomy, Histology and Embryology, Faculty of Veterinary Medicine, Leipzig University, An den Tierkliniken 43, 04103 Leipzig, Germany.
- Department for Horses, Faculty of Veterinary Medicine, Leipzig University, An den Tierkliniken 43, 04103 Leipzig, Germany.
- Small Animal Clinic, Department of Veterinary Medicine, Freie Universität Berlin, Oertzenweg 19b, 14163 Berlin, Germany.
- Institute of Veterinary Anatomy, Histology and Embryology, Faculty of Veterinary Medicine, Leipzig University, An den Tierkliniken 43, 04103 Leipzig, Germany.
Grant Funding
- VetMed2016FW_SG / Faculty of Veterinary Medicine, Leipzig University
Conflict of Interest Statement
The authors declare no conflict of interest.
References
This article includes 83 references
- Williams RB, Harkins LS, Hammond CJ, Wood JL. Racehorse injuries, clinical problems and fatalities recorded on British racecourses from flat racing and National Hunt racing during 1996, 1997 and 1998.. Equine Vet J 2001 Sep;33(5):478-86.
- Smith RK, Birch HL, Goodman S, Heinegård D, Goodship AE. The influence of ageing and exercise on tendon growth and degeneration--hypotheses for the initiation and prevention of strain-induced tendinopathies.. Comp Biochem Physiol A Mol Integr Physiol 2002 Dec;133(4):1039-50.
- Butcher MT, Hermanson JW, Ducharme NG, Mitchell LM, Soderholm LV, Bertram JE. Superficial digital flexor tendon lesions in racehorses as a sequela to muscle fatigue: a preliminary study.. Equine Vet J 2007 Nov;39(6):540-5.
- Patterson-Kane JC, Firth EC. The pathobiology of exercise-induced superficial digital flexor tendon injury in Thoroughbred racehorses.. Vet J 2009 Aug;181(2):79-89.
- Wollenman P, McMahon PJ, Knapp S, Ross MW. Lameness in the Polo Pony. In: Ross M.W., Dyson S.J., editors. Diagnosis and Management of Lameness in the Horse. 2nd ed. Elsevier/Saunders; St. Louis, MO, USA: 2011. pp. 1149–1164.
- Davis CS, Smith RKW. Diseases of tendon and ligament disorders. In: Auer J.A., Stick J.A., editors. Equine Surgery. 3rd ed. W.B. Saunders; St. Louis, MO, USA: 2006.
- Dyson SJ. Medical management of superficial digital flexor tendonitis: a comparative study in 219 horses (1992-2000).. Equine Vet J 2004 Jul;36(5):415-9.
- Thorpe CT, Clegg PD, Birch HL. A review of tendon injury: why is the equine superficial digital flexor tendon most at risk?. Equine Vet J 2010 Mar;42(2):174-80.
- Patterson-Kane JC, Becker DL, Rich T. The pathogenesis of tendon microdamage in athletes: the horse as a natural model for basic cellular research.. J Comp Pathol 2012 Aug-Oct;147(2-3):227-47.
- McCullagh KG, Goodship AE, Silver IA. Tendon injuries and their treatment in the horse.. Vet Rec 1979 Jul 21;105(3):54-7.
- Goodship AE, Birch HL, Wilson AM. The pathobiology and repair of tendon and ligament injury.. Vet Clin North Am Equine Pract 1994 Aug;10(2):323-49.
- Patterson-Kane JC, Wilson AM, Firth EC, Parry DA, Goodship AE. Exercise-related alterations in crimp morphology in the central regions of superficial digital flexor tendons from young thoroughbreds: a controlled study.. Equine Vet J 1998 Jan;30(1):61-4.
- Dowling BA, Dart AJ, Hodgson DR, Smith RK. Superficial digital flexor tendonitis in the horse.. Equine Vet J 2000 Sep;32(5):369-78.
- Stephens PR, Nunamaker DM, Butterweck DM. Application of a Hall-effect transducer for measurement of tendon strains in horses.. Am J Vet Res 1989 Jul;50(7):1089-95.
- Riemersma DJ, van den Bogert AJ, Jansen MO, Schamhardt HC. Tendon strain in the forelimbs as a function of gait and ground characteristics and in vitro limb loading in ponies.. Equine Vet J 1996 Mar;28(2):133-8.
