Structure-related echoes in ultrasonographic images of equine superficial digital flexor tendons

OBJECTIVE: To develop a method to discriminate between structure-related echoes and echoes resulting from interference, as observed in transverse ultrasonographic images of equine superficial digital flexor (SDF) tendons. SAMPLE POPULATION: 2 normal (injury-free) SDF tendons obtained from a 3-year-old Thoroughbred and a 9-year-old Dutch Warmblood horse. PROCEDURE: Tendons were mounted in a custom-made device that permitted exact transverse and perpendicular sequential scanning with precise steps of 0.5 mm along the long axis of the tendon. Photographs of transverse tendon sections at the exact scanning locations were obtained. Propagation, reflection, and refraction artifacts were quantified, and an image rectification procedure was developed, allowing exact matching of each photograph with the corresponding ultrasonographic image. A correlation routine was developed that departed from this transverse ultrasonographic image (position 0); this routine added information from images collected at precise distances of 0.5 and 1 mm on both sides of the actual scan location (positions -2, -1, +1, +2). RESULTS: By use of the correlation routine, echoes that remained steady over all 5 images were enhanced and resolved, and constantly changing echoes were multiplicatively reduced and faded. This correlated image could be projected over the rectified photograph, and the resolved echoes matched perfectly with the endotendon septa surrounding fibers and fasciculi. CONCLUSIONS AND CLINICAL RELEVANCE: The correlation routine permits exclusive resolution of structure-related echoes, as echoes resulting from interference are faded. The technique described can produce images that depict only the essential structure-related information. In this way, the clinical assessment of tendon integrity is greatly facilitated.     

Ultrasonographic tissue characterization of equine superficial digital flexor tendons by means of gray level statistics

OBJECTIVE: To correlate quantitative analysis of ultrasonographic images of normal (injury-free) equine superficial digital flexor (SDF) tendons and equine SFD tendons that have pathologic changes with corresponding histologic sections. SAMPLE POPULATION: 4 SDF tendons, 2 of which had various stages of tissue integrity. The 2 ipsilateral tendons were used as points of reference. PROCEDURE: Tendons were mounted in a custom-made device that permitted sequential scanning, transversely and perpendicular to the tendon long axis. At precise steps of 0.5 mm, transverse ultrasonographic images were collected. Subsequently, tendons were fixed and prepared for histologic examination. The following 8 tissue types were discerned: normal young, normal old, necrotic, early granulation, late granulation, early fibrotic, late fibrotic, and scar tissues. In areas of interest, the corresponding ultrasonographic images were selected for gray level statistical analysis. RESULTS: Compared with other tissue types, early-stage granulation tissue was characterized by substantially lower mean gray level and a clearly different histogram. Necrotic tissue had a higher mean gray level, with a virtually normal histogram. In late granulation and early fibrotic tissues, the mean gray level and the histogram could not be discerned from those of normal tendon tissue. The same applied to late fibrotic and scar tissues; mean gray levels were fractionally lower than those of normal tendon tissue with a completely normal histogram. CONCLUSIONS: Although quantification of the transverse ultrasonographic image by use of first-order gray level statistics may be helpful, the method is not sufficiently sensitive to accurately and unequivocally determine the type of tendon tissue. Quantitative analysis should incorporate transverse and longitudinal information.     

Microdamage in the equine superficial digital flexor tendon

The forelimb superficial digital flexor tendon (SDFT) is an energy-storing tendon that is highly susceptible to injury during activities such as galloping and jumping, such that it is one of the most commonly reported causes of lameness in the performance horse. This review outlines the biomechanical and biothermal effects of strain on the SDFT and how these contribute to the accumulation of microdamage. The effect of age-related alterations on strain response and subsequent injury risk is also considered. Given that tendon is a slowly healing and poorly regenerative tissue, prompt detection of early stages of pathology in vivo and timely adaptations to training protocols are likely to have a greater outcome than advances in treatment. Early screening tools and detection protocols could subsequently be of benefit in identifying subclinical signs of degeneration during the training programme. This provides an opportunity for preventative strategies to be implemented to minimise incidences of SDFT injury and reduce recovery periods in elite performance horses. Therefore, this review will focus on the modalities available to implement early screening and prevention protocols as opposed to methods to diagnose and treat injuries.     

