Load redistribution after desmotomy of the accessory ligament of the deep digital flexor tendon in adult horses

Passive Dynamics of the Head, Neck and Forelimb in Equine Foetuses-An Observational Study

Passive dynamics is an aspect of locomotion which is entirely dependent on the mechanical configuration and linkages of adjacent body segments. Tension distribution along mechanical linkages enables the execution of movement patterns with reduced need for complex neurological pathways and may play a role in reestablishing postural stability following external disturbances. Here we demonstrate a uni-directional mechanical relationship between the equine forelimb, head and neck, which may have implications for balance and forelimb loading in the horse. These observations suggest that forelimb, head and neck movement coordination (observed in the horse during unrestrained locomotion) is significantly influenced by the mechanical linkages between body segments, rather than being entirely dependent on neurological input as previously thought. This highlights the potential significance of research directed at investigating passively induced movements in understanding common locomotory patterns. Additionally, it suggests a mode of postural control which may provide instantaneous adjustments to postural disturbances, thus promoting rapid and efficient locomotion.

Effect of single and double hemitenotomy on equine deep digital flexor tendon length and strength in experimental load challenges

OBJECTIVE

To evaluate a double hemitenotomy (DHT) technique as an alternative to complete deep digital flexor (DDFT) tenotomy.

STUDY DESIGN

Experimental ex vivo study.

SAMPLE POPULATION

Isolated DDFTs (n = 30) and cadaveric forelimbs (n = 16).

METHODS

In part 1, 15 isolated DDFT pairs were used. Two hemitenotomies were created in 1 DDFT while the other served as reference. Monotonic tensile load was applied. Tendon lengthening, load reduction, and load at failure were recorded. In part 2, 16 cadaveric forelimb pairs were subjected to DHT followed by complete tenotomy (CT) under monotonic compressive load. Differences between DHT and controls were assessed with Wilcoxon signed rank tests or Friedman tests.

RESULTS

In isolated tendons and cadaveric forelimbs, DHT resulted in DDFT lengthening (median, +1.9 mm and + 3.05 mm) and load reduction (median, -16.7 and -11.2 kg). Less lengthening was achieved with DHT compared to CT (P = .008). Load reduction did not occur between DHT and CT was observed during compressive testing (P = 1). Load reduction following the first hemitenotomy incision was smaller when compared to the second (P = .022). Isolated DHT tendons failed at a tensile load of 195 kg, while no intact tendons failed (P = .0001).

CONCLUSION

Double hemitenotomy was comparable to CT in load reduction. It reduced tensile strength, but load at failure was similar or exceeded the estimated DDFT load at stance.

CLINICAL SIGNIFICANCE

Hemitenotomy may be a useful alternative for surgical management of horses with laminitis, but in vivo studies are needed to confirm these findings.

Recent advances in conservative and surgical treatment options of common equine foot problems

Foot problems are very common causes of lameness in horses. With the recent diagnostic advances to evaluate and treat foot pathology as well as to monitor response to therapy, it is now possible to more accurately evaluate the effectiveness of many of these treatments. This review details some of the recent advances of the most common conservative and surgical treatment options for foot problems in horses, including an overview of evidence on the efficacy to support the use of these treatment options and on factors that may affect prognosis.

Determination of passive mechanical properties of the superficial and deep digital flexor muscle-ligament-tendon complexes in the forelimbs of horses

OBJECTIVE

To determine the relative contributions of the muscles, tendons, and accessory ligaments to the passive force-length properties of the superficial (SDF) and deep digital flexor (DDF) myotendinous complexes.

SAMPLE POPULATION

8 cadaveric forelimbs from 6 adult Thoroughbreds.

PROCEDURE

In vitro, limb configurations during slack position and myotendinous lengths during subsequent axial loading of forelimbs were recorded before and after transection of accessory ligaments. Expressions were derived to describe the force-length behavior of each muscle, tendon, and accessory ligament-tendon unit; linear stiffness was computed for these components. The elastic modulus was established for the SDF and DDF tendons. RESULTS; Linear stiffness was 2.80 +/- 0.38 kN/cm for the SDF muscle, 3.47 +/- 0.66 kN/cm for the DDF muscle, 2.73 +/- 0.18 kN/cm for the SDF tendon, 3.22 +/- 0.20 kN/cm for the DDF tendon, 6.46 +/- 0.85 kN/cm for the SDF accessory ligament, 1.93 +/- 0.11 kN/cm for the SDF accessory ligament-tendon unit, and 2.47 +/- 0.11 kN/cm for the DDF accessory ligament-tendon unit. The elastic modulus for the SDF and DDF tendons was 920 +/- 77 and 843 +/- 56 MPa, respectively.

