SAEVA Congress 2018 Proceedings | 12-15 February 2018 | ATKV Goudini Spa
examinations in a careful controlled exercise program , a very increase in exercise is warranted with frequent sonographic monitoring , as some lesions do not fill in well sonographically . The exercise level should stay the same if total tendon or ligament cross-sectional area is increased by as much as 10 % or if the cross-sectional area at one injury zone is increased by as much as 20 %, when compared to the previous examination . Increases in tendon or ligament cross-sectional area of greater than 10 % for the entire tendon or ligament or greater than 20 % at any one injury zone are likely indications of excessive loading for the healing that has occurred and re-injury is likely if the current exercise program is maintained . These horses should have their exercise program reduced until improvement in the sonographic appearance of the tendon or ligament occurs .
Several investigators have demonstrated the importance of imaging a good fiber pattern throughout the entire superficial digital flexor tendon prior to beginning cantering or galloping . In all these studies , a better quality of fiber repair was significantly associated with improved chances of horses returning successfully to the races or other types of rigorous athletic competition and competing without reinjury for at least 5 starts .
New areas of injury often occur adjacent to the old healed scar at the margin of the original tendon or ligament injury , often proximal or distal to old healed injury , rather than through the original area of injury .
Future directions for evaluation of horses with injured tendons or ligaments
Diagnostic ultrasound has provided the veterinarian with an objective method of categorizing injury severity in the flexor tendons and ligaments . Further work needs to be done to fine tune the assessments of injury severity in horses with naturally occurring injuries and correlating injury severity with outcome . Frequent sonographic monitoring of tendon or ligament healing is a critical part of a rehabilitation program for horses with naturally occurring tendon and ligament injuries . More work needs to be done to determine which sonographic findings indicate maximal or excessive loading and how the exercise program should be modified to maximize success . Matched populations of injured horses can be evaluated with different treatments in prospective controlled or double blind placebo controlled trials to determine which treatments are truly effective , improving patient management .
Selected References
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