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Hand (N Y) 2022 Jun 3:15589447221093676. Epub 2022 Jun 3.

Baylor College of Medicine, Houston, TX, USA.

Background: Stenosing flexor tenosynovitis is commonly treated by injection of corticosteroids into the flexor tendon sheath. However, there is no consensus in the literature regarding the optimal technique, specifically when not utilizing ultrasound guidance. Here, we present a cadaver study in which 3 common techniques of flexor sheath injection were compared with regard to their accuracy and safety profiles. Read More

Front Vet Sci 2022 18;9:843131. Epub 2022 Feb 18.

Department of Comparative Biomedicine and Food Science, University of Padua-Agripolis Campus, Legnaro, Italy.

In the present case report a show jumping 10-year-old Sella Italiano gelding, presented with severe lameness, swelling and pain at palpation of the mid-metacarpal region of the left forelimb. Clinical and ultrasound examination diagnosed a chronic tendonitis of the central region of the superficial digital flexor tendon (SDFT). The lesion was a reoccurrence since it developed from a previously healed injury. Read More

S D Med 2021 Nov;74(11):532-536

Sanford Orthopedics and Sports Medicine, Sioux Falls, South Dakota.

The use of low-dose 1 percent lidocaine with epinephrine (1:100,000) has changed the practice of hand surgery. The safety of lidocaine and epinephrine in hand surgery has been well documented. Although rare, epinephrine-induced digital vasospasm can occur leading to tissue necrosis and amputation. Read More

Anat Histol Embryol 2022 Mar 9;51(2):236-243. Epub 2022 Jan 9.

Departamento de Cirurgia, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, SP, Brazil.

The neurovascular bundle of the equine distal cannon can dynamically vary with limb position, and this can affect the performance of low 4- or 6-point block. This study aims to identify and describe the anatomical position and variations of the lateral and medial palmar/plantar nerve at the metacarpal/metatarsal distal level in horses by ultrasonography. Eight mares underwent ultrasound examination on the lateral and medial palmar/plantar sides of the metacarpus/metatarsus. Read More

Vet Res Commun 2022 Feb 29;46(1):283-288. Epub 2021 Oct 29.

Departamento de Cirurgia, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, SP, Brazil.

This study aimed to evaluate the distribution of dye at two perineural injection sites of the palmar/plantar nerves and describe their anatomical variations of positioning at the level of the distal metacarpus/metatarsus in horses. Two ml of 1% methylene blue solution was injected in 24 limbs (12 forelimbs and 12 hindlimbs) of horse cadavers at two different points: Group 1: between the branch of the suspensory ligament and deep digital flexor tendon, and Group 2: between the deep and superficial digital flexor tendons. This was followed by dissection and evaluation of the solution diffusion. Read More

Vet J 2021 Dec 19;278:105763. Epub 2021 Oct 19.

Department of Musculoskeletal and Ageing Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L7 8TX, UK; Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Neston CH64 7TE, UK.

Flexor tendon injuries are a common cause of lameness and early retirement in equine athletes. While ultrasonography is most frequently utilised, advanced diagnostic imaging modalities are becoming more widely available for detection and monitoring of flexor tendon lesions. Part two of this literature review details current experience with low- and high-field magnetic resonance imaging (MRI) and computed tomography (CT) for the diagnosis of equine flexor tendinopathy with a focus on the deep digital flexor tendon. Read More

Rheumatol Ther 2021 Dec 15;8(4):1809-1826. Epub 2021 Oct 15.

Department of Clinical Medicine and Surgery, Rheumatology Unit, University of Naples Federico II, via S. Pansini 5, 80131, Naples, Italy.

Introduction: To assess clinical and ultrasound effectiveness of steroid injection (local treatment, LT) into the digital flexor tendon sheath for the treatment of psoriatic dactylitis compared to systemic treatment (ST) alone.

