Musculoskeletal responses of 2-year-old Thoroughbred horses to early training. 4. Morphometric, microscopic and biomechanical properties of the digital tendons of the forelimb

AIM: To determine the weight, volume, density and cross-sectional area (CSA) of the digital flexor tendons, common digital extensor tendon (CDET) and suspensory ligament (SL) of the forelimb of young Thoroughbred horses in early training, and to assess the response to a training programme of known parameters of superficial digital flexor tendon (SDFT) tissue at mid-metacarpal level. METHODS: The tendons of seven 2-year-old Thoroughbred horses in training were inspected, transected into segments of known length, and compared with those from seven untrained horses matched for age, sex and breed. The weight, volume, density and CSA of each segment, and the crimp angle, histological features, and biomechanical ultimate stress and stiffness of tendon samples from the mid-metacarpal region of the SDFT were determined. RESULTS: There was no macroscopic evidence of swelling or discolouration in any of the tendon segments or cut surfaces. The volumes of SDFT and CDET segments of horses in the trained group were significantly greater than those in the untrained group (p=0.036 and p=0.039, respectively). A greater increase in volume than weight resulted in a lower density in the SDFT but not CDET in trained compared with untrained horses (p=0.038). CSA of these two tendons was significantly greater in the trained group (p=0.002 and 0.036, respectively), the percentage increase being greater in the CDET than the SDFT. The number of tenocytes at four sites in the mid-metacarpal SDFT region was less in trained than untrained horses (p=0.025). There was no histological evidence of inflammation, and no difference in crimp angle between groups. There was no significant between-group difference in stiffness or ultimate stress of tendon strips. CONCLUSIONS: Volume and CSA of the SDFT and CDET were larger in trained than untrained horses. The SDFT was less dense in the trained group. Because no evidence of tendonitis was detected and training appeared to have no significant effect on crimp angle or biomechanical properties of tendon strips, the size and density changes were presumed to be adaptive and induced by the training. CLINICAL RELEVANCE: Although evident in this in vitro study, the detection of adaptive from initial pathological increase in size of the SDFT is likely to be difficult in vivo.     

Musculoskeletal responses of 2-year-old Thoroughbred horses to early training. 3. In vivo ultrasonographic assessment of the cross-sectional area and echogenicity of the superficial digital flexor tendon

AIM: To determine if the superficial digital flexor tendon (SDFT) of young Thoroughbred horses changed in size and echogenicity in association with early race training.

METHODS: Cross-sectional area (CSA) and echogenicity were determined ultrasonographically at five levels of the SDFT of the forelimbs of 2-year-old fillies (n=14), corresponding to 4, 8, 12, 16 and 20 cm distal to the accessory carpal bone (DACB). Measurements were made before and after a 13-week period in which a trained group of seven horses was compared with another group of seven untrained horses.

RESULTS: Level below the accessory carpal bone had a significant effect on CSA and Level 8 was smaller than all other levels except Level 12, while Level 12 was smaller than Levels 4 and 20 but not different from Levels 8 and 16. There was a significant interaction between level and time due to effects observed at Level 8. The CSA at Level 8 measured pre-training was different from that of Levels 4 and 20 in both pre- and post-training groups (p<0.05), but when measured post-training was not different from any other measurement. There was also a significant interaction between treatment group and time. There was no difference between CSA for the untrained and trained groups at the pre-training observation (p=0.9), but post-training the CSA (pooled over all levels) in trained horses was significantly larger than that of the untrained horses both post-training (p=0.019) and pre-training (p=0.034), and was not different from the pretraining CSA recorded in the trained group (p=0.29). Treatment group had no effect on echogenicity (p=0.43), while echogenicity was less at the end of the trial in both trained and untrained horses (p<0.001).

CONCLUSIONS: Early training for racing was associated with an increase in mean CSA of the SDFT. Other factors such as age and maturity may play a role in limiting this increase.     

