Students' Research Circle    
 
 
» 2022
Call for papers
The conference
Veterinary Session
Jury
Sponsors
Awards-list
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
Home » Archive » 2022

TDK conference 2022

The rehabilitation of the superficial digital flexor tendon while using a peak load restriction device. The evaluation of tendon matrix composition during recovery by ultrasound tissue characterization
Allen Grace Catherine - year 6
University of Veterinary Medicine Budapest, Department and Clinic of Equine Medicine
Supervisors: Dr. Péter Tóth, Dr. Henk Offereins

Abstract:

Tendon injuries are one of the leading causes of retirement in the equine industry. Injuries of the superficial digital flexor tendon account for 75%-93% of soft tissue injury in our equine athletes. The rehabilitation of an SDFT injury is time consuming and can have quite a limited success rate to preinjury level exercise.

Early mobilisation is known to improve the tendon integrity and fiber matrix of a recovering tendon but proves difficult to maintain peak loading. An alternative method is the use of a peak load restriction device

An optimal method of evaluating the peak load of a tendon is Ultrasound Tissue Characterisation (UTC). UTC characterises the tendon by echo-type thus allowing the ability to see the tendon’s functionality throughout recovery. Echo-type I portrays intact fascicles, echo-type II by discontinuous swollen fascicles, echo-type III by fibers in a lesion and echo-type IV by complete lack of fiber structure.

The aim of the study is to monitor the changes of SDFT injuries throughout recovery whilst using a restricted peak loading device. The integrity of the tendon is evaluated by UTC by means of quantifying the tendon matrix.

The population consisted of 32 horses, 19 geldings (59%) and 13 mares (41%) had naturally occurring SDFT injuries entered a standardised rehabilitation schedule with the use of a peak load restriction device.

The results of UTC analysis were used to evaluate the effect of exercise in a predetermined maximum load protocol that was reevaluated every 4 consecutive weeks. Data analysis of the proportions of the 4 echo-types were taken at each timing interval (T1-T6). The peak load restriction device settings were changed at each interval.

Inclusion criteria of the subjects included age, gender, clinical examination, lesion type and discipline of same, pre-injury. Subject mean age of 8.45 years SD± 2.96 (range: 6 - 18 years). The subjects competed in showjumping 10 (32%), eventing 9(28%), or thoroughbred racing 13(40%) before the initial SDFT injury. The interaction for speed-like estimate between clinical group and echo-type I was significant( p-value = <.0001).

A functional tendon should have < 5% of UTC echo-type III and IV combined. In the evaluation of the clinical group echo-types III and IV combined was 27% = T0, 3.66% = T6 compared to the control group 23% and 10.3% respectively. At T3, there was a significant correlation between lameness and echo-type IV in control group (p-value = 0.01). With the use of restricted peak loading, 27 subjects (84%) of the clinical group reached pre-injury level competition or higher after twelve months post-injury compared to 5 (50%) in the control group. (p-value=0.04).

Assessing the effect of loading on a tendon may lead to reducing the injury rate in the equine athletes in the future. UTC has proven to be an accessible and functional aid for the evaluation of tendinopathies.



List of lectures