Vet Comp Orthop Traumatol 2010; 23(04): 231-239
DOI: 10.3415/VCOT-09-10-0106
Original Research
Schattauer GmbH

A surgical tendonitis model in horses: Technique, clinical, ultra-sonographic and histological characterisation

M. Schramme
1   North Carolina State University, College of Veterinary Medicine, Department of Clinical Sciences, Raleigh, NC, USA;
,
S. Hunter
2   North Carolina State University, College of Veterinary Medicine, Pathology, Raleigh, NC, USA
,
N. Campbell
1   North Carolina State University, College of Veterinary Medicine, Department of Clinical Sciences, Raleigh, NC, USA;
,
A. Blikslager
1   North Carolina State University, College of Veterinary Medicine, Department of Clinical Sciences, Raleigh, NC, USA;
,
R. Smith
3   Royal Veterinary College, University of London, Equine Referral Hospital, Large Animal Care Centre, Hawkshead Campus, Hatfield, United Kingdom
› Author Affiliations
Further Information

Publication History

Received:14 October 2009

Accepted:12 February 2010

Publication Date:
17 December 2017 (online)

Summary

Objective: Tendon injuries are common in all athletic activities in both humans and horses. Research of treatment modalities for this disease has typically been performed on a model of collagenase-induced tendonitis. This model has several disadvantages. Our hypothesis was that a reproducible core lesion could be created surgically in superficial digital flexor tendons (SDFT), which could then be evaluated consistently using ultrasonography. Materials and methods: Four horses free of forelimb lameness were used in this study. Each horse underwent general anaesthesia and a synovial resector was used to create a core lesion in the SDFT of each forelimb. Sono-graphic examination was conducted weekly using 2 cm intervals between a section 7 and 25 cm distal to the accessory carpal bone. At two, four, eight, and 12 weeks after injury, a horse was euthanatized. Histopathological evaluation of the SDFT was performed at the same levels as the sonographic examination. Results: Only mild clinical signs of tendonitis were observed. Ultrasonographic core lesions were 10–16 cm long and had a mean maximum cross-sectional area (CSA) of 18.25 ± 5.91% occurring at 17–23 cm distal to the accessory carpal bone, and a mean volume of 1.86 ± 0.26 cm3. Mean duration taken to achieve maximum lesion CSA and lesion volume was 35 ± 7 days. Histologically, the lesions were characterised by mild inflammation followed by fibroplasia. Conclusion: The reported surgical technique resulted in core lesions that were consistent in size and location, were readily evaluated with ultrasonography, and showed similarities with the ultrasonographic and histological progression of naturally occurring tendonitis lesions.