- Pourcelot P, Defontaine M, Ravary B, Lemâtre M, Crevier-Denoix N. A non-invasive method of tendon force measurement.. J Biomech 2005 Oct;38(10):2124-9.
- Duenwald S, Kobayashi H, Frisch K, Lakes R, Vanderby R Jr. Ultrasound echo is related to stress and strain in tendon.. J Biomech 2011 Feb 3;44(3):424-9.
- Vergari C, Ravary-Plumioën B, Evrard D, Laugier P, Mitton D, Pourcelot P, Crevier-Denoix N. Axial speed of sound is related to tendon's nonlinear elasticity.. J Biomech 2012 Jan 10;45(2):263-8.
- Ellison ME, Duenwald-Kuehl S, Forrest LJ, Vanderby R Jr, Brounts SH. Reproducibility and feasibility of acoustoelastography in the superficial digital flexor tendons of clinically normal horses.. Am J Vet Res 2014 Jun;75(6):581-7.
- Meershoek LS, Lanovaz JL. Sensitivity analysis and application to trotting of a noninvasive method to calculate flexor tendon forces in the equine forelimb.. Am J Vet Res 2001 Oct;62(10):1594-8.
- Crevier-Denoix N, Ruel Y, Dardillat C, Jerbi H, Sanaa M, Collobert-Laugier C, Ribot X, Denoix JM, Pourcelot P. Correlations between mean echogenicity and material properties of normal and diseased equine superficial digital flexor tendons: an in vitro segmental approach.. J Biomech 2005 Nov;38(11):2212-20.
- Brainerd EL, Baier DB, Gatesy SM, Hedrick TL, Metzger KA, Gilbert SL, Crisco JJ. X-ray reconstruction of moving morphology (XROMM): precision, accuracy and applications in comparative biomechanics research.. J Exp Zool A Ecol Genet Physiol 2010 Jun 1;313(5):262-79.
- Fridén T, Ryd L, Lindstrand A. Laxity and graft fixation after reconstruction of the anterior cruciate ligament. A roentgen stereophotogrammetric analysis of 11 patients.. Acta Orthop Scand 1992 Feb;63(1):80-4.
- Schepull T, Kvist J, Andersson C, Aspenberg P. Mechanical properties during healing of Achilles tendon ruptures to predict final outcome: a pilot Roentgen stereophotogrammetric analysis in 10 patients.. BMC Musculoskelet Disord 2007 Nov 26;8:116.
- Cashman PM, Baring T, Reilly P, Emery RJ, Amis AA. Measurement of migration of soft tissue by modified Roentgen stereophotogrammetric analysis (RSA): validation of a new technique to monitor rotator cuff tears.. J Med Eng Technol 2010 Apr;34(3):159-65.
- Marshall NE, Keller RA, Okoroha K, Guest JM, Yu C, Muh S, Moutzouros V. Radiostereometric Evaluation of Tendon Elongation After Distal Biceps Repair.. Orthop J Sports Med 2016 Nov;4(11):2325967116672620.
- Wagner FC, Reese S, Gerlach K, Böttcher P, Mülling CKW. Cyclic tensile tests of Shetland pony superficial digital flexor tendons (SDFTs) with an optimized cryo-clamp combined with biplanar high-speed fluoroscopy.. BMC Vet Res 2021 Jun 25;17(1):223.
- Bussières G, Jacques C, Lainay O, Beauchamp G, Leblond A, Cadoré JL, Desmaizières LM, Cuvelliez SG, Troncy E. Development of a composite orthopaedic pain scale in horses.. Res Vet Sci 2008 Oct;85(2):294-306.
- Smith RK, McIlwraith CW. Consensus on equine tendon disease: building on the 2007 Havemeyer symposium.. Equine Vet J 2012 Jan;44(1):2-6.
- Dalla Costa E, Minero M, Lebelt D, Stucke D, Canali E, Leach MC. Development of the Horse Grimace Scale (HGS) as a pain assessment tool in horses undergoing routine castration.. PLoS One 2014;9(3):e92281.
