[en] [en] OBJECTIVE: To describe type and distribution of tarsal collateral ligament (CL) injuries and to assess the long-term outcome in horses treated conservatively.
ANIMALS: 78 horses (median age, 7 years [IQR, 4 to 9.75 years]) of different breeds and disciplines.
PROCEDURES: Retrospective analysis (2000 through 2020) of horses with tarsal CL lesions diagnosed on ultrasound. The resting time, ability to return to work, and performance level after the injury were compared between horses having a single ligament (group S) or multiple ligaments (group M) affected and according to the case severity.
RESULTS: Most of the horses (57/78) presented a single CL injury, while 21 had multiple CLs affected simultaneously, for a total of 108 CLs injured and 111 lesions. In both groups, the short lateral CL (SLCL) was the most commonly affected (44/108), followed by the long medial CL (LMCL; 27/108). Enthesopathies (72.1%) were more frequent than desmopathies alone (27.9%) and involved mostly the proximal insertion of the SLCL and the distal attachment of the LMCL. Conservative treatment (n = 62) consisted mainly of stall rest. The median resting time (120 days [IQR, 60 to 180 days]) did not significantly differ between the 2 groups (group S vs M) or according to the severity. Most horses (50/62) were able to return to work within 6 months. Horses that did not return (12/62) were more likely to have severe lesions (P = .01). Thirty-eight horses were able to perform at a level equal to or higher than before the injury.
CLINICAL RELEVANCE: This study highlights the importance of thorough ultrasound assessment of tarsal CL injuries and demonstrates that conservative management is a viable option to allow these horses to return to previous performance level.
Disciplines :
Veterinary medicine & animal health
Author, co-author :
Fraschetto, Claudia; 1Center of Imaging and Research on the Equine Locomotor Injuries, Normandie Equine Vallée, Goustranville, France
Dancot, Michaël ; Université de Liège - ULiège > Fundamental and Applied Research for Animals and Health (FARAH) > FARAH: Médecine vétérinaire comparée
Vandersmissen, Maxime ; Université de Liège - ULiège > Département d'Enseignement et de Clinique des Equidés (DCE) > Imagerie médicale des équidés
Denoix, Jean-Marie; 1Center of Imaging and Research on the Equine Locomotor Injuries, Normandie Equine Vallée, Goustranville, France
Coudry, Virginie; 1Center of Imaging and Research on the Equine Locomotor Injuries, Normandie Equine Vallée, Goustranville, France
Language :
English
Title :
Conservative management of equine tarsal collateral ligament injuries may allow return to normal performance.
Publication date :
11 April 2023
Journal title :
Journal of the American Veterinary Medical Association
ISSN :
0003-1488
eISSN :
1943-569X
Publisher :
American Veterinary Medical Association (AVMA), United States
Dyson SJ, Ross MW. The tarsus. In: Dyson SJ, Ross MW, eds. Diagnosis and management of lameness in the horse. 2nd ed. Elsevier Saunders; 2011:508–526. doi:10.1016/B978-1-4160-6069-7.00044-4
Whitton C. Tarsus and stifle. In: Equine Sport Medicine and Surgery. 2nd ed. Elsevier Saunders Ltd; 2014:367–398. doi:10.1016/B978-0-7020-4771-8.00019-3
Sullins KE. The tarsus. In: Stashak TS, ed. Adams’ Lameness in Horses. 5th ed. Lippincott Williams and Wilkins; 2002:930–987.
Tokateloff N, Carmalt J, Manning S. Trauma resulting in hemarthrosis and long medial collateral ligament desmitis of the tarsocrural joint in a horse. Can Vet J. 2011;52(5):519–523.
Lamb L, Zubrod C, Hague B, Brakenhoff J, Major M. Clinical outcome of collateral ligament injuries of the tarsus. Can Vet J. 2012;53(5):518–524.
Bramlage L. Traumatic and developmental lesions of the tarsus. In: Proceedings of the 52nd Annual Meeting of the American Association of Equine Practitioners. American Association of Equine Practitioners; 2006:1–4.
Byron CR. Collateral ligament injuries in horses. Equine Vet Educ. 2016;30(7):367–369. doi:10.1111/eve.12694
Sherlock CE, Eggleston RB, Peroni JF, Parks AH. Desmitis of the medial tarsal collateral ligament in 7 horses. Equine Vet Educ. 2013;24(2):72–80. doi:10.1111/j.2042-3292.2011.00272.x
Boero MJ, Kneller SK, Baker GJ, Metcalf MR, Twardock AR. Clinical, radiographic, and scintigraphic findings associated with enthesitis of the lateral collateral ligaments of the tarsocrural joint in Standardbred racehorses. Equine Vet J Suppl. 1988;6:53–59. doi:10.1111/j.2042-3306.1988.tb04648.x
Barone R. Anatomie Comparée des Mammifères Domestiques. Tome 2: Arthrologie et Myologie. Barrone; 1969:307–309.
Denoix J-M. The tarsus. In: Essential of Clinical Anatomy of the Equine Locomotor System. Taylor & Francis; 2018:229–255.
Updike SJ. Functional anatomy of the equine tarsocrural collateral ligaments. Am J Vet Res. 1984;45(5):867–874.
Kümmerle JM, Kummer MR. Arthroscopically accessible anatomy of the tarsal collateral ligaments in the horse. Vet Surg. 2013;42(3):267–274. doi:10.1111/j.1532-950X.2013.01100.x
Denoix J-M. Hock and crus. International Society of Equine Locomotor Pathology workshop presentation at: Kleider Veterinary Services; September 29 to October 1, 2016; Langley, BC, Canada.