CONCLUSIONS AND CLINICAL RELEVANCE

Both the muscle-tendon and ligament-tendon portions of SDF and DDF myotendinous complexes had important roles in supporting the forelimb of horses. Although muscle tension can be enhanced by elbow joint flexion and active contraction, the accessory ligaments transmitted more force to the distal tendons than did the muscles under the conditions tested.

Sensitivity of forelimb swing phase inverse dynamics to inertial parameter errors

Estimations of segmental inertial parameters are required for true inverse dynamics calculations during the swing phase of locomotion. This study attempts to quantify the effect of inertial parameter errors on inverse dynamic solutions. Swing phase forelimb net joint moments and powers at the trot (mean +/- s.d 3.03 +/- 0.16 m/s) were calculated with sagittal plane kinematic data from 5 Dutch Warmbloods using inertial parameters based on published regression equations for the breed. Significant peaks in the net moment and power curves for each forelimb joint were identified and measured. Net joint moments and powers were then recalculated after varying the segment mass, location of the segment centre of mass and the mass moment of inertia separately for each of the limb segments. Peak values for the net joint moments and joint powers were determined after each variation, and the percent change in peak value per percent change in inertial parameter was calculated. Segment mass was the most influential parameter, followed by location of the centre of mass. Changes in the mass moment of inertia showed little effect on peak values. The most influential single inertial parameter was the mass of the hoof segment with a mean +/- s.d effect 0.74 +/- 0.22 and 0.69 +/- 0.18 percent peak change per percent parameter change on net joint moments and powers, respectively, across all joints. The results demonstrate the need for an accurate approximation of segment masses during the swing phase, especially the hoof, and the need to account for any additional masses in the model, such as shoes.

Forelimb tendon loading during jump landings and the influence of fence height

Lameness in athletic horses is often caused by forelimb tendon injuries, especially in the interosseus tendon (TI) and superficial digital flexor tendon (SDF), but also in the accessory ligament (AL) of the deep digital flexor tendon (DDF). In an attempt to explain the aetiology of these injuries, the present study investigated the loading of the tendons during landing after a jump. In jumping horses, the highest forces can be expected in the trailing limb during landing. Therefore, landing kinematics and ground reaction forces of the trailing forelimb were measured from 6 horses jumping single fences with low to medium heights of 0.80, 1.00 and 1.20 m. The tendon forces were calculated using inverse dynamics and an in vitro model of the lower forelimb. Calculated peak forces in the TI, SDF and DDF + AL during landing were 15.8, 13.9 and 11.7 kN respectively. The relative loading of the tendons (landing forces compared with failure forces determined in a separate study) increased from DDF to TI to SDF and was very high in SDF. This explains the low injury incidence of the DDF and the high injury incidence of the SDF. Fence height substantially influenced SDF forces, whereas it hardly influenced TI forces and did not influence AL strain. Reduction of fence height might therefore limit the risks for SDF injuries, but not for TI and AL injuries.

The forelimb in walking horses: 2. Net joint moments and joint powers

The objective was to measure the net joint moments and joint powers for the joints of the equine forelimb during the walk. Videographic and force data were combined with morphometric information using an inverse dynamics method. During stance phase the predominant joint moment was on the palmar aspect of all forelimb joints except the shoulder, where the peak moment was considerably higher than at any other joint. The entire forelimb showed net energy absorption in both stance and swing phases. The elbow was the only joint that showed net generation of energy, which was used to maintain the limb in extension in early stance as the horse's body vaults over the limb and to drive protraction and retraction of the limb during swing. The carpus aligned the limb into a supportive strut, but did not play an important role in energy absorption or generation. A small burst of positive work on the flexor aspect at the start of breakover indicated that the carpus played an active role in initiating breakover during walking. The fetlock functioned elastically to store and release strain energy during stance. The coffin joint acted as an energy damper during most of stance with a small burst of energy generation on the flexor aspect as the joint flexed during breakover. The magnitude of the peak joint power during swing decreased in a proximal to distal sequence. It is concluded that the elbow joint is the main site of energy generation. The shoulder and coffin joints act as energy dampers during stance. The distal joints had very low joint powers and appeared to be driven by inertial forces during the swing phase. This information will be applied to describe how horses compensate for different lamenesses in terms of redistributing the functions of energy generation and absorption between joints.