Methods: In this observational, multicentre, prospective study, 88 cases of symptomatic hand dactylitis were evaluated clinically and sonographically by high-frequency ultrasound (US) probe in both greyscale (GS) and power Doppler (PD). The presence of flexor tenosynovitis (FT), soft tissue oedema (STO), peritendon extensor inflammation and synovitis was assessed (including DACtylitis glObal Sonographic-DACTOS-score) before treatment, at 1-month (T1) and 3-months (T3) follow-up. Read More

Vet Radiol Ultrasound 2022 Jan 28;63(1):111-123. Epub 2021 Sep 28.

Department of Clinical Sciences, Orthopaedic Research Center, C. Wayne McIlwraith Translational Medicine Institute, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.

Elastography is an emerging imaging modality for characterizing tendon injury in horses, but its ability to differentiate tissue deformability relative to treatment group and biochemical properties using a prospective, experimental study design remain unknown. Objectives of the current study were to (a) to investigate differences in glycosaminoglycan, DNA, and soluble collagen levels in mesenchymal stem cell (MSC) treated limbs compared to untreated control limbs utilizing a collagenase model of tendinopathy; (b) compare elastographic features between treatment groups; and (c) determine tissue-level predictive capabilities of elastography in relation to biochemical outcomes. Bone marrow was collected for MSC culture and expansion. Read More

Front Vet Sci 2021 5;8:697551. Epub 2021 Jul 5.

Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, United States.

Autologous protein solution (APS) has been used anecdotally for intralesional treatment of tendon and ligament injuries, however, its use in these injuries has never been studied . Our objective was to evaluate the effect of APS on tendon healing in an equine superficial digital flexor (SDF) tendonitis model. We hypothesized intralesional injection of APS would result in superior structural and biomechanical healing. Read More

J Med Imaging Radiat Oncol 2021 Oct 21;65(6):672-677. Epub 2021 Mar 21.

Radiology, Benson Radiology, Wayville, SA, Australia.

Introduction: Ultrasound-guided percutaneous first annular pulley (A1) release is a non-surgical management for the treatment of trigger finger, also known as stenosing tenosynovitis. Trigger finger occurs secondary to inflammation and retinacular sheath hypertrophy with subsequent restriction of the flexor tendons. Trigger finger can have a marked functional impact, with current conservative measures including steroids and/or splinting, and surgical therapy involving open release. Read More

Front Vet Sci 2021 5;8:641441. Epub 2021 Mar 5.

Department of Surgery and Anaesthesiology of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.

Tendon injuries are very common in horses and jeopardize the athletic performance, and due to the high risk of reinjury may lead to early retirement. The use of mesenchymal stem cells for the treatment of equine tendon disease is widely investigated because of their regenerative potential. The objective of this study is to investigate the safety and efficacy of equine allogeneic tenogenic primed mesenchymal stem cells (tpMSCs) for the management of tendinitis in horses. Read More

Transl Anim Sci 2019 Jul 4;3(4):1389-1398. Epub 2019 Jun 4.

Department of Animal Sciences, College of Agriculture Sciences, Colorado State University, Fort Collins, CO.

The objective of the control study was to assess 2 prominent fluctuations in a single optical signal as being either a true first hoof contact or a last break-over based on descriptive measures. The study builds on initial findings from a preliminary investigation of the embedded-optical-base system's (EOBS) capabilities in signal capturing and feasibility as potential alternative to existing gait technologies, such as piezoelectric (e.g. Read More

Clin Rheumatol 2020 Nov 16;39(11):3383-3392. Epub 2020 May 16.

Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, via Sergio Pansini 5, 80131, Naples, Italy.

Objective: To assess the effectiveness of steroid injection (local treatment, LT) into the digital flexor tendon sheath of dactylitis in psoriatic arthritis (PsA) patients as compared with systemic treatment (ST).