- Weiss M, Reich E, Grund S, Mülling CKW, Geiger SM. Validation of 2 noninvasive, markerless reconstruction techniques in biplane high-speed fluoroscopy for 3-dimensional research of bovine distal limb kinematics.. J Dairy Sci 2017 Oct;100(10):8372-8384.
- Geiger SM, Reich E, Böttcher P, Grund S, Hagen J. Validation of biplane high-speed fluoroscopy combined with two different noninvasive tracking methodologies for measuring in vivo distal limb kinematics of the horse.. Equine Vet J 2018 Mar;50(2):261-269.
- Knörlein BJ, Baier DB, Gatesy SM, Laurence-Chasen JD, Brainerd EL. Validation of XMALab software for marker-based XROMM.. J Exp Biol 2016 Dec 1;219(Pt 23):3701-3711.
- de Grauw JC, van Loon JP. Systematic pain assessment in horses.. Vet J 2016 Mar;209:14-22.
- van Loon JPAM, Van Dierendonck MC. Pain assessment in horses after orthopaedic surgery and with orthopaedic trauma.. Vet J 2019 Apr;246:85-91.
- Khan KM, Cook JL, Bonar F, Harcourt P, Astrom M. Histopathology of common tendinopathies. Update and implications for clinical management.. Sports Med 1999 Jun;27(6):393-408.
- Sugg KB, Lubardic J, Gumucio JP, Mendias CL. Changes in macrophage phenotype and induction of epithelial-to-mesenchymal transition genes following acute Achilles tenotomy and repair.. J Orthop Res 2014 Jul;32(7):944-51.
- Killian ML, Cavinatto L, Galatz LM, Thomopoulos S. The role of mechanobiology in tendon healing.. J Shoulder Elbow Surg 2012 Feb;21(2):228-37.
- Alberius P. Bone reactions to tantalum markers. A scanning electron microscopic study.. Acta Anat (Basel) 1983 Apr;115(4):310-8.
- Aronson AS, Jonsson N, Alberius P. Tantalum markers in radiography. An assessment of tissue reactions.. Skeletal Radiol 1985;14(3):207-11.
- Roos PJ, Hull ML, Howell SM. How cyclic loading affects the migration of radio-opaque markers attached to tendon grafts using a new method: a study using roentgen stereophotogrammetric analysis (RSA).. J Biomech Eng 2004 Feb;126(1):62-9.
- Goldin B, Block WD, Pearson JR. Wound healing of tendon--I. Physical, mechanical and metabolic changes.. J Biomech 1980;13(3):241-56.
- Silver IA, Brown PN, Goodship AE, Lanyon LE, McCullagh KG, Perry GC, Williams IF. A clinical and experimental study of tendon injury, healing and treatment in the horse.. Equine Vet J Suppl 1983 Jul;(1):1-43.
- Enwemeka CS. Inflammation, cellularity, and fibrillogenesis in regenerating tendon: implications for tendon rehabilitation.. Phys Ther 1989 Oct;69(10):816-25.
- Denoix JM. Functional anatomy of tendons and ligaments in the distal limbs (manus and pes).. Vet Clin North Am Equine Pract 1994 Aug;10(2):273-322.
- Watkins JP, Auer JA, Gay S, Morgan SJ. Healing of surgically created defects in the equine superficial digital flexor tendon: collagen-type transformation and tissue morphologic reorganization.. Am J Vet Res 1985 Oct;46(10):2091-6.
- van den Boom R, Wilmink JM, O'Kane S, Wood J, Ferguson MW. Transforming growth factor-beta levels during second- intention healing are related to the different course of wound contraction in horses and ponies.. Wound Repair Regen 2002 May-Jun;10(3):188-94.
- Wilmink JM, van Herten J, van Weeren PR, Barneveld A. Retrospective study of primary intention healing and sequestrum formation in horses compared to ponies under clinical circumstances.. Equine Vet J 2002 May;34(3):270-3.
- Pickersgill CH, Marr CM, Reid SW. Repeatability of diagnostic ultrasonography in the assessment of the equine superficial digital flexor tendon.. Equine Vet J 2001 Jan;33(1):33-7.
- Karlin WM, Stewart AA, Durgam SS, Naughton JF, O'Dell-Anderson KJ, Stewart MC. Evaluation of experimentally induced injury to the superficial digital flexor tendon in horses by use of low-field magnetic resonance imaging and ultrasonography.. Am J Vet Res 2011 Jun;72(6):791-8.
