Monitoring of the repair process of surgically created lesions in equine superficial digital flexor tendons by use of computerized ultrasonography.
Abstract: To evaluate quantitative ultrasonography for objective monitoring of the healing process and prognostication of repair quality in equine superficial digital flexor (SDF) tendons. Methods: 6 horses with standardized surgical lesions in SDF tendons of both forelimbs. Methods: Healing was monitored for 20 weeks after surgery by use of computerized ultrasonography. Pixels were categorized as C (intact fasciculi), B (incomplete fasciculi), E (accumulations of cells and fibrils), or N (homogenous fluid or cells). Four scars with the best quality of repair (repair group) and 4 scars with the lowest quality (inferior repair group) were identified histologically. Ratios for C, B, E, and N in both groups were compared. Results: During 4 weeks after surgery, lesions increased 2- to 4-fold in length and 10-fold in volume. Until week 3 or 4, structure-related C and B ratios decreased sharply, whereas E and N ratios increased. After week 4, C and B ratios increased with gradually decreasing E and N ratios. At week 12, C and B ratios were equivalent. After week 12, C ratio increased slowly, but B ratio more rapidly. At week 20, C ratio remained constant, B ratio was substantially increased, and E and N ratios decreased. Values for the inferior repair group were most aberrant from normal. Ratios for C differed significantly between repair and inferior repair groups at weeks 16 and 18 and for B beginning at 14 weeks. Conclusions: Computerized ultrasonography provided an excellent tool for objective monitoring of healing tendons in horses and reliable prognostication of repair quality.
Publication Date: 2009-01-06 PubMed ID: 19119947DOI: 10.2460/ajvr.70.1.37Google Scholar: Lookup
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- Comparative Study
- Journal Article
Summary
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The research presents results of a study where computerized ultrasonography was used to monitor the healing process of lesions in horse tendons. The study showed the effectiveness of this technique in not only monitoring the healing process, but also in predicting the quality of the repair.
Research Methods
- The study was conducted on six horses with standard surgical lesions in their superficial digital flexor (SDF) tendons in both forelimbs.
- The process of healing was monitored for a duration of 20 weeks after surgery using computerized ultrasonography.
- Images obtained from the ultrasonography were analyzed and pixels were categorized into four types: C (intact fasciculi), B (incomplete fasciculi), E (accumulations of cells and fibrils), or N (homogenous fluid or cells).
- Measurements were taken at different stages of the repair process and compared between four horses with the best quality repair (repair group) and four with the lowest quality (inferior repair group).
Results
- In the four weeks following surgery, the size of lesions increased 2 to 4 times in length and 10 times in volume.
- The ratio of intact fasciculi (C) and incomplete fasciculi (B) sharply decreased until the third or fourth week, with a corresponding increase in the ratios of accumulations of cells and fibrils (E) and homogenous fluid or cells (N).
- After the fourth week, C and B ratios showed an increase while E and N ratios started to decrease.
- By the twelfth week, C and B ratios were found to be equivalent.
- After the twelfth week, the C ratio showed a slow increase while the B ratio increased more rapidly.
- At the end of the twenty-week study period, it was observed that the C ratio remained constant, the B ratio had increased significantly, and the E and N ratios had decreased.
- The values obtained for the inferior repair group most noticeably varied from the normal ratios.
- Significant differences were found between the repair and inferior repair groups in the C ratio at 16 and 18 weeks and in the B ratio from 14 weeks onwards.
Conclusion
- The study concludes that computerized ultrasonography is an excellent tool for objectively monitoring the healing of tendons in horses.
- Aside from monitoring, it also provides reliable predictions of the quality of the repair.
Cite This Article
APA
van Schie HT, Bakker EM, Cherdchutham W, Jonker AM, van de Lest CH, van Weeren PR.
(2009).
Monitoring of the repair process of surgically created lesions in equine superficial digital flexor tendons by use of computerized ultrasonography.
Am J Vet Res, 70(1), 37-48.
https://doi.org/10.2460/ajvr.70.1.37 Publication
Researcher Affiliations
- Departments of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, 3508 TD Utrecht, The Netherlands.