Methods: Forty-six PsA patients with a total of 73 dactylitic fingers were assessed in an observational, multicentre, prospective study by the Leeds Dactylitis Index basic (LDI-b) score and evaluated for local pain (visual analogue scale-VAS pain) and functional impairment (VAS-FI). Steroid injection was proposed to all patients. Read More

Hand Surg Rehabil 2020 09 7;39(4):328-331. Epub 2020 May 7.

Orthopedic Department, HaEmek Medical Center, Yitshak Rabin Boulevard 21, 1834111 Afula, Israel; Faculty of Medicine, Technion, 3200003 Haifa, Israel. Electronic address:

The second case of high temperature molten metal, high-pressure injection injury of the hand is reported here. Like in the previous case, there was an innocent-looking entry point with deep thermal injury to the flexor tendons and the digital nerves that appeared a few days after the injury and lead to finger amputation. LEVEL OF EVIDENCE: 5. Read More

Equine Vet J 2021 Jan 26;53(1):167-176. Epub 2020 May 26.

Department of Clinical Sciences, College of Veterinary Medicine, Université de Montréal, St. Hyacinthe, Quebec, Canada.

Background: The effect of intrathecal anaesthesia of the carpal sheath on distal forelimb sensitivity in horses remains unknown.

Objectives: To assess the effect of carpal sheath anaesthesia on skin sensitivity of the distal forelimb and to determine potential locations for desensitisation of palmar nerves.

Study Design: In vivo experimental and descriptive anatomical studies. Read More

PLoS One 2020 15;15(4):e0231619. Epub 2020 Apr 15.

Department of Orthopedics, Balgrist University Hospital, Zurich, Switzerland.

Background: Tendinopathy is a common musculoskeletal disorder and current treatment options show limited success. Genipin is an effective collagen crosslinker with low cytotoxicity and a promising therapeutic strategy for stabilizing an intratendinous lesion.

Purpose: This study examined the mechanical effect and delivery of intratendinous genipin injection in healthy and degenerated tendons. Read More

Tissue Eng Part C Methods 2020 05 5;26(5):253-262. Epub 2020 May 5.

Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, Illinois, USA.

Histological evaluation of healing tendons is primarily focused on monitoring restoration of longitudinal collagen alignment, although the elastic property of energy-storing flexor tendons is largely attributed to interfascicular sliding facilitated by the interfascicular matrix (IFM). The objectives of this study were to explore the utility of second harmonic generation (SHG) imaging to objectively assess cross-sectional tendon fascicle architecture, to combine SHG microscopy with elastin immunofluorescence to assess the ultrastructure of collagen and elastin in longitudinal and transverse sections, and lastly, to quantify changes in IFM elastin and fascicle collagen alignment of normal and collagenase-injured flexor tendons. Paraffin-embedded transverse and longitudinal histological sections (10-μm thickness) derived from normal and collagenase-injured (6- and 16-week time-points) equine superficial digital flexor tendons were de-paraffinized, treated with Tris EDTA at 80°C for epitope retrieval, and incubated with mouse monoclonal anti-elastin antibody (1:100 dilution) overnight. Read More

Tech Hand Up Extrem Surg 2019 Dec;23(4):196-198

Department of Orthopedic Surgery and Sports Medicine, University of Kentucky.

Collagenase injections are used as a minimally invasive treatment for Dupuytren contracture of the palm and fingers, with good published success. Most complications are related to injection-site swelling, pain, and ecchymosis. However, the risk of flexor tendon and digital nerve injury can occur when injecting cords that cause proximal interphalangeal joint contractures. Read More

Stem Cell Res Ther 2019 06 18;10(1):181. Epub 2019 Jun 18.

Division of Physiology, Department of Basic Sciences, Faculty of Veterinary Medicine, Ferdowsi University of Mashhad, Mashhad, Iran.