Raes EV, Vanderperren K, Pille F, Saunders JH. Ultrasonographic findings in 100 horses with tarsal region disorders. Vet J. 2010;186(2):201–209. doi:10.1016/j.tvjl.2009.07.026
Vanderperren K, Raes E, Hoegaerts M, Saunders JH. Diagnostic imaging of the equine tarsal region using radiography and ultrasonography. Part 1: the soft tissues. Vet J. 2009;179(2):179–187. doi:10.1016/j.tvjl.2007.08.030
Denoix J-M. Diagnostic techniques for identification and documentation of tendon and ligament injuries. Vet Clin North Am Equine Pract. 1994;10(2):365–407. doi:10.1016/s0749-0739(17)30361-9
Denoix JM. Ultrasonographic examination in diagnosis of joint disease. In: McIlwraith C, Trotter GW, Saunders WB, eds. Joint Disease in the Horse. Saunders; 1996:165–202.
Denoix JM. Ultrasound examination of joints and miscellaneous tendons. In: Rantanen N, McKinnon A, eds. Equine Diagnostic Ultrasound. Saunders; 1998:475–514.
Denoix JM, Busoni V. Ultrasonography of joints and synovia. In: White NA, Moore JN. Current Techniques in Equine Surgery and Lameness. 2nd ed. Saunders; 1998;643–654.
Whitcomb MB. Ultrasonography of the tarsus. In: Proceedings of the 52nd Annual Meeting of the American Association of Equine Practitioners. American Association of Equine Practitioners; 2006:13-30.
McIlwraith CW, Nixon AJ, Wright IM, Boening KJ. Diagnostic and surgical arthroscopy of the tarsocrural (tibiotarsal) joint. In: Diagnostic and Surgical Arthroscopy in the Horse. 3rd ed. Mosby Elsevier; 2005:269–306. doi:10.1016/B978-0-7234-3281-4.50011-7
Wright IM. Fractures of the lateral malleolus of the tibia in 16 horses. Equine Vet J. 1992;24(6):424–429. doi:10.1111/j.2042-3306.1992.tb02871.x
Smith MR, Wright IM. Arthroscopic treatment of fractures of the lateral malleolus of the tibia: 26 cases. Equine Vet J. 2011;43(3):280–287. doi:10.1111/j.2042-3306.2010.00183.x
O’Neill HD, Bladon BM. Arthroscopic removal of fractures of the lateral malleolus of the tibia in the tarsocrural joint: a retrospective study of 13 cases. Equine Vet J. 2010;42(6):558–562. doi:10.1111/j.2042-3306.2010.00103.x
Gentman LM, Ross MW, Smith AS. Surgical repair of fractures of the lateral and medial tibial malleoli in a yearling Arabian filly. Equine Vet Educ. 2012;24(10):496–502. doi:10.1111/j.2042-3292.2011.00328.x
American Association of Equine Practitioners. American Association of Equine Practitioners definition and classification of lameness. In: Veterinarian’s Guide to Equestrian Competition Official Duties. American Association of Equine Practitioners; 2020.
Jakovljevic S, Gibbs C, Yeats JJ. Traumatic fractures of the equinehock:areportof13cases.EquineVetJ.1982;14(1):62–68. doi:10.1111/j.2042-3306.1982.tb02338.x
Rose PL, Moore I. Imaging diagnosis—avulsion of the medial collateral ligament of the tarsus in a horse. Vet Radiol Ultrasound. 2003;44(6):657–659. doi:10.1111/j.1740-8261.2003.tb00528.x
Elliott CRB, Lumsden JM. Desmitis of the short lateral collateral ligament of the tarsus in a Thoroughbred racehorse. Aust Equine Vet. 2016;35(2):63–67.
Lanovaz JL, Khumsap S, Clayton HM, Stick JA, Brown J. Three-dimensional kinematics of the tarsal joint at the trot. Equine Vet J Suppl. 2002;34:308–313. doi:10.1111/j.2042-3306.2002.tb05438.x
Denoix J-M. Functional anatomy of tendons and ligaments in the distal limbs (manus and pes). Vet Clin North Am Equine Pract. 1994;10(2):273–322. doi:10.1016/ s0749-0739(17)30358-9
Clegg P. Differential diagnosis of a swollen hock in the horse. In Pract. 2003;6:328–341. doi:10.1136/inpract.25.6.328
Wright IM. Ligaments associated with joints. In: Dyson S, ed. Tendon and Ligament Injuries II. Saunders; 1995:283–286.
Barker WH, Smith MRW, Minshall GJ, Wright IM. Soft tissue injuries of the tarsocrural joint: a retrospective analysis of 30 cases evaluated arthroscopically. Equine Vet J. 2013;45(4):435–441. doi:10.1111/j.2042-3306.2012.00685.x
Denoix JM, Dupays AG, Bertoni L, Werpy N, Audigié F. Ultrasonographic examination of the collateral ligaments of the distal interphalangeal joint in horses. Part B: abnormal findings and lesions. Equine Vet Educ. 2011;23(12):616–625. doi:10.1111/j.2042-3292.2011.00303.x
Mendez-Angulo JL, Firshman AM, Groschen DM, Kieffer PJ, Trumble TN. Effect of water depth on amount of flexion and extension of joints of the distal aspects of the limbs in healthy horses walking on an underwater treadmill. Am J Vet Res. 2013;74(4):557–566. doi:10.2460/ajvr.74.4.557
Denoix JM, Château H, Crevier-Denoix N. Corrective shoeing of equine foot injuries. In: Proceedings of the 10th Geneva Congress of Equine Medicine and Surgery. Geneva Congress of Equine Medicine and Surgery; 2007:136–143.