- Dakin SG, Jespers K, Warner S, O'Hara LK, Dudhia J, Goodship AE, Wilson AM, Smith RK. The relationship between in vivo limb and in vitro tendon mechanics after injury: a potential novel clinical tool for monitoring tendon repair.. Equine Vet J 2011 Jul;43(4):418-23.
- Crevier N, Pourcelot P, Denoix JM, Geiger D, Bortolussi C, Ribot X, Sanaa M. Segmental variations of in vitro mechanical properties in equine superficial digital flexor tendons.. Am J Vet Res 1996 Aug;57(8):1111-7.
- Solomon LB, Callary SA. Emerging ideas: soft tissue applications of radiostereometric analysis.. Clin Orthop Relat Res 2011 May;469(5):1512-6.
- Smith CK, Hull ML, Howell SM. Migration of radio-opaque markers injected into tendon grafts: a study using roentgen stereophotogrammetric analysis (RSA).. J Biomech Eng 2005 Oct;127(5):887-90.
- Rohwedder T, Fischer M, Böttcher P. In vivo fluoroscopic kinematography of dynamic radio-ulnar incongruence in dogs.. Open Vet J 2017;7(3):221-228.
- Rohwedder T, Fischer M, Böttcher P. In vivo axial humero-ulnar rotation in normal and dysplastic canine elbow joints.. Tierarztl Prax Ausg K Kleintiere Heimtiere 2018 Apr;46(2):83-89.
- Flanigan P, Kshettry VR, Benzel EC. World War II, tantalum, and the evolution of modern cranioplasty technique.. Neurosurg Focus 2014 Apr;36(4):E22.
- Harrison SM, Whitton RC, Kawcak CE, Stover SM, Pandy MG. Relationship between muscle forces, joint loading and utilization of elastic strain energy in equine locomotion.. J Exp Biol 2010 Dec 1;213(Pt 23):3998-4009.
- Williams IF, McCullagh KG, Goodship AE, Silver IA. Studies on the pathogenesis of equine tendonitis following collagenase injury.. Res Vet Sci 1984 May;36(3):326-38.
- Wilmink J, Wilson AM, Goodship AE. Functional significance of the morphology and micromechanics of collagen fibres in relation to partial rupture of the superficial digital flexor tendon in racehorses.. Res Vet Sci 1992 Nov;53(3):354-9.
- Nabeshima Y, Grood ES, Sakurai A, Herman JH. Uniaxial tension inhibits tendon collagen degradation by collagenase in vitro.. J Orthop Res 1996 Jan;14(1):123-30.
- Oloumi MM, Vosough D, Derakhshanfar A, Nematollahi MH. The healing potential of plantago lanceolata ointment on collagenase-induced tendinitis in burros (Equus asinus). J. Equine Vet. Sci. 2011;31:470–474.
- Clayton HM, Schamhardt HC, Willemen MA, Lanovaz JL, Colborne GR. Kinematics and ground reaction forces in horses with superficial digital flexor tendinitis.. Am J Vet Res 2000 Feb;61(2):191-6.
- Clayton HM, Schamhardt HC, Willemen MA, Lanovaz JL, Colborne GR. Net joint moments and joint powers in horses with superficial digital flexor tendinitis.. Am J Vet Res 2000 Feb;61(2):197-201.
- Clayton HM, Willemen MA, Lanovaz JL, Schamhardt HC. Effects of a Heel Wedge in Horses with Superficial Digital Flexor Tendinitis. Vet. Comp. Orthop. Traumatol. 2000;13:1–8.
- Meershoek LS, Lanovaz JL, Schamhardt HC, Clayton HM. Calculated forelimb flexor tendon forces in horses with experimentally induced superficial digital flexor tendinitis and the effects of application of heel wedges.. Am J Vet Res 2002 Mar;63(3):432-7.
- Lustgarten M, Redding WR, Labens R, Davis W, Daniel TM, Griffith E, Seiler GS. ELASTOGRAPHIC EVALUATION OF NATURALLY OCCURING TENDON AND LIGAMENT INJURIES OF THE EQUINE DISTAL LIMB.. Vet Radiol Ultrasound 2015 Nov-Dec;56(6):670-9.