Musculoskeletal responses of 2-year-old Thoroughbred horses to early training. 3. In vivo ultrasonographic assessment of the cross-sectional area and echogenicity of the superficial digital flexor tendon

AIM: To determine if the superficial digital flexor tendon (SDFT) of young Thoroughbred horses changed in size and echogenicity in association with early race training. METHODS: Cross-sectional area (CSA) and echogenicity were determined ultrasonographically at five levels of the SDFT of the forelimbs of 2-year-old fillies (n=14), corresponding to 4, 8, 12, 16 and 20 cm distal to the accessory carpal bone (DACB). Measurements were made before and after a 13-week period in which a trained group of seven horses was compared with another group of seven untrained horses. RESULTS: Level below the accessory carpal bone had a significant effect on CSA and Level 8 was smaller than all other levels except Level 12, while Level 12 was smaller than Levels 4 and 20 but not different from Levels 8 and 16. There was a significant interaction between level and time due to effects observed at Level 8. The CSA at Level 8 measured pre-training was different from that of Levels 4 and 20 in both pre- and post-training groups (p<0.05), but when measured post-training was not different from any other measurement. There was also a significant interaction between treatment group and time. There was no difference between CSA for the untrained and trained groups at the pre-training observation (p=0.9), but post-training the CSA (pooled over all levels) in trained horses was significantly larger than that of the untrained horses both post-training (p=0.019) and pre-training (p=0.034), and was not different from the pre-training CSA recorded in the trained group (p=0.29). Treatment group had no effect on echogenicity (p=0.43), while echogenicity was less at the end of the trial in both trained and untrained horses (p<0.001). CONCLUSIONS: Early training for racing was associated with an increase in mean CSA of the SDFT. Other factors such as age and maturity may play a role in limiting this increase.     

Effects of exercise on tenocyte cellularity and tenocyte nuclear morphology in immature and mature equine digital tendons

REASON FOR PERFORMING STUDY: The injury-prone, energy-storing equine superficial digital flexor tendon (SDFT) of the mature performance horse has a limited ability to respond to exercise in contrast with the noninjury-prone, anatomically opposing common digital extensor tendon (CDET). Previous studies have indicated low levels of cellular activity in the mature SDFT, but in foal tendons the tenocytes may still have the ability to adapt positively to increased exercise. OBJECTIVES: To measure tenocyte densities and types in histological sections from the SDFT and CDET of horses from controlled long-term, short-term and foal exercise studies. METHODS: Specimens were collected from mid-metacarpal segments of the CDET and SDFT for each horse and processed for histology; central and peripheral regions of the SDFT cross-section were analysed separately (SDFTc, SDFTp). Tenocyte nuclei were counted in a total area of 1.59 mm(2) for each tendon region in each horse. Each nucleus was classified as type 1 (elongate and thin), type 2 (ovoid and plump) or type 3 (chondrocyte-like); type 1 cells are proposed to be less synthetically active than type 2 cells. RESULTS: No significant differences were noted between exercise and control groups in any of the studies, with the exception of an exercise-related reduction in the proportion of type 1 tenocytes for all tendons combined in the long-term study. There were tendon- and site-specific differences in tenocyte densities and proportions of type 1 and 2 cells in all 3 studies. CONCLUSIONS AND POTENTIAL RELEVANCE: There was no indication that exercise increased tenocyte density or proportions of the (theoretically) more active type 2 cells in immature horses (short-term and foal studies), perhaps because the training regimens did not achieve certain threshold strain levels. In the foal study these findings can still be interpreted positively as evidence that the training regimen did not induce subclinical damage.     

The influence of exercise during growth on ultrasonographic parameters of the superficial digital flexor tendon of young Thoroughbred horses

REASON FOR PERFORMING STUDY: Conditioning by early training may influence the composition of certain musculoskeletal tissues, but very few data exist on its effect during growth on tendon structure and function. OBJECTIVES: To investigate whether conditioning exercise in young foals would lead to any ultrasonographically detectable damage to the superficial digital flexor tendon or an increase in cross-sectional area (CSA). METHODS: Thirty-three Thoroughbred foals reared at pasture were allocated to 2 groups: control (PASTEX) allowed exercise freely at pasture; and CONDEX, also at pasture, began conditioning exercise from mean age 21 days over 1030 m on a purpose-built oval grass track, for 5 days/week until mean age 18 months. Foals were observed daily, and underwent orthopaedic examination monthly. Ultrasonographic images of the superficial digital flexor tendon (SDFT) at the mid-metacarpal level of both forelimbs were obtained in all foals at ages 5, 8, 12, 15 and 18 months. CSA was validated (r(2) = 0.89) by determining CSA from digital photographs of the transected SDFT surface from 12 of the horses necropsied at age 17.1 months. RESULTS: here was no clinical or ultrasonographic evidence of tendonopathy in either group and the greatest increase in mean CSA in both groups occurred between age 5 and 8 months. Across all age categories, there was no significant difference in mean CSA between the left and right limbs, or colts and fillies; there was a trend towards a larger CSA in the CONDEX group (P = 0.058). CONCLUSIONS: There was no conclusive evidence for a structural adaptive hypertrophy of the SDFT, probably because the regimen was insufficiently rigorous or because spontaneous pasture exercise may induce maximal development of energy storing tendons. POTENTIAL RELEVANCE: A moderate amount of early conditioning exercise against a background of constant exercise at pasture is not harmful to the development of the flexor tendons.     