Influence of topically applied cold treatment on core temperature and cell viability in equine superficial digital flexor tendons

OBJECTIVE: To determine rate and degree of cooling for the superficial digital flexor tendon (SDFT) during a standard cryotherapy application in horses and evaluate in vitro effects of cooling on survival of tendon cells. SAMPLE POPULATION: 6 limbs of 5 adult horses and cultured cells obtained from SDFT of 3 adult horses during necropsy. PROCEDURE: In vivo data were acquired by use of a thermocouple temperature probe inserted into the SDFT of a forelimb of each standing sedated horse. After baseline temperatures were recorded, a commercial compression splint with circulating coolant was placed on each selected limb, which was then exposed to cold treatment for 60 minutes. Temperatures were recorded at 30-second intervals. Mean minimum core temperature was calculated and used to design a protocol for in vitro cold treatment of cells. Specimens were obtained from the SDFT of horses during necropsy; tendon cells were cultured in suspension and exposed to 1-hour of cold treatment that mimicked the in vivo procedure. Viability of cells after cold treatment was compared with viability of cells maintained at body temperature. RESULTS: After 1 hour of cold treatment, SDFT core temperature was reduced by a mean of 21.8 degrees C, reaching a mean minimum temperature of 10 degrees C. Viability did not differ significantly between cold-treated and control cells. CONCLUSION AND CLINICAL RELEVANCE: Results indicated that topical application of cryotherapy significantly reduced core SDFT temperature in standing sedated horses. Temperatures achieved in vivo during cold treatment were not detrimental to the in vitro viability of tendon cells.     

The effect of recombinant equine growth hormone on the biomechanical properties of healing superficial digital flexor tendons in horses

OBJECTIVE: To evaluate the effect of recombinant equine growth hormone (rEGH) on the in vitro biomechanical properties of healing superficial digital flexor tendon (SDFT) in horses. STUDY DESIGN: Completely randomized design. SAMPLE POPULATION: Twelve Standardbred horses, 3 to 7 years of age, with ultrasonographically normal forelimb SDFT. METHODS: One week after induction of collagenase (2,000 U) induced superficial flexor tendonitis, horses were randomly divided into groups of 6. One group was administered intramuscular rEGH (10 microg/kg/day for 1 week, then 20 microg/kg/day for 5 weeks), whereas the other group (control subjects) were administered an equivalent volume of saline (0.9% NaCl) solution. At the end of this 6-week treatment, horses were killed and one forelimb SDFT from each horse was harvested for biomechanical testing under uniaxial tension. Results were analyzed using an unpaired Student's t test; significance was set at P 相似文献   

Functional adaptation of equine articular cartilage: the formation of regional biochemical characteristics up to age one year

Biochemical heterogeneity of cartilage within a joint is well known in mature individuals. It has recently been reported that heterogeneity for proteoglycan content and chondrocyte metabolism in sheep develops postnatally under the influence of loading. No data exist on the collagen network in general or on the specific situation in the horse. The objective of this study was to investigate the alterations in equine articular cartilage biochemistry that occur from birth up to age one year, testing the hypothesis that the molecular composition of equine cartilage matrix is uniform at birth and biochemical heterogeneity is formed postnatally. Water content, DNA content, glycosaminoglycan content (GAG) and biochemical characteristics of the collagen network (collagen content, hydroxylysine content and hydroxylysylpyridinoline [HP] crosslinks) were measured in immature articular cartilage of neonatal (n = 16), 5-month-old foals (n = 16) and yearlings (n = 16) at 2 predefined differently loaded sites within the metacarpophalangeal joint. Statistical differences between sites were analysed by ANOVA (P<0.01), and age correlation was tested by Pearson's product moment correlation analysis (P<0.01). In neonatal cartilage no significant site differences were found for any of the measured biochemical parameters. This revealed that the horse has a biochemically uniform joint (i.e. the cartilage) at birth. In the 5-month-old foals and yearlings, significant site differences, comparable to those in the mature horse, were found for DNA, GAG, collagen content and hydroxylysine content. This indicates that functional adaptation of articular cartilage to weight bearing for these biochemical parameters takes place during the first months postpartum. Water content and HP crosslinks showed no difference between the 2 sites from neonatal horses, 5-month-old animals and yearlings. At both sites water, DNA and GAG decreased during maturation while collagen content, hydroxylysine content and HP crosslinks increased. We propose that a foal is born with a uniform biochemical composition of cartilage in which the functional adaptation to weight bearing takes place early in life. This adaptation results in biochemical and therefore biomechanical heterogeneity and is thought to be essential to resist the different loading conditions to which articular cartilage is subjected during later life. As collagen turnover is extremely low at mature age, an undisturbed functional adaptation of the collagen network of articular cartilage at a young age may be of significant importance for future strength and resistance to injury.     

