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ability to upregulate a variety of genes involved in tissue repair, as evidenced by gene microarray analysis and lead to a fetal like or regenerative tissue response. Depending on the tissue type, cells that bind to this bioscaffold will have significant, measurable increases in select tissue repair factors, including
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Lloyd W, Klann R, Sutton J, Hill R. Tissue specific response to a fetal like extracellular matrix: differential in vitro gene expression associated with regenerative wound repair. Presented at North
Carolina Tissue Engineering Interest Group Meeting, September 30, 2004, NC Biotechnology Center, RTP,
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can damage its collagen fibers. This is most commonly seen in performance horses that gallop or jump, who usually strain a tendon as a result of fetlock overextension when their weight is loaded on one leg. The overextension of the fetlock causes overstretching of the flexor tendons, resulting in the
154:
usually involves disruption of the tendon fibers. It is most commonly seen in the superficial digital flexor tendon (SDFT) in a front leg—the tendon that runs down the back of the leg, closest to the surface. Tendinitis creating a "bow" is uncommon in the deep digital flexor tendon (DDFT) of a front
312:
Signs of acute tendinitis include swelling, heat, and pain when the affected area is palpated. If mild, swelling may not be readily apparent, although there will still be heat and pain in the area, as well as mild lameness. If more severe, the injury is usually accompanied by moderate lameness (2-3
158:
When the SDFT is damaged, there is a thickening of the tendon, giving it a bowed appearance when the leg is viewed from the side. Bows usually occur in the middle of the tendon region, although they may also be seen in the upper third, right below the knee or hock (high bows), and lower third, just
352:
For the first several months, large area turnout is discouraged, since even a small amount of running or playing could easily re-injure the weakened tendon. As the tendon heals, it is loaded in increasing amounts. The use of diagnostic ultrasonography is extremely valuable in guiding changes in
299:
Bandage bows are caused by applying a bandage too tightly, creating an acute pressure injury to the tendons. The compression may cause the area to swell once the bandage is removed, giving a "bowed" appearance. However, the damage is often just to the skin and not to the tendon itself, but tendon
223:
from the knee, and the bottom third supplied by the vessels in the fetlock. The middle third has a poor supply of blood, relying on the tiny vessels of the peritendon (the membrane that surrounds the tendons). If this supply is for some reason compromised, the collagen fibers in the area may die,
469:
The best way to ensure that an injured horse returns to full work is to rehabilitate the animal correctly. This includes slowly bringing the horse back into training, and giving the horse light exercise each day as the tendon is healing. An impatient trainer who rushes to bring the horse back to
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and produces fetal-like repair mechanisms, known to be involved in tissue turnover and repair. The new bioscaffold is currently being evaluated for a variety of connective tissue disorders in veterinary medicine. The bioscaffold structure is responsible for its non-immunogenic property and its
617:
Klann RC, Lloyd WH, Sutton JC and Hill RS (2003). DNA microarray analysis of gene expression changes in human skin fibroblasts treated with E-Matrix, a novel wound healing hydrogel formulation. Presented at, NIDDK/NIAID/NHLIB Workshop, Advanced Topics in
Microarray Analysis, Bethesda, MD. 2003
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Initial treatment of a bowed tendon should concentrate on anti-inflammatory therapies, including cold water or ice therapy, and anti-inflammatory medications on the direction of a veterinarian. The horse should be confined to a small area until the severity of the injury can be assessed with
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The treatment used: horses with moderate or severe tendinitis have a better prognosis if managed conservatively (rested, brought back to work slowly), with about 50-60 percent returning to training. If they undergo surgery and are rehabilitated correctly, up to 70-80 percent return to full
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It is important not only to palpate the SDFT but the branches of the SDFT, the DDFT, check ligament, and suspensory ligament as well. These structures could have been damaged at the same time as the SDFT. Both legs should be checked, although tendinitis usually only occurs in one leg.
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Klann, Richard C.,Lloyd, William H., Sutton, Jereme C.,Shih, Mei-Shu, Enterline, Dave S., and Hill, Ronald S. A novel biopolymer matrix induces BMP-2 production and stimulates bone repair in critical size ulnar defects. Presentation, Regenerate 2004, Seattle, WA, 2004 June
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Klann RC, LloydB, Sutton J and Hill R. Selective induction of TGF Beta 3 as a marker for scarless regenerative healing in the skin. Presented at North
Carolina Tissue Engineering Interest Group Meeting, NC Biotechnology Center, RTP, NC. 2003 June
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Horses with bandage bows usually respond to sweats or poultices. These treatments must be applied under a bandage that is not tightly fitted and the bandage should only be left on for a few hours. Cold hosing, NSAIDs and DMSO may also help.