Musculoskeletal responses of 2-year-old Thoroughbred horses to early training. 6. Bone parameters in the third metacarpal and third metatarsal bones

AIM: To determine the effect of a known training regimen on the size and mineral content of the third metacarpal (Mc3) and third metatarsal (Mt3) bones of 2-year-old Thoroughbred horses trained on racetracks. METHODS: Mc3 and Mt3 of seven horses trained on grass and sand tracks were scanned at several sites using conventional quantitative and peripheral computed tomography (CT). Bone dimensions and density in the diaphysis and epiphysis were compared with those from seven untrained horses. Calcein label was injected in two clusters, during Weeks 9 and 12. The extent and rate of diaphyseal modelling was determined by confocal fluorescent microscopic examination of thin plane parallel sections of the mid-metacarpal region. RESULTS: Volumetric bone mineral density (BMDv) of the epiphysis was markedly higher and of the diaphysis was slightly higher in trained compared with untrained horses, but greater bone size in the trained horses had the greatest effect on an index of bone strength. Active osteons, defined as Haversian systems containing calcein label, were fewer, of smaller diameter at the time of calcein injection, and had a greater bone apposition rate in trained than in untrained horses. CONCLUSIONS: Conventional training of 2-year-old Thoroughbred racehorses over a 13-week period had a significant effect on bone size, density and strength index when compared to untrained horses. CLINICAL RELEVANCE: Bone responded rapidly to early training. The data provide reference values and sites for use in longitudinal studies of commercial training regimens.     

Are the material properties and matrix composition of equine flexor and extensor tendons determined by their functions?

REASONS FOR PERFORMING STUDY: Injury to the superficial digital flexor tendon (SDFT) is common in competition horses. The SDFT contributes to locomotory efficiency by storing energy; such tendons have low safety margins. Tendons which merely position the limb, including the opposing common digital extensor tendon (CDET), are rarely injured. The current failure of strategies to prevent or effectively treat injury to the SDFT indicates the importance of understanding how it differs from tendons which are not injury-prone. HYPOTHESIS: That the structural and material properties and matrix composition of the SDFT and CDET differ, reflecting their specific functional requirements in vivo. METHODS: Forelimb tendons were harvested from 26 mature horses and loaded to failure prior to matrix composition analysis of specimens. RESULTS: The SDFT had a significantly higher cross-sectional area, structural stiffness, failure load and failure strain and a lower elastic modulus than the CDET (P < 0.0001). CONCLUSIONS: The SDFT has conflicting requirements for strength and elasticity; although as a whole it is a stiffer structure than the CDET, differences in the matrix molecular composition including water and total sulphated glycosaminoglycan contents allow it to remain more elastic as a material. POTENTIAL RELEVANCE: Further information on how the two tendons attain these different properties may be of use in the development of prevention and treatment strategies for SDFT rupture.     

Musculoskeletal responses of 2-year-old Thoroughbred horses to early training. 6. Bone parameters in the third metacarpal and third metatarsal bones

AIM: To determine the effect of a known training regimen on the size and mineral content of the third metacarpal (Mc3) and third metatarsal (Mt3) bones of 2-year-old Thoroughbred horses trained on racetracks.

METHODS: Mc3 and Mt3 of seven horses trained on grass and sand tracks were scanned at several sites using conventional quantitative and peripheral computed tomography (CT). Bone dimensions and density in the diaphysis and epiphysis were compared with those from seven untrained horses. Calcein label was injected in two clusters, during Weeks 9 and 12. The extent and rate of diaphyseal modelling was determined by confocal fl uorescent microscopic examination of thin plane parallel sections of the mid-metacarpal region.

RESULTS: Volumetric bone mineral density (BMDv) of the epiphysis was markedly higher and of the diaphysis was slightly higher in trained compared with untrained horses, but greater bone size in the trained horses had the greatest effect on an index of bone strength. Active osteons, defined as Haversian systems containing calcein label, were fewer, of smaller diameter at the time of calcein injection, and had a greater bone apposition rate in trained than in untrained horses.

CONCLUSIONS: Conventional training of 2-year-old Thoroughbred racehorses over a 13-week period had a significant effect on bone size, density and strength index when compared to untrained horses.

CLINICAL RELEVANCE: Bone responded rapidly to early training. The data provide reference values and sites for use in longitudinal studies of commercial training regimens.     

