Vet Comp Orthop Traumatol 2006; 19(02): 99-105
DOI: 10.1055/s-0038-1632982
Original Research
Schattauer GmbH

The evaluation of extracorporeal shock wave therapy on collagenase induced superficial digital flexor tendonitis

K. D. Kersh
1   Departments of Veterinary Clinical Sciences
,
S. R. McClure
1   Departments of Veterinary Clinical Sciences
,
D. Van Sickle
2   Department of Basic Medical Sciences, School of Veterinary Medicine, Purdue University, West Lafayette, Indiana, USA
,
R. B. Evans
3   Veterinary Diagnostic and Production Animal Medicine, College of Veterinary Medicine, Iowa State University, Ames, Iowa, USA
› Author Affiliations
Further Information

Publication History

Received 30 May 2005

Accepted 15 December 2005

Publication Date:
08 February 2018 (online)

Summary

Extracorporeal shock wave therapy (ESWT) is being used to treat desmitis and tendonitis in horses. This paper compares the clinical, ultrasonographic and histological characteristics of ESWT treated collagenase induced superficial digital flexor tendon (SDFT) lesions, versus untreated controls. This blinded study utilizes six mature, healthy horses where bilateral forelimb SDFT lesions were induced. One forelimb was treated while the other served as an untreated control. Three shock wave treatments were administered at three week intervals. At weekly intervals, ultrasonograms were used to measure: 1) percentage lesion at the maximum injury zone (MIZ), 2) the grey scale of the SDFT at the MIZ, 3) the percentage disruption of the longitudinal fibres at the MIZ. The data were also summed from 8–20 cm distal to the accessory carpal bone. Measurements of the external width of the SDFT were obtained through the study period. Examinations were performed on four occasions to evaluate heat, response to palpation, presence/character of swelling over the SDFT, and lameness. At the completion of the study all tendons were evaluated histologicalally. The lesion size, grey scale, and longitudinal fibre disruption at the MIZ, and sum of each variable changed significantly over time, however, there was no difference between treated and control groups. Histopathology showed increased neovascularization in treated tendons (p = 0.001). When compared to untreated controls, ESWT did not change the ultrasonographic appearance of the tendons. However, it did increase neovascularization.

 
  • References

  • 1 McIlwraith CW. Diseases ofjoints, tendons, ligaments, and related structures. in Stashak TS. (ed) Adams' Lameness in Horses (5th ed). Philadelphia, PA, Lippincott: Williams, and Wilkins; 2002: 594-619.
  • 2 Nixon AJ. Superficial flexor tendonitis. in White NA, Moore JN. (eds) Current Practice of Equine Surgery. Philadelphia, PA: Lippincott; 1990: 441-8.
  • 3 Foland JW, Trotter GW, Powers BE. et al. Effect of sodium hyaluronate in collagenase-induced superficial digital flexor tendonitis in horses. Am J Vet Res 1992; 53: 2371-6.
  • 4 Gaughan EM, Gift LJ, DeBowes RM. et al. The influence of sequential intratendinous sodium hyaluronate on tendon healing in horses. Vet Comp Orthop Traumatol 1995; 8: 40-5.
  • 5 Redding WR, Booth LC, Pool RR. The effects of polysulphated glycosaminoglycan on the healing of collagenase induced tendonitis. Vet Comp Orthop Traumatol 1999; 12: 48-55.
  • 6 Dyson SJ. Medical management of superficial digital flexor tendonitis: A comparative study in 219 horses (1992-2000). Equine Vet J 2004; 36: 415-9.
  • 7 Dahlgren LA, van der Meulen MC, Bertram JE. et al. Insulin-like growth factor-I improves cellular and molecular aspects ofhealing in a collagenase-induced model of flexor tendonitis. J Orthop Res 2002; 20: 910-9.
  • 8 Smith RKW, Korda M, Blunn GW, et al. Isolation and implantation of autologous equine mesenchymal stem cells from bone marrow into the superficial digital flexor tendon as a potential novel treatment. Equine Vet J 2003; 35: 99-102.
  • 9 Mitchell RD. Treatment of tendon and ligament injuries with UBM powder (ACell-Vet®). Proceedings 32nd Annu Meet ACVS 2004; 190-3.
  • 10 Sturtevant B. Shock wave physics of lithotriptors. in Smith A, Badlani GH, Bagley DH. et al. (eds) Smith's textbook of endourology. St Louis: Quality Medical Publishing Inc; 1996: 529-52.
  • 11 Kusnierczak D, Brocai DRC, Vettel U. et al: The influence of extracorporeal shock-wave (ESWA) on the biological behavior of bone cells in vitro [in German]. Z Orthop Ihre Grenzgeb 2000; 138: 29-33.
  • 12 Wang FA, Yang KD, Chen RF. et al. Extracorporeal shock wave promotes growth and differentiation of bone-marrow stromal cells towards osteoprogenitors associated with induction of TGF-beta 1. J Bone Joint Surg Br 2002; 84: 457-61.
  • 13 Wang CJ, Huang HY, Pai CH. Shock wave-enhanced neovascularization at the tendon-bone junction: An experiment in dogs. J Foot Ankle Surg 2002; 41: 16-22.
  • 14 Hsu RW, Hsu WH, Tai CL. et al. Effect of shockwave therapy on patellar tendinopathy in a rabbit model. J Orthop Res 2004; 22: 221-7.
  • 15 McClure SR, Van Sickle D, Evans R. et al. The effects of extracorporeal shock wave therapy on the ultrasonographic and histological appearance of collagenase-induced equine forelimb suspensory ligament desmitis. Ultrasound Med Biol 2004; 30: 461-7.
  • 16 Reef V. Equine diagnostic ultrasound. Philadelphia: WB. Saunders; 1998: 139-86.
  • 17 American Association of Equine Practitioners, Guide to Veterinary Services for Horse Shows (ed 7). Lexington, KY: 1999
  • 18 Chen YJ, Wang CJ, Yang KD. et al. Extracorporeal shock waves promote healing of collagenase-induced Achilles tendonitis and increase TGF-ßl and IGF-I expression. J Orthop Res 2004; 22: 854-61.
  • 19 Orhan Z, Ozturan K, Guven A. et al. The effect of extracorporeal shock waves on a rat model of injury to tendo Achillis. J Bone Joint Surg 2004; 86: 613-8.
  • 20 Rompe JD, Kirkpatrick CJ, Kullmer K. et al. Dose-related effects of shock waves on rabbit tendo Achillis. J Bone Joint Surg 1998; 80: 546-52.
  • 21 Dahlgren LA, Brower-Toland BD, Nixon AJ. Cloning and expression oftype III collagen innormal and injured tendons of horses. Am J Vet Res 2005; 66: 266-70.
  • 22 McClure SR, Weinberger T. Extracorporeal shock wave therapy: Clinical applications and regulation. Clinical techniques in equine practice 2003; 4: 358-67.
  • 23 Gaughan EM, Nixon AJ, Krook LP. et al. Effect of sodium hyaluronate on tendon healing and adhesion formation in horses. Am J Vet Res 1991; 52: 764-73.