676:
Lloyd W, Lacy S, Sutton J, Usala A and Hill R. A novel hydrogel copolymer reduces scar formation and increases TGF-β3 gene expression. Platform
Presentation at the 15th Annual Symposium on Advanced Wound Care, Baltimore, MD. 2002 April
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that causes a hoof shape that predisposed the horse to tendon injuries (such as a long-toe and low-heel), or one that shoes a horse with toe grabs, which artificially create a long-toe and low heel by lifting the toe
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Many adjunctive therapies have been attempted to improve the quality of healing or to speed the recovery process. There is no consensus in the veterinary community as to which treatments are the most effective.
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Klann RC. Fetal like tissue scaffolding as a substrate for regenerative tissue repair. East
Carolina University Brody School of Medicine, Department of Anatomy and Cell Biology Seminar Series, November 12,
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Usala A-L,Dudek R, Lacy S, Olson J, Penland S,Sutton J, Ziats N, and Hill R. Induction of fetal-like wound repair mechanisms in vivo with a novel matrix scaffolding. Diabetes. 2001 50 (Suppl. 2): A488.
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The damage to the tendon: if there was not obvious disruption of the tendon fibers, or if the damage was minimal and healed quickly and completely, the horse has a better prognosis for returning to full
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rupture of tendon fibers. Horses in intense training, especially those that were not conditioned properly, may damage many collagen fibers. This may occur gradually or suddenly.
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Improper conditioning: such as working a horse at an intensity that it has not yet been conditioned for, working an unfit horse, and continuing to work an extremely fatigued
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Generally speaking, the most important aspect of long-term therapy is controlling the level of exercise. A balance must be struck between two competing ideas:
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When the tendon is healed, it will still have a thickened, bowed appearance that feels firm and woody. However, all heat, lameness, and pain should disappear.
391:(BMP-2) and other repair factors. These factors are important for cellular ingrowth, extracellular matrix turnover, scarless wound healing, and sustained
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implants have been proven to be ineffective: these fibers are extremely strong, but inflexible, causing increased strain on adjacent normal tissue.
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is a horseman's term for a tendon after a horse has sustained an injury that causes swelling in one or more tendons creating a "bowed" appearance.
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of core lesion tissue is controversial, but likely has some benefit in the early phases where the tear is filled with fluid. Once the lesion has
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The SDFT is narrower in its middle third than its top or bottom sections, making it weaker. The top and bottom of the SDFT has a better supply of
429:, derived from the affected horse's bone marrow or fat are currently being used as a potential therapy for SDFT tendinitis and other injuries.
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is more likely to overstretch the SDFT than the DDFT, which simply travels straight down behind the fetlock and pastern, to attach to the
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King, Christine, BVSc, MACVSc, and
Mansmann, Richard, VDM, PhD. "Equine Lameness." Equine Research, Inc. 1997. Pages 400-415, 532-533.
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Checking the Legs: especially after hard work, it is important to feel each leg for swelling and heat, and to palpate it for pain.
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leg, but is not uncommon in the pastern and foot regions. Tendinitis of the SDFT or DDFT in the hind leg is less common.
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Dahlgren, L.A. "Review of
Treatment Options for Equine Tendon and Ligament Injuries: What's New and How Do They Work?".
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Correct
Conditioning: with a base of long, slow distance work, and a fitness schedule that is not increased too rapidly.
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Poor footing: working a horse on uneven or slippery footing can cause tendon strain, as well as deep, “thick” footing.
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will trim the horse's feet correctly, preserving the pastern-hoof angle, and will properly support the horse’s heels.
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has been shown to return horses to work faster, but is thought by some to predispose to suspensory ligament injury.
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454:, racing) are less likely to return to their previous level of performance than those in less strenuous work (
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The SDFT branches below the fetlock, creating a sling under the back of the joint. Thus, overextension of the
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further by destroying the cross-linking of undamaged collagen fibers and preventing the flow of
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The middle third of the SDFT is most likely to suffer from tendinitis for several reasons.
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The injured tendon is weakened, making it prone to further injury with excessive exercise.