Risk factors for injury to the superficial digital flexor tendon and suspensory apparatus in Thoroughbred racehorses in New Zealand

AIM: To investigate risk factors for injury to the superficial digital flexor tendon (SDFT) and suspensory apparatus (SA) of the forelimbs in Thoroughbred racehorses in New Zealand.

METHODS: Poisson and negative binomial regression, with exposure time represented by cumulative training days for each horse, were used to relate explanatory variables to the incidence rate (IR) of cases of inflammation of the SDFT (n=51), and injuries involving the SA (n=48) in a population of 1,571 commercially-trained racehorses over 554,745 study days. Only the first occurrence of an injury for any one horse was eligible for inclusion. Separate analyses were run for data from horses in training regardless of whether they had started in a trial or race, and using a subset of these data restricted to those preparations associated with at least one start in a trial or race. Results were reported as incidence rate ratios (IRR) and 95% confidence intervals (CI).

RESULTS: Male horses had a higher risk of injury to the SA (IRR 2.57; p=0.005) and tended to have a higher risk of injury to the SDFT (IRR 1.74; p=0.09) than female horses. Increasing age was associated with increased risk of injury. Horses aged 4 and ≥5 years were 6.76 (p<0.001) and 15.26 (p<0.001) times more likely to incur injury to the SDFT, and 2.91 (p=0.02) and 3.54 (p=0.005) times more likely to incur injury to the SA, respectively, than 2-year-olds. Horses were more likely to suffer an injury to the SDFT or SA in a training preparation that was not associated with any starts in official trials or races compared with those preparations that were associated with more than one start (p<0.001), and more likely to injure the SA compared with preparations containing one start (p=0.03). The IR of injury to the SDFT tended to be lower between November–January (IRR 0.78; p=0.08) and February-April (IRR 0.75; p=0.08) compared with August–October. Incidence of injury to the SDFT or SA was not associated with the cumulative distance raced in the last 30 days of a training preparation.

CONCLUSION: This study identified risk factors for injury to the SDFT and SA in Thoroughbred racehorses in New Zealand. Injuries were more likely in males, older horses and in horses in training preparations without any starts. There was no evidence of association between injury and cumulative high-speed exercise.     

Ultrasonographic assessment of the superficial digital flexor tendons of National Hunt racehorses in training over two racing seasons

Reasons for performing study: It is important to ascertain the prevalence of superficial digital flexor tendon (SDFT) injuries and to improve methods of predicting injury in National Hunt (NH) racehorses. Objectives: To establish: 1) the prevalence of SDFT tendinopathy in NH horses; 2) whether routine ultrasonography can be used to predict SDFT injuries; 3) whether previous tendinopathy predisposes to reinjury; 4) a normal range for the SDFT cross‐sectional area (CSA); and 5) the effects of gender, age, background (ex‐flat or exstore), limb, training and rest periods on SDFT CSA. Methods: Routine ultrasound assessment of the palmar metacarpal soft tissues of 263 NH racehorses was performed on up to 6 occasions over 2 NH racing seasons. Results: The prevalence of SDFT pathology detected using ultrasonography was 24% (n = 148), with a nonsignificant variation between yards of 10–40%. No changes in SDFT CSA or ultrasonographic appearance were detected prior to injury. Older horses had a significantly higher prevalence of SDFT pathology compared to younger horses, and horses with tendinopathy were more likely to suffer an acute injury compared to horses with no evidence of pathology. A reference range for normal CSA measurements was established as 77–139 mm² at level 4, from 142 horses with no ultrasonographic evidence of SDFT pathology. The CSA of normal horses did not vary significantly with age, limb or over 2 racing seasons, but did with sex and background. Conclusions: The study confirms that SDFT tendinopathy is common in NH horses, with substantial variation between training yards. Ultrasonography at 3 month intervals did not seem to predict acute SDFT injuries. Potential relevance: Variation in the prevalence of tendinopathy between yards suggests that training methods may influence injury rate. It was not possible to predict injury using routine ultrasonography and therefore other methods must be identified. A normal reference range for SDFT CSA is provided.     