Tendon injuries, as one of the most common orthopedic disorders, are the major cause of early retirement or wastage among sport horses which mainly affect the superficial digital flexor tendon (SDFT). Tendon repair is a slow process, and tendon tissue is often replaced by scar tissue. The current treatment options are often followed by an incomplete recovery that increases the susceptibility to re-injury. Read More

Vet J 2019 May 23;247:26-31. Epub 2019 Feb 23.

Environmental and Radiological Health Sciences Department, Colorado State University, 300 W. Drake Rd., Fort Collins, CO 80523, USA.

Injuries to the structures within the digital flexor tendon sheath (DFTS) can lead to lameness with a variable degree of effusion in horses. In some cases, effusion is absent or minimal, and this may be related to the chronicity and type of injury, or veterinary interventions. The purpose of this study was to determine if saline injection into the DFTS would improve ultrasonographic and magnetic resonance imaging of the distal limb without introducing artifact. Read More

Open Vet J 2018 15;8(4):471-478. Epub 2018 Dec 15.

Dipartimento di Medicina Veterinaria, Centro Clinico Veterinario e Zootecnico Sperimentale, Università degli Studi di Milano, Italy.

The use of contrast enhanced magnetic resonance imaging (MRI) for the detection of orthopedic pathologies in equine patients is poorly described. In few studies, enhanced MRI allowed to differentiate active lesions from chronic ones and to classify ambiguous lesions. The aim of this clinical prospective pilot study is to describe and compare the MRI lesions observed in horses with lameness localized to the foot using a single intravenous bolus dose of gadolinium contrast versus regional intraarterial bolus of contrast agent. Read More

Anat Histol Embryol 2018 Dec 6;47(6):537-543. Epub 2018 Aug 6.

Anatomy and Embryology Department, Faculty of Veterinary Medicine, Sadat-City University, Sadat City, Egypt.

The camel digits have a complex structure with tendons, joints and ligaments. The objective of the study was to determine the anatomical features of the metatarsophalangeal joint and its puncture site in dromedary camel using anatomical dissection, radiography, computed tomography (CT) bone and soft tissue window scans and 3D reconstruction render volume of CT. The study used six adult camels of both sexes (three males and three females), aged 9-15 years (Mean ± SD equal 11. Read More

Hand Clin 2018 08 8;34(3):387-394. Epub 2018 Jun 8.

Hand Surgery Service, Department of Orthopaedics, Yawkey Center, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA. Electronic address:

Dupuytren contracture is a progressive disease involving collagen within the palmar fascia. When the contracture progresses to meet specific parameters, intervention is considered and includes collagenase injection, percutaneous or open fasciotomy, or palmar fasciectomy. Complications after treatment include contracture recurrence, digital nerve injury or postoperative neurapraxia, flexor tendon injury/rupture, delayed wound healing or skin necrosis, dysvascular digit/arterial injury, hematoma, and infection. Read More

Stem Cell Res Ther 2018 06 19;9(1):169. Epub 2018 Jun 19.

Royal Veterinary College, Hawkshead Lane, Hatfield, AL9 7TA, UK.

Background: Intra-synovial tendon injuries display poor healing, which often results in reduced functionality and pain. A lack of effective therapeutic options has led to experimental approaches to augment natural tendon repair with autologous mesenchymal stem cells (MSCs) although the effects of the intra-synovial environment on the distribution, engraftment and functionality of implanted MSCs is not known. This study utilised a novel sheep model which, although in an anatomically different location, more accurately mimics the mechanical and synovial environment of the human rotator cuff, to determine the effects of intra-synovial implantation of MSCs. Read More

PLoS One 2018 9;13(3):e0191796. Epub 2018 Mar 9.

Centre d'Imagerie et de Recherche sur les Affections Locomotrices Equines, Ecole Nationale vétérinaire d'Alfort, Maisons-Alfort, France.