- Bukowiecki CF, Bramlage LR, Gabel AA. In vitro strength of the suspensory apparatus in training and resting horses.. Vet Surg 1987 Mar-Apr;16(2):126-30.
- Wang JH. Mechanobiology of tendon.. J Biomech 2006;39(9):1563-82.
- Smith RK, Goodship AE. The effect of early training and the adaptation and conditioning of skeletal tissues.. Vet Clin North Am Equine Pract 2008 Apr;24(1):37-51.
- Narici MV, Maganaris CN. Adaptability of elderly human muscles and tendons to increased loading.. J Anat 2006 Apr;208(4):433-43.
- Fouré A, Nordez A, Cornu C. Plyometric training effects on Achilles tendon stiffness and dissipative properties.. J Appl Physiol (1985) 2010 Sep;109(3):849-54.
- Kubo K, Ikebukuro T, Maki A, Yata H, Tsunoda N. Time course of changes in the human Achilles tendon properties and metabolism during training and detraining in vivo.. Eur J Appl Physiol 2012 Jul;112(7):2679-91.
- Lochner FK, Milne DW, Mills EJ, Groom JJ. In vivo and in vitro measurement of tendon strain in the horse.. Am J Vet Res 1980 Dec;41(12):1929-37.
- Johnson GA, Livesay GA, Woo SL, Rajagopal KR. A single integral finite strain viscoelastic model of ligaments and tendons.. J Biomech Eng 1996 May;118(2):221-6.
- Williams IF, Heaton A, McCullagh KG. Cell morphology and collagen types in equine tendon scar.. Res Vet Sci 1980 May;28(3):302-10.
- Parry DA, Barnes GR, Craig AS. A comparison of the size distribution of collagen fibrils in connective tissues as a function of age and a possible relation between fibril size distribution and mechanical properties.. Proc R Soc Lond B Biol Sci 1978 Dec 18;203(1152):305-21.
- Diamant J, Keller A, Baer E, Litt M, Arridge RG. Collagen; ultrastructure and its relation to mechanical properties as a function of ageing.. Proc R Soc Lond B Biol Sci 1972 Mar 14;180(1060):293-315.
- Stashak TS, Theoret C. Equine Wound Management. Veterinary Wound Management Society/V.W.M.S.; Ames, IA, USA: 2008.
- Crevier-Denoix N, Collobert C, Pourcelot P, Denoix JM, Sanaa M, Geiger D, Bernard N, Ribot X, Bortolussi C, Bousseau B. Mechanical properties of pathological equine superficial digital flexor tendons.. Equine Vet J Suppl 1997 May;(23):23-6.
- Buchner HH, Savelberg HH, Schamhardt HC, Merkens HW, Barneveld A. Kinematics of treadmill versus overground locomotion in horses.. Vet Q 1994 May;16 Suppl 2:S87-90.
- Back W, Schamhardt HC, Van Weeren PR, Barneveld A. A comparison between the trot of pony and horse foals to characterize equine locomotion at young age.. Equine Vet J Suppl 1999 Jul;(30):240-4.
- Crevier-Denoix N, Ravary-Plumioën B, Vergari C, Camus M, Holden-Douilly L, Falala S, Jerbi H, Desquilbet L, Chateau H, Denoix JM, Pourcelot P. Comparison of superficial digital flexor tendon loading on asphalt and sand in horses at the walk and trot.. Vet J 2013 Dec;198 Suppl 1:e130-6.
Citations
This article has been cited 1 times.- Demuth OE, Herbst E, Polet DT, Wiseman ALA, Hutchinson JR. Modern three-dimensional digital methods for studying locomotor biomechanics in tetrapods.. J Exp Biol 2023 Apr 25;226(Suppl_1).
Use Nutrition Calculator
Check if your horse's diet meets their nutrition requirements with our easy-to-use tool Check your horse's diet with our easy-to-use tool
Talk to a Nutritionist
Discuss your horse's feeding plan with our experts over a free phone consultation Discuss your horse's diet over a phone consultation
Submit Diet Evaluation
Get a customized feeding plan for your horse formulated by our equine nutritionists Get a custom feeding plan formulated by our nutritionists