Risk factors for injury to the superficial digital flexor tendon and suspensory apparatus in Thoroughbred racehorses in New Zealand

AIM: To investigate risk factors for injury to the superficial digital flexor tendon (SDFT) and suspensory apparatus (SA) of the forelimbs in Thoroughbred racehorses in New Zealand. METHODS: Poisson and negative binomial regression, with exposure time represented by cumulative training days for each horse, were used to relate explanatory variables to the incidence rate (IR) of cases of inflammation of the SDFT (n=51), and injuries involving the SA (n=48) in a population of 1,571 commercially- trained racehorses over 554,745 study days. Only the first occurrence of an injury for any one horse was eligible for inclusion. Separate analyses were run for data from horses in training regardless of whether they had started in a trial or race, and using a subset of these data restricted to those preparations associated with at least one start in a trial or race. Results were reported as incidence rate ratios (IRR) and 95% confidence intervals (CI). RESULTS: Male horses had a higher risk of injury to the SA (IRR 2.57; p=0.005) and tended to have a higher risk of injury to the SDFT (IRR 1.74; p=0.09) than female horses. Increasing age was associated with increased risk of injury. Horses aged 4 and > or =5 years were 6.76 (p<0.001) and 15.26 (p<0.001) times more likely to incur injury to the SDFT, and 2.91 (p=0.02) and 3.54 (p=0.005) times more likely to incur injury to the SA, respectively, than 2-year-olds. Horses were more likely to suffer an injury to the SDFT or SA in a training preparation that was not associated with any starts in official trials or races compared with those preparations that were associated with more than one start (p<0.001), and more likely to injure the SA compared with preparations containing one start (p=0.03). The IR of injury to the SDFT tended to be lower between November-January (IRR 0.78; p=0.08) and February-April (IRR 0.75; p=0.08) compared with August-October. Incidence of injury to the SDFT or SA was not associated with the cumulative distance raced in the last 30 days of a training preparation. CONCLUSION: This study identified risk factors for injury to the SDFT and SA in Thoroughbred racehorses in New Zealand. Injuries were more likely in males, older horses and in horses in training preparations without any starts. There was no evidence of association between injury and cumulative high-speed exercise.     

Age-related changes to the molecular and cellular components of equine flexor tendons.

Specific tendons show a high incidence of partial central core rupture which is preceded by degeneration. In the performance horse, the superficial digital flexor tendon (SDFT) is most often affected. We have described previously the molecular changes that are associated with degeneration in the central core region of the equine SDFT. The pathophysiological mechanism leading to change in synthetic activity of central zone cells in degenerated tendons is not known. In this study, we test the hypothesis that ageing results in matrix composition changes within the central zone of the SDFT. Extracellular matrix composition and cellularity were analysed in equine SDFTs collected from Thoroughbred horses and compared with a flexor tendon which rarely shows degenerative change and subsequent injury (deep digital flexor tendon, DDFT). Data were examined for age-related changes to central and peripheral zone tissue of the SDFT and DDFT. Ageing in both tendons (SDFT and DDFT) resulted in a significant increase in collagen-linked fluorescence and a decrease in cellularity in the DDFT but not the SDFT. The central zone tissue from the SDFT had a significantly higher proportion of type III collagen than the peripheral zone of the tendon. The highest level of type III collagen was found in the central zone tissue of the SDFT from the older group of horses and this may represent the early stages of a degenerative change. Collagen content did not differ between the 2 flexor tendons; however, there were differences in collagen type and organisation. The SDFT had a higher type III collagen content, higher levels of the mature trifunctional collagen crosslink hydroxylysylpyridinoline, lower total chondroitin sulphate equivalent glycosaminoglycan content, smaller diameter collagen fibrils and a higher cellularity than the DDFT. In conclusion, differences in macromolecular composition exist between the flexor tendons and ageing contributes to a tendon specific change in composition.     

Musculoskeletal responses of 2-year-old Thoroughbred horses to early training. 8. Quantitative back-scattered electron scanning electron microscopy and confocal fluorescence microscopy of the epiphysis of the third metacarpal bone

AIM: To characterise and explain the increase in density evident by computerised tomography (CT) and radiography in companion studies as a response to training, in bone in the palmar and dorsal regions of the condyles of the third metacarpal bone (Mc3) of 2-year-old Thoroughbred horses.

METHODS: Compositional back-scattered electron (BSE) imaging in scanning electron microscopy (SEM) and confocal scanning laser microscopy (CSLM) were conducted on polymethyl methacrylate (PMMA)-embedded mediolateral slices of the right distal Mc3 from seven 2-year-old Thoroughbred horses trained on a racetrack and seven untrained horses kept at pasture. One left Mc3 from each group was studied in transverse section planes. This study focussed on regions of Mc3 found to differ in density between the trained and untrained horses in companion studies using CT and radiography.

