L2: Tendon Injury and Rehabilitation

Question 1

Describe tendon structure

Answer 1

Composed of bundles of collagen (predominantly type I).

Dense fibrous extracellular matrix

Parrelel rows of fibroblasts known as tenocytes.

High water content

Non-collagenous proteins (GAG, COMP)

Question 2

A bit abount tendon collagen ..

Answer 2

Fibrils orientated in direction of force application.

Collagen molecules stabilised by chemical crosslinks

High tensile strength

Question 3

What are the non-collagenous proteins?

Answer 3

Proteoglycans: regulate fibrillogenesis and organise matrix

Glycoproteins: COMP must abundent

Question 4

What is the function of the tendon?

Answer 4

To position limb during locomotion.

Question 5

What is the function of the Superficial Digital Flexor Tendon and Suspensory Ligament?

Answer 5

Springs to store and release energy during stretching.

Main energy storing structures.

Question 6

Injury occurs in 1 of 2 ways which is what?

Answer 6

Overstrain and trauma.

Question 7

What are the factors increasing risk of tendon injury?

Answer 7

Increased age, speed, and male horse

Question 8

What are the mechanisms of an overstrain injury?

Answer 8

Accumulation of microdamage over time (icrease in MMP gene epression and limited ability to repair).

Increased age which reduces crimp and tendon fascicle sliding.

Hysteresis (increased pro-inflamm mediators).

Muscle fatigue, abnormal loading

Question 9

How do you diagnose a tendon injury?

Answer 9

Clinical examination which can include palpation and lameness exam.

Ultrasound examination.

Question 10

What do rehabilitation programs include for a tendon injury?

Answer 10

Reducing inflamm: ice/cold water hosing, bandaging, NSAIDs, confinement.

Uncontrolled and controlled exercise.

Intralesional therapy: stem cells

Surgical management.

Shockwave therapy.