Download PDF
Vet Comp Orthop Traumatol 2015; 28(05): 306-311
DOI: 10.3415/VCOT-15-01-0018
Original Research
Schattauer GmbH

The equine forelimb suspensory ligament exhibits a heterogeneous strain pattern under tensile load

M. Lavagnino
,
J. Madison
,
M. R. Williams
,
S. P. Arnoczky
Further Information

Publication History

Received:22 January 2015

Accepted:19 June 2015

Publication Date:
28 December 2017 (online)

Also available at
    Permissions and Reprints

Summary

Objectives: To determine if regional variations in strain patterns occur within the suspensory ligament under tensile load. Local increases in strain may put certain regions of the suspensory ligament at risk and may explain the poor healing and high recurrence rates associated with suspensory branch injuries.

Methods: The suspensory ligament and its bone attachments were isolated from each of 10 adult equine cadaveric forelimbs and radiodense reference beads were inserted throughout the length of the ligament. Specimens were attached to a custom fixture secured to a materials testing system. Radio-graphs were acquired at 50, 445, 1112, and 2224 N of applied tensile load. Changes in distances between the beads in each region of the suspensory ligament were measured and the regional strain was calculated. Significant differences were determined using a repeated-measures analysis of variance.

Results: The suspensory ligament exhibited significant differences in regional strain (p <0.001). The distal branches of the suspensory ligament had significantly greater strains than the proximal (p = 0.025) and mid-body (p = 0.002) regions. The mid-body of the suspensory ligament also exhibited local strain variation, with the distal mid-body having significantly higher strains than the proximal mid-body (p = 0.038).

Clinical significance: The equine suspensory ligament demonstrates a heterogeneous strain pattern during tensile loading, with the distal regions exhibiting significantly more strain than the proximal region. The nonhomogenous strain pattern could explain the regional difference in injury and re-injury rates.