RESULTS: The increase of bone density in the condyles of Mc3 in trained horses compared with untrained horses occurred, without prior osteoclastic resorption, via the deposition of new bone on pre-existing internal surfaces. Within prior marrow spaces of cancellous bone, there was also rapid formation of immature strands and fronds of bone which were more cellular and mineralised, and more lamellar bone tissue was deposited on these new scaffolding elements in the trained horses. Both resulted in increased bone volume fraction (BVF). The microscopic mineralisation density of the bulk of the new tissue was lower than in pre-existing bone, and CT and radiography underestimated the increase in BVF. The new tissue was thus probably less stiff at the microscopic scale than pre-existing bone, though its addition would stiffen the global structure.

CONCLUSIONS: In Mc3 of all the trained horses, there were obvious differences in microscopic structure compared with those from the untrained horses. Moderate, industry-standard levels of exercise used to prepare young horses for racing induced the formation of new bone in non-bone spaces in bone tissue, such that the bone organ should better withstand later increased levels of exercise.     

Microwave thermography: a non-invasive technique for investigation of injury of the superficial digital flexor tendon in the horse.

Microwave thermographs were recorded from 77 normal horses. In 51% the lowest temperature was recorded in the mid-metacarpal region, and in 41% it was in the distal metacarpal region. The mean temperature of the normal limbs ranged from 25.04 to 37.4 degrees C. Maximum temperature differences between symmetrical points in both forelimbs ranged from 0 to 5.33 degrees C and differences in mean limb temperatures between both forelimbs ranged from 0 to 2.91 degrees C. In 48 horses with acute (less than 4 weeks' duration) injury of the superficial digital flexor tendon (SDFT) (36 unilateral, 12 bilateral) and 12 horses with acute injury of the soft tissues of the palmar metacarpal region other than the SDFT (all unilateral) 66% of forelimbs had acute SDFT injury, and 50% of those with other soft tissue injuries, had elevations of the temperature in the mid- or distal metacarpal region. Abnormal values for mean limb temperature, difference in mean limb temperature and maximum temperature difference between locations in opposite forelimbs were detected in 75% of the horses with SDFT injury and in only 16% of the horses with other soft tissue injury. The sensitivity of microwave thermography for the detection of SDFT injury was 81% and the specificity 74%. When 30 horses in National Hunt training were examined weekly for 5 weeks, 2 horses sustained SDFT injury during that period. The microwave thermographs recorded from these 2 horses, at 1 and 2 weeks before the onset of clinical signs, were abnormal. However, 16 horses which did not develop tendon injury also displayed thermographic abnormalities.     

Musculoskeletal responses of 2-year-old Thoroughbred horses to early training. 7. Bone and articular cartilage response in the carpus

AIM: To describe features of the morphology of the carpus, quantify the thickness of hyaline and calcified cartilage, and to describe the morphology and density of subchondral bone in the third carpal bone (C3) of young Thoroughbred horses in early training.

METHODS: C3 of seven 2-year-old horses in training and seven untrained horses matched for age, sex and breed were assessed by gross appearance, computed tomography, fine-structure radiography, image analysis of high-resolution photographs, and histology.

RESULTS: Macroscopic lesions in cartilage were few and mild, and not significantly different between groups. High bone mineral density (BMD), in some cases typical of cortical bone, was confined to the dorsal load path, and was significantly higher in trained than in untrained horses (p<0.01). In the most dorsoproximal aspect of the radial articular facet, apparently outside the dorsal load path, the BMD in both trained and untrained horses was significantly less than in other regions of interest (ROIs). Adaptive increase in density was associated with thickening of the (junctions of) trabeculae oriented proximo-distally. Hyaline cartilage was thicker (p<0.001) in the concavity of the radial articular facet than dorsal or palmar to it, and was thicker in the trained than untrained group (p=0.007). No such differences were detected in the thickness of articular calcified cartilage (ACC).

CONCLUSIONS: The rapid response of bone in C3 to relatively small amounts of high-speed exercise was confirmed. A previously unreported increase in thickness of hyaline cartilage was evident, perhaps indicating that this tissue may be more responsive than hitherto thought, at least to particular types of exercise at particular times. These changes occurred with little evidence of abnormality, and thus appeared to be adaptive to the exercise regimen. The model developed should be used for further definition of the exercise stimulus required to produce adaptive, protective changes in sites susceptible to athletic injury.

CLINICAL RELEVANCE: The data will serve as reference for use in subsequent imaging studies in which sophisticated aids such as magnetic resonance imaging (MRI) may be used to predict carpal lesions.     

