Tendon injury & rehab

Question 1

Structure of tendons & ligaments…

Answer 1

• Specialised molecular composition -> high strength structure
• Dense fibrous ECM
  
  • high water, collagen I main, non-collagen proteins (GAGs, COMP)

Question 2

Hierarchical structure of collagen…

Answer 2

Hierarchical structure -> fibrils orientated in direction of force application -> high tensile strength

Question 3

NON-COLLAGENOUS PROTEINS?

Answer 3

• Proteoglycans - regulate fibrillogenesis & organise matrix

- Glycoproteins - COMP mainly

Question 4

TENDON FUNCTION? involve which 2 structures?

Answer 4

Position limb during locomotion

involve SDFT & suspensory ligament (SL)

Question 5

What do the SDFT & suspensory ligament (SL) do?

Answer 5

springs to store and release energy during stretching -> decrease energetic cost of locomotion

Question 6

Most common cause of MSI…?

Answer 6

46% of all MSI involve tendons/ligaments

SDFT most commonly injured (75-93% of cases)

Question 7

Increased risks of injury…?

Answer 7

increased age, speed, male horses

Question 8

Injuryoccursinoneof2 ways…?

Answer 8

overstrain

trauma

Question 9

MECHANISMS OF OVERSTRAIN INJURY?

Answer 9

• Accumulation of microdamage over time
• Increased age
• Hysteresis??
• Muscle fatigue

Question 10

DIAGNOSIS?

Answer 10

1. Clinical examination
   - Palpation
   - Lameness examination
2. ultrasound

Question 11

Rehab programs…?

Answer 11

Initial treatment

• Reduce inflammation - Ice/cold water hosing - Bandaging
• NSAIDs
• Confinement

Question 12

REHABILITATION PROGRAMS…?

Answer 12

Options include
- Uncontrolled exercise 
- Controlled exercise
- Intralesional therapy
- Surgical management
- Shockwave therapy

Question 13

2 intralesional therapies

Answer 13

MSC therapy

platelet rich plasma