Keywords

Equine - suspensory ligament - strain
 

  • References

  • 1 Dyson S. Proximal suspensory desmitis: Clinical, ultrasonographic and radiographc features. Equine Vet J 1991; 23: 25-31.
    CrossrefPubMedGoogle Scholar
  • 2 Dyson SJ, Arthur RM, Palmer SE. et al. Suspensory ligament desmitis. Vet Clin N Am Equine Pract 1995; 11: 177-215.
    CrossrefPubMedGoogle Scholar
  • 3 Crowe OM, Dyson SJ, Wright IM. et al. Treatment of chronic or recurrent proximal suspensory desmitis using radial pressure wave therapy in the horse. Equine Vet J 2004; 36: 313-316.
    CrossrefPubMedGoogle Scholar
  • 4 Gibson KT, Steel CM. Conditions of the suspensory ligament causing lameness in horses. Equine Vet Educ 2002; 14: 39-50.
    PubMedGoogle Scholar
  • 5 Singer ER, Barnes J, Saxby F. et al. Injuries in the event horse: Training versus competition. Vet J 2008; 175: 76-81.
    CrossrefPubMedGoogle Scholar
  • 6 Dyson S. Diagnosis and management of common suspensory lesions in the forelimbs and hindlimbs of sport horses. Clin Tech Equine Pract 2007; 6: 177-188.
    PubMedGoogle Scholar
  • 7 Dyson S, Genovese RL. The suspensory apparatus. In: Ross MW, Dyson S.. editors. Diagnosis and Management of Lameness in the Horse St. Louis: Saunders Co; 2003: 654-672.
    Google Scholar
  • 8 Marneris D, Dyson S. Clinical features, diagnostic imaging findings and concurrent injuries in 71 sports horses with suspensory branch injuries. Equine Vet Educ 2014; 26: 312-321.
    CrossrefPubMedGoogle Scholar
  • 9 Kraus-Hansen AE, Fackelman GE, Becker C. et al. Preliminary studies on the vascular anatomy of the equine superficial digital flexor tendon. Equine Vet J 1992; 24: 46-51.
    CrossrefPubMedGoogle Scholar
  • 10 Hay Kraus BL, Kirker-Head CA, Kraus KH. et al. Vascular supply of the tendon of the equine deep digital flexor muscle within the digital sheath. Vet Surg 1995; 24: 102-111.
    CrossrefPubMedGoogle Scholar
  • 11 Bales CP, Placzek JD, Malone KJ. et al. Microvascular supply of the lateral epicondyle and common extensor origin. J Shoulder Elbow Surg 2007; 16: 497-501.
    CrossrefPubMedGoogle Scholar
  • 12 Carr AJ, Norris SH. The blood supply of the calcaneal tendon. J Bone Joint Surg Br 1989; 71: 100-101.
    CrossrefPubMedGoogle Scholar
  • 13 Chen TM, Rozen WM, Pan WR. et al. The arterial anatomy of the Achilles tendon: anatomical study and clinical implications. Clin Anat 2009; 22: 377-385.
    CrossrefPubMedGoogle Scholar
  • 14 Cheng NM, Pan WR, LeRoux CM. et al. The arterial supply of the long head of biceps tendon: anatomical study with implications for tendon rupture. Clin Anat 2010; 23: 683-692.
    CrossrefPubMedGoogle Scholar
  • 15 Lohr JF, Uhthoff HK. The microvascular pattern of the supraspinatus tendon. Clin Orthop Relat Res 1990; 254: 35-38.
    PubMedGoogle Scholar
  • 16 Rathburn JB, Macnab I. The microvascular pattern of the rotator cuff. J Bone Joint Surg Br 1970; 52: 540-553.
    PubMedGoogle Scholar
  • 17 Rothman RH, Parke WW. The vascular anatomy of the rotator cuff. Clin Orthop Relat Res 1965; 41: 176-186.
    PubMedGoogle Scholar
  • 18 Yepes H, Tang M, Morris SF. et al. Relationship between hypovascular zones and patterns of ruptures of the quadriceps tendon. J Bone Joint Surg Am 2008; 90: 2135-2141.
    CrossrefPubMedGoogle Scholar
  • 19 Williams MR, Arnoczky SP, Pease AP. et al. Microvasculature of the suspensory ligament of the forelimb of horses. Am J Vet Res 2013; 74: 1481-1486.
    CrossrefPubMedGoogle Scholar
  • 20 Souza MV, van Weeren PR, van Schie HT. et al. Regional differences in biochemical, biomechanical, and histomorphological characteristics of the equine suspensory ligament. Equine Vet J 2010; 42: 611-620.
    CrossrefPubMedGoogle Scholar
  • 21 Shikh Alsook MK, Antoine N, Piret J. et al. Morphometric analyses of the body and the branches of the normal third interosseous muscle (suspensory ligament) in Standardbreds. Anat Histol Embryol 2013; 42: 461-470.
    CrossrefPubMedGoogle Scholar
  • 22 Reilly P, Amis AA, Wallace AL. et al. Mechanical factors in the initiation and propagation of tears of the rotator cuff. Quantification of strains of the supraspinatus tendon in vitro. J Bone Joint Surg Br 2003; 85: 594-599.
    CrossrefPubMedGoogle Scholar
  • 23 Bey MJ, Song HK, Wehrli FW. et al. Intratendinous strain fields of the intact supraspinatus tendon: the effect of glenohumeral joint position and tendon region. J Orthop Res 2002; 20: 869-874.
    CrossrefPubMedGoogle Scholar
  • 24 Lavagnino M, Arnoczky SP, Elvin N. et al. Patellar tendon strain is increased at the site of the jumper's knee lesion during knee flexion and tendon loading: results and cadaveric testing of a computational model. Am J Sports Med 2008; 36: 2110-2118.
    CrossrefPubMedGoogle Scholar