Association between race history and risk of superficial digital flexor tendon injury in Thoroughbred racehorses

OBJECTIVE: To determine whether race history, including the number of races and total race distance, was associated with risk of superficial digital flexor tendon (SDFT) injury in Thoroughbred racehorses in Japan. DESIGN: Matched case-control study. ANIMALS: 515 Thoroughbred racehorses (case horses) that sustained an SDFT injury during training or racing in Japan during 2002 and 951 horses (control horses) without SDFT injury that were matched with case horses on the basis of age and month of the latest race. PROCEDURE: Variables related to race history were compared between case and control horses by means of conditional logistic regression. RESULTS: The odds of SDFT injury increased as mean race distance and mean body weight at race time increased. Compared with females that had never competed in steeplechase races, males regardless of steeplechase race history and females that had competed in steeplechase races had higher odds of SDFT injury. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that longer mean distance per race, heavier mean body weight at race time, steeplechase experience, and sex (male) increased the risk of SDFT injury in Thoroughbred racehorses.     

Effect of exercise on age-related changes in collagen fibril diameter distributions in the common digital extensor tendons of young horses

OBJECTIVE: To determine whether specific treadmill exercise regimens would accelerate age-related changes in collagen fibril diameter distributions in the common digital extensor tendon (CDET) of the forelimbs of young Thoroughbreds. ANIMALS: 24 female Thoroughbreds. PROCEDURE: Horses were trained for 18 weeks (6 horses; short term) or 18 months (5 horses; long term) on a high-speed treadmill; 2 age-matched control groups (6 horses/group) performed walking exercise only. Horses were (mean +/- SD) 24 +/- 1 months and 39 +/- 1 months old at termination of the short-term and long-term regimens, respectively. Midmetacarpal CDET specimens were obtained and processed for transmission electron microscopy. Diameter and area of at least 1,000 collagen fibrils/specimen were measured by use of computerized image analysis. Mass-average diameter (MAD) of collagen fibrils and collagen fibril index were calculated for each horse. RESULTS: Collagen fibril MAD for the older horses was significantly less than that for the younger horses. Exercise did not significantly affect fibril diameter or distributions in either age group, and collagen fibril index did not differ significantly between groups. CONCLUSIONS AND CLINICAL RELEVANCE: Age-related reduction in collagen fibril MAD agreed with findings for other tendons and species. Training did not accelerate age-related change in the CDET in contrast to a reported decrease in collagen fibril MAD in the superficial digital flexor tendon of horses trained long term. Our results support the concept that the functionally distinct nature of the CDET and superficial digital flexor tendon in horses results in fundamentally different responses to high-speed exercise regimens.     

Musculoskeletal responses of 2-year-old Thoroughbred horses to early training. 1. Study design,and clinical,nutritional, radiological and histological observations

AIMS: This is the first in a series of papers reporting studies in 2-year-old Thoroughbred racehorses that aimed to determine the response of musculoskeletal tissues to early training on grass and sand racetracks. In this paper, the experimental set-up of the whole study is described, and nutritional, workload, and clinical, radiographic and pathological outcomes are reported, including semi-quantitative assessment of macroscopic changes in articular cartilage.

METHODS: The study group comprised 14 two-year-old Thoroughbred fillies reared entirely at pasture. Of these, seven were selected by a licensed racehorse trainer to undergo a 4-week period of initial training in which they were taught to accept saddle and rider, followed by a 13-week period of flatrace training at a racetrack (Weeks 1–13); the other seven fillies were confined to large grass enclosures and were not trained. Nutrient, including macro- and trace-element intakes were estimated. Distances cantered or galloped and average velocities were quantified for the trained horses. All horses were observed daily, weighed approximately weekly, and underwent a clinical lameness examination at Weeks 5, 9 and 13. Distal forelimbs were radiographed prior to Week 1, during Weeks 7–8, and again at the end of the study, when macroscopic changes in articular cartilage of the proximal surface of the proximal phalanx were also scored after staining with India ink.