Mechanical and functional properties of the equine superficial digital flexor tendon

The in vitro and in vivo mechanical properties of the superficial digital flexor tendon have been described. To date the focus has been on single load to failure testing, however refined in vivo methods may prove useful to evaluate the effects of treatment and exercise on tendons. During maximal exercise, the adult superficial digital flexor tendon operates close to its functional limits with a narrow biomechanical safety margin. This combined with exercise and age associated microdamage, and a limited adaptive ability may increase the risk of fatigue failure. Studies evaluating treatment regimens for tendonitis have focused on repair and regeneration and yielded varying results. It would appear that the superficial digital flexor tendon has a limited ability if any to adapt positively to exercise after maturity. In contrast, the foal's superficial digital flexor tendon may have a greater adaptive ability and may respond to an appropriate exercise regimen to produce a more functionally adapted tendon. Recent studies have shown that foals allowed free pasture exercise develop a larger, stronger, more elastic tendon compared to foals that were confined or subjected to a training program. Effects on the non-collagenous matrix appear to be responsible for these differences. In contrast, training or excess exercise may have permanent detrimental effects on the biomechanical and functional properties of the superficial digital flexor tendon in the foal. The implication is that the determination of optimum exercise intensity and timing, and the role of the non-collagenous matrix in tendon physiology in the young horse may hold the key to developing tendons more capable of resisting injury.     

A review of the healing processes in equine superficial digital flexor tendinopathy

Tendinopathy is a significant cause of morbidity and mortality in athletic and aged horses. These injuries require prolonged convalescence and heal by the formation of scar tissue instead of neo‐tendon, predisposing to reinjury. This article reviews the biological processes involved in tendon healing and their implications for clinical practice to improve future treatment of these injuries.     

Computerized ultrasonographic tissue characterization of equine superficial digital flexor tendons by means of stability quantification of echo patterns in contiguous transverse ultrasonographic images

OBJECTIVE: To describe a method of computerized ultrasonographic tissue characterization that includes structures below the size limits of resolution in equine superficial digital flexor tendons. SAMPLE POPULATION: 2 damaged and 2 structurally normal superficial digital flexor tendons. PROCEDURE: Transverse ultrasonographic images were collected along the tendon long axis. Stability of echo pattern was quantified by means of variation in gray levels of each pixel in contiguous images and expressed as correlation, entropy, and waviness ratios. RESULTS: Normal young and normal old tissues were characterized by high correlation and low entropy and waviness ratios. In necrotic tissue, collapsed intratendinous septa resulted in high correlation, moderate entropy, and high waviness ratios. In early granulation tissue, complete lack of bundle formation resulted in values of zero for correlation and waviness ratios; loose connective tissue matrix resulted in a high entropy ratio. In late granulation tissue, formation of new bundles resulted in a high correlation ratio; swollen intratendinous septa and incomplete organization of connective tissue matrix were reflected in high entropy and waviness ratios. In early fibrotic tissue, rearrangement of tendon bundles resulted in a correlation ratio within reference range and a slight increase in the waviness ratio; an increase in cellularity and lack of fibrillar arrangement led to an increase in the entropy ratio. In late fibrotic and scar tissues, inferior quality of repair with almost complete lack of organization was reflected in low to moderate correlation, low waviness, and high entropy ratios. CONCLUSIONS AND CLINICAL RELEVANCE: Stability of echo patterns accurately reflects homogeneity of tendons in horses.     

Repeatability of diagnostic ultrasonography in the assessment of the equine superficial digital flexor tendon

A quantitative investigation of the variation that can occur during the course of ultrasonography of the equine superficial digital flexor tendons (SDFT) was undertaken. The aim of this investigation was to use an objective measure, namely the measurement of CSA, to quantify the variability occurring during the course of the ultrasonographic assessment of the equine SDFT. The effects of 3 variables on the CSA measurements were determined. 1) Image acquisition operator (IAc): two different operators undertaking the ultrasonographic examination; 2) image analysis operator (IAn): two different operators undertaking the calculation of CSA values from previously stored images; and 3) analytical equipment (used during CSA measurement) (IEq): the use of 2 different sets of equipment during calculation of CSA values. Tendon cross-sectional area (CSA) measurements were used as the comparative variable of 3 potential sources: interoperator, during image acquisition; interoperator, during CSA measurement; and intraoperator, when using different analytical equipment. Two operators obtained transverse ultrasonographic images from the forelimb SDFTs of 16 National Hunt (NH) Thoroughbred (TB) racehorses, each undertaking analysis of their own and the other operator's images. One operator undertook analysis of their images using 2 sets of equipment. There was no statistically significant difference in the results obtained when different operators undertook image acquisition (P>0.05). At all but the most distal level, there was no significant difference when different equipment was used during analysis (P>0.05). A significant difference (P<0.01) was reported when different operators undertook image analysis, one operator consistently returning larger measurements. Different operators undertaking different stages of an examination can result in significant variability. To reduce confounding during ultrasonographic investigations involving multiple persons, one operator should undertake image analysis, although different operators may undertake image acquisition.     

