Tendon / Ligament Surgery
Tendon and ligament injuries are common causes of lameness in performance horses. State-of-the-art treatments include many forms of regenerative therapy, including injection of protein-rich-plasma, non-cellular structural elements, or stem cells into the injured tendon. Focused extracorporeal shock wave therapy is also a valuable aid in healing these injuries. Flexural deformities of the limbs of young horses represent still another cause of lameness that are treated with corrective trimming and shoeing in conjunction with surgery in some cases. The surgeons at the New Jersey Equine Clinic use selected surgical procedures such as check ligament desmotomy, annular ligament desmotomy (see below), fasciotomy, and splitting procedures in order to encourage tendon/ligament healing or to correct flexural disorders, when appropriate.
The two ultrasound images above were obtained from a Thoroughbred with a chronic tendon injury of the left hind limb at the level of the fetlock joint. In the image on the left above, you can see fiber disruption and enlargement of the deep digital flexor tendon (DDFT). The normal right hind DDFT is pictured in the image to the right for comparison. The volar annular ligament is thickened in the left hind limb (seen between the yellow arrows) when compared with the normal ligament seen in the right hind. In the image below, the left hind volar annular ligament of this horse is being surgically divided in order to relieve the pressure that was exerted upon the injured tendon within the tendon sheath. This procedure is analogous to the carpal tunnel release procedure that is used to ease the pain caused by "carpal tunnel syndrome" in people. Relief of the pressure within the tendon sheath eliminates pain and allows for improved circulation to the injured tendon.