RESULTS: Dietary intakes met or exceeded recommended requirements for all nutrients except sodium, which was low in the trained horses. Bodyweight increased throughout the study in the untrained horses, and increased until Week 7 and then decreased slightly in the trained horses. Mean velocity data were used to define three stages of the training programme: Stage 1 comprised canter in Weeks 1–4; Stage 2 comprised canter in Weeks 5–8; and Stage 3 comprised canter in Weeks 9–13 and galloping twice weekly. Four of seven horses completed training. These covered a mean distance of 179.2 km at mean velocities (excluding gallops) of 7.63 m/sec (SD 0.58), 8.99 m/sec (SD 0.56), and 8.43 m/sec (SD 0.74) for Stages 1–3, respectively, and galloped 4.45 km at 14.4 (SD 0.1) m/sec. The three horses that did not complete training became lame in Weeks 9, 10 and 11, and covered 147.9 km at velocities of 7.38 m/sec (SD 0.44), 8.88 m/sec (SD 0.33) and 8.43 m/sec (SD 0.59) and galloped 2.1 km. Overall, slight or intermittent lameness in trained horses was noted on 76/655 (12%) of horse observation days. Swelling was evident on 284/655 (41%) of horse observation days in the metacarpophalangeal (MCPJ) and metatarsophalangeal (MTPJ) joints (92%), palmar metacarpal tendon region (7%) or carpus (1%). Swelling of the MCPJ or MTPJ was not associated with obvious lameness. Radiographic changes were minor and no gross lesions in bone or tendon tissue were evident except for one case of dorsal metacarpal disease. Post mortem, the cartilage of some MCPJ and MTPJ had obvious wear lines and high lesion scores, which were not consistently related to clinical evidence of pain, lameness or joint swelling. Mean lesion scores were not significantly different between the MCPJ and MTPJ, or between trained and untrained horses.

CONCLUSIONS: Workload can be readily quantified in racehorses under semi-commercial training conditions. Obvious lesions in cartilage of the MCPJ or MTPJ were present in some trained and some untrained horses and not consistently associated with clinical evidence of lameness, joint swelling or change in other connective tissues.

CLINICAL RELEVANCE: Workload data in racing horses are likely to be highly relevant for studying the pathogenesis of changes in bone, tendon and cartilage during training, for training management and for risk analysis in racehorse populations. Although obvious cartilage lesions produced little clinical effect, such lesions have previously been shown to be progressive and to prejudice athletic capability. Detection of such occult lesions in young horses will require more sophisticated detection methods.     

Extracellular matrix composition of the equine superficial digital flexor tendon: relationship with age and anatomical site

The objectives of the present study were to test the hypotheses that: (1) the composition of the extracellular matrix of the equine superficial digital flexor tendon (SDFT) shows great functional similarities with articular cartilage, i.e. that significant differences exist in biochemical composition of differently loaded areas (which in the case of tendons may be more apparent as tendon shows more obvious differences than cartilage); and (2) that, as in articular cartilage, no substantial alterations in biochemical composition take place during ageing once adulthood has been attained. Tendon samples were taken from 60 adult slaughter horses from a central area at cross-section in the mid-metacarpal region and at the height of the proximal sesamoid bones (sesamoid region) of the SDFT. Contents of collagenous and non-collagenous components were determined. None of the parameters were correlated with age in either region, except for a significant increase in pentosidine cross-links with age in the sesamoid region. Between the two anatomical regions, there were significant differences in all variables, except for hydroxylysylpyridinoline cross-links. It was concluded that in the equine SDFT, similar to articular cartilage, most molecular parameters are not influenced by age in mature horses, indicating a low remodelling rate. Tendon composition is clearly different between regions, apparently reflecting different specific modes of biomechanical loading at the points sampled.     

Age-related differences in collagen crimp patterns in the superficial digital flexor tendon core region of untrained horses

Objective To measure collagen fibril crimp angles and lengths as well as collagen fibril mass-average diameters in central and peripheral regions of the superficial digital flexor tendon of wild horses, to ascertain any age-related changes in either region in the absence of imposed galloping exercise.
Design Measurements from a random cull of wild horses.
Sample population Superficial digital flexor tendon samples were taken from 23 wild horses ranging in age from two to ten years.
Procedure Horses were divided into 'young' (< 5 years, n = 10), 'middle-aged' (5 to < 10 years, n = 9) and 'old' groups (10+ years, n = 4) and the mean crimp angle, mean crimp length and collagen fibril mass-average diameter calculated for the central region, and for the peripheral region of each group. Differences between groups and regions were analysed using two-tailed t tests.
Results The crimp angle for the central region was found to decrease with age, so that in old horses it was smaller than that for the tendon periphery (P < 0.05). The crimp angle for the latter region did not alter significantly with age. Crimp period lengths and collagen fibril mass-average diameters did not show significant changes with age in either region.
Conclusion Reduction of the crimp angle in the core of the superficial digital flexor tendon occurs normally with age, as tendons of older animals would have undergone a higher number of loading cycles. It is possible that athletic training increases the frequency and/or the magnitude of high loading cycles experienced by the tendon, and may accelerate and worsen the normal load-related ageing process in the superficial digital flexor tendons of young performance horses, particularly in the central regions where lesions usually occur.