MeSH Terms
- Animals
- Female
- Horses / injuries
- Horses / physiology
- Image Processing, Computer-Assisted
- Longitudinal Studies
- Male
- Tendon Injuries / diagnostic imaging
- Tendon Injuries / veterinary
- Ultrasonography / methods
- Ultrasonography / veterinary
- Wound Healing / physiology
Citations
This article has been cited 18 times.- Khajeh A, Baniadam A, Oryan A, Ghadiri A, Naddaf H. Effectiveness of nuchal ligament autograft in the healing of an experimental superficial digital flexor tendon defect in equid. Vet Res Forum 2021 Winter;12(1):53-61.
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- Zielińska P, Nicpoń J, Kiełbowicz Z, Soroko M, Dudek K, Zaborski D. Effects of High Intensity Laser Therapy in the Treatment of Tendon and Ligament Injuries in Performance Horses. Animals (Basel) 2020 Jul 31;10(8).
- Lawson A, Noorkoiv M, Masci L, Mohagheghi AA. Ankle Joint Position and the Reliability of Ultrasound Tissue Characterization of the Achilles Tendon: A Pilot Study. Med Sci Monit 2019 Sep 13;25:6884-6893.
- Frame K, Ben-Amotz O, Simpler R, Zuckerman J, Ben-Amotz R. The use of bidirectional barbed suture in the treatment of a complete common calcanean tendon rupture in a dog: Long-term clinical and ultrasonographic evaluation. Clin Case Rep 2019 Aug;7(8):1565-1572.
- Pereira CS, Santos RCG, Whiteley R, Finni T. Reliability and methodology of quantitative assessment of harvested and unharvested patellar tendons of ACL injured athletes using ultrasound tissue characterization. BMC Sports Sci Med Rehabil 2019;11:12.
- King D, Yakubek G, Chughtai M, Khlopas A, Saluan P, Mont MA, Genin J. Quadriceps tendinopathy: a review-part 1: epidemiology and diagnosis. Ann Transl Med 2019 Feb;7(4):71.
- Wagner JR, Taguchi T, Cho JY, Charavaryamath C, Griffon DJ. Evaluation of Stem Cell Therapies in a Bilateral Patellar Tendon Injury Model in Rats. J Vis Exp 2018 Mar 30;(133).
- Watts AE, Millar NL, Platt J, Kitson SM, Akbar M, Rech R, Griffin J, Pool R, Hughes T, McInnes IB, Gilchrist DS. MicroRNA29a Treatment Improves Early Tendon Injury. Mol Ther 2017 Oct 4;25(10):2415-2426.
- Geburek F, Roggel F, van Schie HTM, Beineke A, Estrada R, Weber K, Hellige M, Rohn K, Jagodzinski M, Welke B, Hurschler C, Conrad S, Skutella T, van de Lest C, van Weeren R, Stadler PM. Effect of single intralesional treatment of surgically induced equine superficial digital flexor tendon core lesions with adipose-derived mesenchymal stromal cells: a controlled experimental trial. Stem Cell Res Ther 2017 Jun 5;8(1):129.
- Masci L, Spang C, van Schie HT, Alfredson H. Achilles tendinopathy-do plantaris tendon removal and Achilles tendon scraping improve tendon structure? A prospective study using ultrasound tissue characterisation. BMJ Open Sport Exerc Med 2015;1(1):e000005.
- Geburek F, Gaus M, van Schie HT, Rohn K, Stadler PM. Effect of intralesional platelet-rich plasma (PRP) treatment on clinical and ultrasonographic parameters in equine naturally occurring superficial digital flexor tendinopathies - a randomized prospective controlled clinical trial. BMC Vet Res 2016 Sep 7;12(1):191.
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- Hatazoe T, Endo Y, Iwamoto Y, Korosue K, Kuroda T, Inoue S, Murata D, Hobo S, Misumi K. A study of the distribution of color Doppler flows in the superficial digital flexor tendon of young Thoroughbreds during their training periods. J Equine Sci 2015;26(4):99-104.
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