Medical management of superficial digital flexor tendonitis: a comparative study in 219 horses (1992‐2000)

Abstract

Summary Reasons for performing study: There is a lack of long‐term follow‐up data for outcome of medical treatment of superficial digital flexor (SDF) tendonitis. Objectives: To determine whether intralesional injection of hyaluronan, beta aminoproprionitrile fumarate (BAPN) or polysulphated glycosaminoglycans (PSGAG) or systemic administration of PSGAG yielded better results than a controlled exercise programme alone in the management of SDF tendonitis, with a minimum follow‐up period of 2 years after resumption of full work; and to determine whether reinjury rate was related to sports discipline and whether fibre alignment score (FAS) at 4 months could predict outcome. Methods: In Study 1, 50 horses were managed by controlled exercise alone (Group A), 50 were treated with intralesional injection of hyaluronan (Group B), 20 received intralesional and systemic treatment with PSGAG (Group Ci) and 30 received systemic treatment with PSGAG (Group Cii). Horses in Groups B, Ci and Cii followed the same controlled exercise programme as Group A. In Study 2, 69 horses (Group D) were treated by intralesional injection of BAPN and followed a modified controlled exercise programme. Horses were re‐examined clinically and ultrasonographically at intervals. Follow‐up data were obtained for horses 2 years after resuming full work and for up to 6 years. Results: There was no significant difference in reinjury rate of the treated limb(s) between Groups A, B, Ci and Cii (42.5‐44.4%) (P>0.9). The reinjury rate (16%) in the treated limb(s) in Group D was significantly lower than in the other groups (P<0.001). However, when injury rate of the uninjured limb was considered, the results were similar to Study 1. In Study 2, the FAS at 4 months after treatment was a good predictor of outcome (P<0.001). Reinjury rates for different disciplines were similar in the 2 studies, with the risk of reinjury ascending from showjumpers to event horses to National Hunt and flat racehorses. Conclusions: Treatment with BAPN reduced the risk of reinjury in the treated limb, although the overall rate of subsequent injury was not affected. FAS at 4 months after treatment is a good predictor of outcome in the treated limb(s). Potential relevance: This study provides long‐term follow‐up data in horses from a variety of sports disciplines that can be used to provide prognostic information.

First Application of Axial Speed of Sound to Follow Up Injured Equine Tendons

“…Tendon lesions are the most investigated and most common equine musculoskeletal injuries (Thorpe et al 2010); they present a high rate of recurrence and their outcome is often negative (Dyson 2004;Marr et al 1993;van den Belt et al 1994). Training and competing are both responsible of these injuries (Ely et al 2004;Murray et al 2006;Pinchbeck et al 2004).…”

In Vitro Studies of Horse Umbilical Cord Matrix-Derived Cells: From Characterization to Labeling for Magnetic Resonance Imaging

“…Standard treatments are conservative and tendon healing is a prolonged process, with a high risk of re-injury during athletic performance (56% for jumping horses and 66% for racing horses) [1]. The use of BM-MSCs undoubtedly represents a new therapeutic approach to the treatment of tendon injuries but the harvesting of bone marrow remains a highly invasive and painful procedure.…”

Three-Dimensional Culture and Transforming Growth Factor Beta3 Synergistically Promote Tenogenic Differentiation of Equine Embryo-Derived Stem Cells

“…As with many other species; this damage leads to the formation of biomechanically inferior scar tissue, resulting in a high probability of re-injury. 1 For a successful regenerative therapy to be clinically applied and modulated, the molecular pathways regulating and initiating tendon development should be better understood. Transforming growth factor betas (TGF-bs) are a family of cytokines whose isoforms have multiple roles in cell proliferation and tissue morphogenesis.…”