  • 25 Lochner FK, Milne DW, Mills EJ. et al. In vivo and in vitro measurement of tendon strain in the horse. Am J Vet Res 1980; 41: 1929-1937.
    PubMedGoogle Scholar
  • 26 Butcher MT, Hermanson JW, Ducharme NG. et al. Superficial digital flexor tendon lesions in racehorses as a sequela to muscle fatigue: a preliminary study. Equine Vet J 2007; 39: 540-545.
    CrossrefPubMedGoogle Scholar
  • 27 Jansen MO, van den Bogert AJ, Riemersma DJ. et al. In vivo tendon forces in the forelimb of ponies at the walk, validated by ground reaction force measurements. Acta Anat (Basel) 1993; 146: 162-167.
    CrossrefPubMedGoogle Scholar
  • 28 Jansen MO, van Buiten A, van den Bogert AJ. et al. Strain of the musculus interosseus medius and its rami extensorii in the horse, deduced from in vivo kinematics. Acta Anat (Basel) 1993; 147: 118-124.
    CrossrefPubMedGoogle Scholar
  • 29 Lawson SE, Chateau H, Pourcelot P. et al. Effect of toe and heel elevation on calculated tendon strains in the horse and the influence of the proximal interphalangeal joint. J Anat 2007; 210: 583-591.
    CrossrefPubMedGoogle Scholar
  • 30 Harrison SM, Whitton RC, Kawcak CE. et al. Relationship between muscle forces, joint loading and utilization of elastic strain energy in equine locomotion. J Exp Biol 2010; 213: 3998-4009.
    CrossrefPubMedGoogle Scholar
  • 31 Jansen MO, van den Bogert AJ, Riemersma DJ. et al. In vivo tendon forces in the forelimb of ponies at the walk, validated by ground reaction force measurements. Acta Anat (Basel) 1993; 146: 162-167.
    CrossrefPubMedGoogle Scholar
  • 32 Meershoek LS, Lanovaz JL, Schamhardt HC. et al. Calculated forelimb flexor tendon forces in horses with experimentally induced superficial digital flexor tendinitis and the effects of application of heel wedges. Am J Vet Res 2002; 63: 432-437.
    CrossrefPubMedGoogle Scholar
  • 33 Ferraro GL, Stover SM, Whitcomb MB. Suspensory Ligament Injuries in Horses. Davis, CA, USA: University of California, Davis, School of Veterinary Medicine, Center for Equine Health, Davis, CA Available from: 1999 www.vetmed.ucdavis.edu/ceh/local_resources/pdfs/Pubs-SuspBrochure-bkm-sec.pdf
    PubMedGoogle Scholar
  • 34 Kainer RA. Functional anatomy of the equine locomotor organs. In: Stashak TS.. editor. Adams’ Lameness in Horses. 4th edition Philadelphia: Lea & Febiger; 1987: 12-13.
    Google Scholar
  • 35 Sisson S. Equine syndesmology. In: Getty R.. editor. Sisson and Grossman’s, The Anatomy of the Domestic Animals. 5th edition. Philadelphia: W.B. Saunders; 1975: 358-360.
    Google Scholar
  • 36 Murray RC, Dyson SJ, Tranquille C. et al. Association of type of sport and performance level with anatomic site of orthopaedic injury diagnosis. Equine Vet JSuppl 2006; 36: 411-416.
    PubMedGoogle Scholar
  • 37 Souza MV, van Weeren PR, van Schie HTM. et al. Regional differences in biochemical, biomechanical and histomorphologic characteristics of the equine suspensory ligament. Equine Vet J 2010; 42: 611-620.
    CrossrefPubMedGoogle Scholar
  • 38 Gardiner JC, Weiss JA. Subject-specific finite element analysis of the human medial collateral ligament during valgus knee loading. J Orthop Res 2003; 21: 1098-1106.
    CrossrefPubMedGoogle Scholar
  • 39 Limbert G, Taylor M, Middleton J. Three-dimensional finite element modeling of human ACL: Simulation of passive knee flexion with a stressed and stress-free ACL. J Biomech 2004; 37: 1723-1731.
    CrossrefPubMedGoogle Scholar
  • 40 Renström P, Johnson RJ. Overuse injuries in sports. A review. Sports Med 1985; 2: 316-333.
    CrossrefPubMedGoogle Scholar
  • 41 Hill AE, Gardner IA, Carpenter TE. et al Prevalence, location, and symmetry of noncatastrophic ligamentous suspensory apparatus lesions in California Thoroughbred racehorses, and association of these lesions with catastrophic injuries. Equine Vet J 2014. October 7 Epub ahead of print
    Google Scholar
  • 42 Pufe T, Petersen WJ, Mentlein R. et al. The role of vasculature and angiogenesis for the pathogenesis of degenerative tendon disease. Scand J Med Sci Sports 2005; 15: 211-222.
    CrossrefPubMedGoogle Scholar
  • 43 Gilday SD, Casstevens EC, Kenter K. et al. Murine patellar tendon biomechanical properties and regional strain patterns during natural tendon-to-bone healing after acute injury. J Biomech 2014; 47: 2035-2042.
    CrossrefPubMedGoogle Scholar
  • 44 Jansen MO, Schamhardt HC, van den Bogert AJ. et al. Mechanical properties of the tendinous equine interosseus muscle are affected by in vivo transducer implantation. J Biomech 1998; 31: 485-490.
    CrossrefPubMedGoogle Scholar
  • 45 Meershoek LS, van den Bogert AJ, Schamhardt HC. Model formulation and determination of in vitro parameters of a noninvasive method to calculate flexor tendon forces in the equine forelimb. Am J Vet Res 2001; 62: 1585-1593.
    CrossrefPubMedGoogle Scholar