Forelimb kinematics and net joint moments during the swing phase of the trot

The purpose of this study was to calculate net moments of force at the joints of the forelimb during the swing phase of the stride. An optoelectronic system was used to measure segmental kinematics for 3 strides in 5 sound, Warmblood horses trotting at a mean velocity +/- s.d. of 3.03 +/- 0.16 m/s. A link segment model was used to determine the net moments of force about the joints of the left forelimb. The model combined kinematic data with morphometric data describing the inertial parameters of the limb segments of warmblood horses, and incorporated correction factors for skin displacement. At each joint the net moment of force was on the cranial/dorsal side during the early swing phase and on the caudal/palmar side during the later swing phase. The transition (time of zero moment) occurred between 35-52% of the swing phase. The peak magnitude of the net joint moments decreased progressively in a proximal to distal direction. Published electromyographic (EMG) data correlated well with the timing of muscular activity required to generate the calculated net joint moments. The moments in the proximal limb are indicative of muscular activity accelerating the limb forward during the first 30-40% of the swing phase, then decelerating the forward swing of the upper limb segments. The net joint moments at all of the joints except the elbow work to slow the motion of the joints. The net joint moment about the elbow actively flex and then extend the joint. The low net joint moments at the distal joints during the first half of swing are consistent with their motion being primarily a result of inertial forces. Flexor muscle activity during the last half of swing indicate active control in preparation for ground contact.

Net joint moments and powers in the equine forelimb during the stance phase of the trot

The objective of this study was to provide normative data describing the net joint moments and joint powers for the stance phase of the forelimb in trotting horses. Kinematic and force plate data, synchronised in time and space, were collected for the right forelimb of 6 Warmblood horses moving at a trot. The 3-D kinematic data were collapsed onto a sagittal plane, and were combined with the vertical and longitudinal ground reaction forces and with segment morphometric data to calculate net joint moments in the sagittal plane across the distal interphalangeal (coffin), metacarpophalangeal (fetlock), carpal, elbow and shoulder joints. The joint mechanical power was calculated as the product of the joint moment and the joint's angular velocity. Major peaks on the moment and power curves were identified. Each joint showed consistent and repeatable patterns in the net joint moments and joint powers. During most of stance the net joint moment was on the caudal/palmar side of all joints except the shoulder. At the coffin joint the power profile indicated an energy absorbing function that peaked at 74% stance, which coincided with the maximal longitudinal propulsive force. The fetlock joint behaved as an elastic spring; energy was absorbed in the first half of stance as the flexor tendons and SL stored elastic energy, which was released in the second half of stance as a result of elastic recoil. The carpus did not appear to play an important role in energy absorption or propulsion. Both the elbow and shoulder joints showed what appeared to be phases of elastic energy storage and release in the middle part of the stance phase, followed by a propulsive function at the shoulder in the later part of stance. The fetlock, carpus and elbow showed virtually no net generation or absorption of energy. The net energy generation at the shoulder joint was approximately equal to the energy absorption at the coffin joint. In human subjects specific gait pathologies produce characteristic alterations in the shape of the power profile as well as changes in the amount of energy absorbed and generated at the joints. In horses evaluation of net joint moments and joint powers will further our understanding of the mechanics and energetics of lameness, and may prove to be a useful diagnostic tool. An understanding of the function and dysfunction of different anatomical structures will facilitate the interpretation of clinical findings in terms of mechanical deficits.

Variations in the force applied to flexion tests of the distal limb of horses

A pressure-sensitive device was developed to measure the force applied to flexion tests of the distal limb of horses. The mean force applied by a group of experienced clinicians was 150 N which results in a moment on the flexed fetlock joint of about 28.5 Nm. The coefficient of variation of the force applied by one experienced clinician was only about 12 per cent, but the coefficient of variation between clinicians was considerably higher (20 per cent), irrespective of whether the clinicians were considered to be experienced or not. The mean force applied by a group of women examiners (114 N) was significantly lower than that applied by the group of male examiners. It is concluded that the flexion test used in the clinical examination of the locomotor system of the horse should be better standardised.

Recovery of equine forelimb function after desmotomy of the accessory ligament of the deep digital flexor tendon

The recovery process of the equine locomotor system after desmotomy of the accessory ligament of the deep digital flexor tendon (AL-DDFT) was investigated by studying the movement patterns and joint moments in 6 horses before and 10 days and 6 months following surgery. Using a modified CODA-3 system the joint angles and angular velocities of the lower limb were assessed in the operated forelimb as before the operation. Simultaneously ground reaction forces were measured and joint moments calculated. At 10 days and 6 months after the operation the carpal joint started to bend earlier in the stance phase. At that instant, the fetlock joint was more extended and displayed a higher angular velocity. The moment of the coffin joint was significantly decreased 10 days after desmotomy. After 6 months it had recovered considerably, but still the shape of the curve was significantly different compared to that before the operation. The fetlock joint moment was not affected, but turned out to be generated for a greater part by the suspensory ligament and the superficial digital flexor 10 days after the operation. Further analysis of these results showed that 6 months after the desmotomy the locomotor system was able to cope with almost similar external moments. To accomplish this, it had adopted a new co-ordination pattern during the recovery process.