A randomized controlled trial was performed on racing horses, to evaluate the efficacy of a new class of therapeutic agents in regenerative medicine-ReGeneraTing Agents® (RGTA®), to treat tendinopathies. Preliminary uncontrolled studies on tendon healing in racing horses with RGTA® (OTR4131)-Equitend® showed encouraging results, justifying performing a randomized, controlled, multicenter study with a two-year racing performance follow up. The objective of this study was to evaluate the effect of Equitend® versus placebo on acute superficial digital flexor tendonitis in racing French Standardbred Trotters (ST). Read More

Front Vet Sci 2017 16;4:169. Epub 2017 Oct 16.

Faculty of Science, School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, NSW, Australia.

Navicular bursa (NB) centesis is a common diagnostic and therapeutic procedure in equine practice. This case report documents the clinical, diagnostic imaging and histological findings in a horse with a suspected iatrogenic deep digital flexor tendon (DDFT) injury following centesis of the NB a modified distal plantar approach (placement of two needles in a weight bearing position). Although it cannot be proven with absolute certainty, the authors believe that this is the first reported case where NB centesis is the likely cause of a DDFT lesion, and with magnetic resonance imaging performed both pre- and post-centesis. Read More

Front Vet Sci 2017 26;4:158. Epub 2017 Sep 26.

Global Stem Cell Technology, ANACURA Group, Evergem, Belgium.

Poor healing of tendon and ligament lesions often results in early retirement of sport horses. Therefore, regenerative therapies are being explored as potentially promising treatment for these injuries. In this study, an intralesional injection was performed with allogeneic tenogenically induced mesenchymal stem cells and platelet-rich plasma 5-6 days after diagnosis of suspensory ligament (SL) ( = 68) or superficial digital flexor tendon (SDFT) ( = 36) lesion. Read More

Mol Ther 2017 10 28;25(10):2415-2426. Epub 2017 Jul 28.

Institute of Infection, Immunity, and Inflammation, College of Medicine, Veterinary, and Life Sciences, University of Glasgow, Glasgow G12 8TA, UK. Electronic address:

Tendon injuries (tendinopathies) are common in human and equine athletes and characterized by dysregulated collagen matrix, resulting in tendon damage. We have previously demonstrated a functional role for microRNA29a (miR29a) as a post-transcriptional regulator of collagen 3 expression in murine and human tendon injury. Given the translational potential, we designed a randomized, blinded trial to evaluate the potential of a miR29a replacement therapy as a therapeutic option to treat tendinopathy in an equine model that closely mimics human disease. Read More

Vet Radiol Ultrasound 2017 Nov 6;58(6):671-678. Epub 2017 Jul 6.

Marion duPont Scott Equine Medical Center, Virginia-Maryland Regional College of Veterinary Medicine, Leesburg, VA, 24060.

Lesions of the distal deep digital flexor tendon (DDFT) are frequently diagnosed using MRI in horses with foot pain. Intralesional injection of biologic therapeutics shows promise in tendon healing; however, accurate injection of distal deep digital flexor tendon lesions within the hoof is difficult. The aim of this experimental study was to evaluate accuracy of a technique for injection of the deep digital flexor tendon within the hoof using MRI-guidance, which could be performed in standing patients. Read More

Stem Cell Res Ther 2017 06 5;8(1):129. Epub 2017 Jun 5.

Equine Clinic, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, 30559, Hannover, Germany.

Background: Adipose tissue is a promising source of mesenchymal stromal cells (MSCs) for the treatment of tendon disease. The goal of this study was to assess the effect of a single intralesional implantation of adipose tissue-derived mesenchymal stromal cells (AT-MSCs) on artificial lesions in equine superficial digital flexor tendons (SDFTs).

Methods: During this randomized, controlled, blinded experimental study, either autologous cultured AT-MSCs suspended in autologous inactivated serum (AT-MSC-serum) or autologous inactivated serum (serum) were injected intralesionally 2 weeks after surgical creation of centrally located SDFT lesions in both forelimbs of nine horses. Read More