 
  • References

  • 1 Wang JH, Iosifidis MI, Fu FH. Biomechanical basis for tendinopathy. Clin Orthop Relat Res 2006; 443: 320-332.
  • 2 Williams RB, Harkins LS, Hammond CJ. et al. Race-horse 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; 33: 478-486.
  • 3 Lam KH, Parkin TD, Riggs CM. et al. Descriptive analysis of retirement of Thoroughbred racehorses due to tendon injuries at the Hong Kong Jockey Club (1992–2004). Equine Vet J 2007; 39: 143-148.
  • 4 Silver IA, Brown PN, Goodship AE. et al. A clinical and experimental study of tendon injury, healing and treatment in the horse. Equine Vet J Suppl 1983; 1: 1-49.
  • 5 Spurlock GS, Spurlock SL, Parker GA. Ultra-sonographic, gross and histologic evaluation of a tendonitis disease model in the horse. Vet Radiol 1989; 30: 184-188.
  • 6 Williams IF, McCullagh KG, Goodship AE. et al. Studies on the pathogenesis of equine tendonitis following collagenase injury. Res Vet Sci 1984; 36: 326-338.
  • 7 Dahlgren LA, Mohammed HO, Nixon AJ. Temporal expression of growth factors and matrix molecules in healing tendon lesions. J Orthop Res 2005; 23: 84-92.
  • 8 Dahlgren LA, Mohammed HO, Nixon AJ. Expression of insulin-like growth factor binding proteins in healing tendon lesions. J Orthop Res 2006; 24: 183-192.
  • 9 Patterson-Kane JC, Firth EC. The pathobiology of exercise-induced superficial digital flexor tendon injury in Thoroughbred racehorses. Vet J 2009; 181: 79-89.
  • 10 Redding WR, Booth LC, Pool RR. The effects of polysulphated glycosaminoglycans on the healing of collagenase induced tendinitis. Vet Comp Orthop Traumatol 1999; 12: 48-55.
  • 11 Dahlgren LA, van der Meulen MC, Bertram JE. et al. Insulin-like growth factor-I improves cellular and molecular aspects of healing in a collagenase-induced model of flexor tendinitis. J Orthop Res 2002; 20: 910-919.
  • 12 Kersh KD, McClure SR, Van Sickle D. et al. The evaluation of extracorporeal shock wave therapy on collagenase induced superficial digital flexor tendonitis. Vet Comp Orthop Traumatol 2006; 19: 99-105.
  • 13 Nixon AJ, Dahlgren LA, Haupt JL. et al. Effect of adipose-derived nucleated cell fractions on tendon repair in horses with collagenase-induced tendinitis. Am J Vet Res 2008; 69: 928-933.
  • 14 Schnabel LV, Lynch ME, van der Meulen MC. et al. Mesenchymal stem cells and insulin-like growth factor-I gene-enhanced mesenchymal stem cells improve structural aspects of healing in equine flex-or digitorum superficialis tendons. J Orthop Res 2009; 27: 1392-1398.
  • 15 Crovace A, Lacitignola L, Francioso E. et al. Histology and immunohistochemistry study of ovine tendon grafted with cBMSCs and BMMNCs after collagenase-induced tendinitis. Vet Comp Orthop Traumatol 2008; 21: 329-336.
  • 16 Stone D, Green C, Rao U. et al. Cytokine-induced tendinitis: a preliminary study in rabbits. J Orthop Res 1999; 17: 168-177.
  • 17 American Association of Equine Practitioners. Definition and classification of lameness. In Guide for Veterinary Service and Judging of Equestrian Events. Lexington, KY, USA: American Association of Equine Practitioners; 1991
  • 18 Marr CM, McMillan I, Boyd JS. et al. Ultra-sonographic and histopathological findings in equine superficial digital flexor tendon injury. Equine vet J 1993; 25: 23-29.
  • 19 Watkins JP, Auer JA, Gay S. et al. Healing of surgically created defects in the equine superficial digital flexor tendon: collagen-type transformation and tissue morphologic reorganization. Am J Vet Res 1985; 46: 2091-2096.
  • 20 Bertone AL, Stashak TS, Smith FW. et al. A comparison of repair methods for gap healing in equine flexor tendon. Vet Surg 1990; 19: 254-265.
  • 21 Van Schie HT, Bakker EM, Cherdchutham W. et al. Monitoring of the repair process of surgically created lesions in equine superficial digital flexor ten-dons by use of computerized ultrasonography. Am J Vet Res 2009; 70: 37-48.
  • 22 Chong AK, Ang AD, Goh JC. et al. Bone marrow-derived mesenchymal stem cells influence early tendon-healing in a rabbit achilles tendon model. J Bone Joint Surg Am 2007; 89: 74-81.
  • 23 Virchenko O, Fahlgren A, Rundgren M. et al. Early Achilles tendon healing in sheep. Arch Orthop Trauma Surg 2008; 128: 1001-1006.
  • 24 Thomopoulos S, Zampiakis E, Das R. et al. The effect of muscle loading on flexor tendon-to-bone healing in a canine model. J Orthop Res 2008; 26: 1611-1617.
  • 25 Smith RK. Tendon and ligament injury. Proc 54th Ann Conv Am Assoc Eq Pract 2008; 54: 475-501.
  • 26 Marr C, Love S, Boyd J. et al. Factors affecting the clinical outcome of injuries to the superficial digital flexor tendon in national hunt and point-to-point racehorses. Vet Rec 1993; 132: 476-479.
  • 27 Genovese R, Reef VB, Longo KL. et al. Superficial digital flexor tendonitis: Long term sonographic and clincial study of racehorses. In Rantanen NW, Hauser ML. editors. Proceedings of the 1996 Dubai International Equine Symposium: The equine athlete: tendon, ligament and soft tissue injuries. MR Rantanen Design: 1996; 187-205.
  • 28 Crass JR, Genovese RL, Render JA. Magnetic resonance, ultrasound and histopathologic correlation of acute and healing equine tendon injuries. Vet Radiol Ultrasound 1992; 33: 206-216.
  • 29 Tsukiyama K, Acorda JA, Yamada H. Evaluation of superficial digital flexor tendinitis in racing horses through gray scale histogram analysis of tendon ultrasonograms. Vet Radiol Ultrasound 1996; 37: 46-50.
  • 30 Van Schie HT, Bakker EM, Jonker AM. et al. Ultra-sonographic tissue characterization of equine superficial digital flexor tendons by means of gray level statistics. Am J Vet Res 2000; 61: 210-219.
  • 31 Dourte LM, Kuntz AF, Soslowsky LJ. Twenty-five years of tendon and ligament research. J Orthop Res 2008; 26: 1297-1305.
  • 32 Watkins JP. Treatment principles of tendon disorders. In Auer JA. editor. Equine surgery. 2nd ed. Philadelphia, Pennsylvania, USA: Saunders Co; 1992: 916-924.