The inside story
QAre there any new treatment options for tendon injuries? Liz Thomas, Pembrokeshire
Gil says... MRI scanning has revolutionised hoof care and the vet world’s knowledge of foot lameness. For example, few horses are now diagnosed with ‘navicular disease’. Instead, many with ‘navicular’ pain are now, through MRI, shown to be actually suffering from damage to the deep digital flexor tendon (DDFT), the tendon that travels over the navicular bone before attaching to the pedal bone within the hoof.
If it’s not possible to take an MRI scan of the foot, a nerve block of the navicular bursa can be used to test for damage to the DDFT, and if the horse resents this injection and then the lameness is eliminated within a few minutes of the block being performed, it’s a pretty sure sign that the answer’s going to be ‘yes’. Injuries to the check ligament, a support structure for the DDFT, are frequently seen too. The check ligament runs from it’s attachment to the DDFT in the lower cannon area, up to the back of the knee. Treatment The latest treatments for tendon injuries include the injection of stem cells — harvested from bone marrow taken from the horse’s sternum or pelvis, or platelet-enriched plasma (PRP), which is harvested from the horse’s blood — into the damaged area of tendon.
Stem cell injections help to improve the quality of the tendon repair — the injected undeveloped cells turning into new tendon cells. The platelets in PRP are full of growth factors that encourage new blood vessels to grow in the tendon and more fibres to develop. Surgery is often the best approach to treating horses with injuries to the DDFT in the foot where any dead or injured tissue is removed. Lesions in the superficial digital flexor tendon (SDFT) respond well to a procedure whereby your vet pops a needle into the lesion and draws out fluid, reducing pressure on the healthy tendon fibres surrounding the injured tissue.