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in the area as well as increasing the pressure. The increase in pressure may damage the
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Use of the horse: horses that are used for athletic events that strain their tendons (
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688:"UK Stem Cell Company Cures Race Horse Tendons, Humans Next | Singularity Hub"
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involve the use of autologous mesenchymal stem cells to regenerate torn tendons.
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713:"Stem-Cell Therapy Works Wonders for Race Horses; Are Human Treatments Next?"
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Suspending
Training: if any sign of heat, swelling, or pain is detected.
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weakening the tendon in that area and making it more likely to tear.
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Tendons strengthen along lines of tension, which requires exercise.
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and knee during work. Several of these factors at once can add up.
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Prevention of bowing and reducing the risk of re-injury to tendons
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Tribology at Your
Fingertips: Frictional Forces in Tendon Repair
546:"Diagnostic Ultrasound & Musculoskeletal injuries in Horses"
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A tissue regenerating bioscaffold material, being developed by
248:: long, sloping pasterns and a long-toe, low-heel shape to the
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intense training is likely to cause re-injury of the tendon.
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Journal of the American Association of Equine Practitioners
290:: such as when a horse hits its front leg with a hind hoof.
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Each of these factors encourage the overextension of the
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New treatments developed by VetCell Bioscience Ltd. and
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is now more commonly used as an adjunctive therapy.
46:. Unsourced material may be challenged and removed.
497:can help prevent the overextension of the fetlock.
438:The prognosis for return to full work depends on:
8:
411:, this procedure is of questionable benefit.
219:as well, with the top third supplied by the
300:injury can occur from impaired blood flow.
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167:Causes and factors of tendinitis in horses
131:, often involving torn collagen fibers. A
106:Learn how and when to remove this message
313:on a scale of 5) with obvious swelling.
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184:After the fibers are torn, the tendon
370:, has unique properties that permits
259:Poor trimming and shoeing: such as a
7:
405:Surgical drainage (tendon splitting)
256:) predisposes a horse to tendinitis.
44:adding citations to reliable sources
147:Description of tendinitis in horses
493:Bandaging: using properly applied
14:
434:Prognosis of tendinitis in horses
421:Proximal check ligament desmotomy
324:Treatment of tendinitis in horses
415:Extracorporeal shockwave therapy
20:
589:Amadio, Peter C. (2008-09-09).
381:connective tissue growth factor
31:needs additional citations for
1:
458:, pleasure and trail riding).
308:Signs of tendinitis in horses
591:"Wolff's law of soft tissue"
385:transforming growth factors
768:
752:Equine injury and lameness
192:), creating swelling and
389:bone morphogenic protein
142:Bilateral bowed tendons.
522:Equine forelimb anatomy
738:at horsetackreview.com
732:at poolhousevets.co.uk
544:Whitcomb, MB; Weiser.
427:Mesenchymal stem cells
176:Excessive strain on a
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482:Correct Trimming and
387:(TGF-β1 and TBF-β3),
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357:Adjunctive therapies
188:and collects fluid (
40:improve this article
337:Controlled exercise
286:Direct trauma to a
252:(seen commonly in
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495:exercise bandages
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51:Find sources:
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29:This article
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736:Bowed tendon
707:
696:. Retrieved
692:the original
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602:. Retrieved
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554:. Retrieved
550:the original
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399:Carbon fiber
372:angiogenesis
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295:Bandage bows
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246:conformation
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163:(low bows).
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133:bowed tendon
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125:inflammation
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38:Please help
33:verification
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618:January 22.
599:Mayo Clinic
233:coffin bone
186:hemorrhages
698:2012-02-16
604:2008-10-26
556:2008-10-26
528:References
409:granulated
353:workload.
331:ultrasound
159:above the
152:Tendinitis
120:Tendinitis
66:newspapers
486:: a good
746:Category
516:See also
463:Vet-Stem
456:dressage
452:eventing
383:(CTGF),
377:aggrecan
208:The SDFT
194:lameness
508:Sources
488:farrier
484:Shoeing
280:fetlock
261:farrier
229:fetlock
221:vessels
161:fetlock
80:scholar
677:27–30.
288:tendon
198:tendon
178:tendon
129:tendon
82:
75:
68:
61:
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667:2003.
638:9–12.
447:work.
443:work.
269:horse
244:Poor
217:blood
202:blood
190:edema
127:of a
87:JSTOR
73:books
250:hoof
59:news
657:NC.
628:20.
264:up.
42:by
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536:^
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