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.     

Recombinant equine growth hormone does not affect the in vitro biomechanical properties of equine superficial digital flexor tendon

OBJECTIVE: To evaluate the effect of recombinant equine growth hormone (rEGH) on the in vitro biomechanical properties of normal adult equine superficial digital flexor tendon (SDFT). STUDY DESIGN: Completely randomized design. SAMPLE POPULATION: Nine Standardbred horses, 6 to 9 years of age with ultrasonographically normal forelimb SDFT. METHODS: Six horses were administered intramuscular (IM) rEGH at 10 microg/kg/day for 1 week, and then 20 microg/kg/day for another 5 weeks; 3 horses (control subjects) were administered an equivalent daily volume of sterile water IM. Horses were killed at the end of the 6-week treatment period, and both forelimb SDFT were harvested and stored at -70 degrees C. In vitro biomechanical testing was performed under uniaxial tension. Results were analyzed using a general linear model of analysis of variance; significance was set at P <.05. RESULTS: There were no differences in cross-sectional area, maximal load at failure, yield load, ultimate and yield tensile strain, ultimate and yield tensile stress, or stiffness between tendons from control and treated horses. CONCLUSIONS: Administration of rEGH to adult Standardbred horses for 6 weeks had no detectable effect on the in vitro biomechanical properties of normal SDFT. CLINICAL RELEVANCE: Administration of rEGH does not modulate the in vitro biomechanical properties of SDFT from adult Standardbred horses.     

Quantitative effect of tenorrhaphy on intrinsic vasculature of the equine superficial digital flexor tendon

OBJECTIVE: To compare effects of the locking-loop suture pattern (LLP) and 3-loop pulley (3LP) suture pattern for tenorrhaphy on the intrinsic vasculature of the superficial digital flexor tendon (SDFT) of horses in vitro after surgery. SAMPLE POPULATION: 16 forelimbs obtained from 8 mature horses. PROCEDURE: Tenotomy and subsequent tenorrhaphy was performed in anesthetized horses. Following systemic administration of heparin, horses were euthanatized and the limbs were removed and placed under tension to load the flexor tendons. The intrinsic vasculature was then perfused with a mixture of barium sulfate and water. Four-millimeter sections of the SDFT were prepared for microangiographic analysis. Mean vessel density was calculated for each section by use of a grid consisting of 1.5-mm2 vascular assessment squares (VAS). Comparisons were made among the control, LLP and 3LP groups. RESULTS: Mean +/- SD vessel density was 3.11 +/- 0.38, 1.47 +/- 0.47, and 2.01 +/- 0.63 perfused vessels/1.5 mm2 for control, LLP and 3LP groups, respectively. Significant differences in vascular density were detected between the control and 3LP groups, control and LLP groups, and LLP and 3LP groups. CONCLUSIONS AND CLINICAL RELEVANCE: Use of the LLP and 3LP pattern has deleterious effects in vitro on the intrinsic vasculature of the SDFT. However, the 3LP pattern was less disruptive to the intrinsic vasculature, compared with the effects for the LLP. Use of the 3LP tenorrhaphy suture pattern in clinical situations may result in less damage to the intrinsic vasculature of the SDFT of horses during convalescence.     

Preliminary studies on the vascular anatomy of the equine superficial digital flexor tendon.

The vascular and microvascular anatomy of normal equine superficial digital flexor tendons was studied by dissection of vinyl-perfused specimens and by microangiography on high detail film. The presence of an extensive intratendinous vascular latticework was confirmed, and a 'nutrient artery' described closely associated with the accessory ligament of the superficial digital flexor tendon (proximal check ligament). Circumferential stripping of the paratenon from the tendon to eliminate afferent vessels was performed bilaterally in three horses and unilaterally in a fourth, followed by a treadmill training regimen. No resulting intratendinous lesions could be documented on gross post mortem and histological examination at three, 10, or 35 days post operatively. There was mild paratendinous proliferation in all instances. In one horse, four intratendinous ligatures were placed within the medial and lateral borders of the contralateral tendon to isolate further from its blood supply a 10 cm segment. Gross lesions at 35 days post operatively included a marked paratendinous response involving the entire 10 cm segment, and a darkened, soft focus within the core of the tendon. Histopathology and electron microscopy demonstrated focal degeneration. It was concluded that the blood supply of the normal equine superficial digital flexor tendon is primarily intratendinous, rather than paratendinous as previously thought. The lesions in one horse similar to those in naturally occurring tendinitis supported a vascular aetiology of the disease, and set the groundwork for studies aimed at the development of a clinically relevant tendinitis model.     

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.     

Control of the collagen fibril diameter in the equine superficial digital flexor tendon in horses by decorin

The distribution pattern of collagen fibril diameter in the equine superficial digital flexor tendon (SDFT) is known to differ in central and peripheral areas of some regions. This study reports the essence of collagen fibril differences among different regions of the equine SDFT by transmission electron microscopic (TEM) and high-voltage electron microscopic observations and biochemical analysis. The distribution of large collagen fibrils increased but the density of collagen fibrils decreased from the proximal metacarpal region to the distal metacarpal region. Large collagen fibrils with an irregular cross-sectional profile were found more frequently in the middle metacarpal region than in other regions. Three-dimensional reconstruction of images of irregularly shaped collagen fibrils revealed that these fibrils are formed through fusion of small collagen fibrils with large ones. The amount of decorin, which reportedly inhibits the lateral fusion of collagen fibrils, decreased in the direction of the distal metacarpal region. On the other hand, the size of decorin gradually increased in the direction of the distal metacarpal region. These results suggest that regional differences in collagen fibril distribution and density of collagen fibrils in the SDFT are due, at least in part, to fusion of collagen fibrils and the concomitant regional differences in the amount and size of decorin.     

Active expression of matrix metalloproteinase-13 mRNA in the granulation tissue of equine superficial digital flexor tendinitis

The DNA microarray analysis for matrix metalloproteinase (MMP)-related mRNA expression in equine superficial digital flexor tendinitis indicated that mRNA level of MMP-13 was apparently up-regulated in the tendinitis as compared to normal tendon. In situ hybridization also revealed that fibroblastic cells proliferated in the granulation tissue generated in the tendinitis actively expressed MMP-13 mRNA. On the other hand, in normal tendon, a few fibroblastic cells and vascular components lied in the endotenon barely expressed its mRNA, but other cellular components in the tendon bundle were not positively hybridized. As mentioned above, MMP-13 but not other collagenases or gelatinases, may play an important role in tendon injuries in the racehorses.     

The effects of polyester (terylene) fibre implants on normal equine superficial digital flexor tendon

AIM: To determine the effect of polyester (terylene) fibre implants on normal equine superficial digital flexor (SDF) tendon structure. METHODS: Normal forelimb SDF tendons (n=24) of 12 horses were divided into unoperated, sham-operated, and implanted (terylene fibre implant) groups. Horses were assessed for lameness and ultrasonographic changes to SDF tendons at intervals up to 48 weeks post-operatively. After euthanasia, SDF tendons were collected for histological and ultrastructural examination. Histological sections were examined for alcian blue staining intensity, cellularity, fibril bundle alignment, fascicle separation and crimp morphology. Mass-average diameters (MADs) of collagen fibrils were calculated from electron micrographs and compared between treatment groups. RESULTS: Insertion of terylene fibre implants resulted in short-term (8 weeks) lameness in implanted limbs. Ultrasonographically, the implants could be detected in 50% of implanted tendons, but were associated with tendon swelling and the presence of hypoechoic core lesions in 7/8 implanted limbs. There were significant alterations in alcian blue staining, cellularity and crimp morphology in the central fascicles of sham-operated and implanted tendons, and alteration in fibril alignment in the central fascicles of implanted tendons. Unoperated tendons remained histologically normal. MADs of collagen fibrils did not differ between sham-operated, implanted and unoperated limbs. CONCLUSIONS: Both the sham procedure and the insertion of terylene fibre implants led to alterations in tendon structure that persisted for up to 48 weeks. Persistence of disorganised connective tissue at the proximal and distal ends of the terylene fibre implants may predispose implanted tendons to continued risk of injury. CLINICAL RELEVANCE: It is unlikely that terylene fibre implants offer any advantage over standard non-surgical treatments for mild to moderate cases of SDF tendonitis in the horse.     

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.