{"id":4555,"date":"2025-12-16T15:01:59","date_gmt":"2025-12-16T14:01:59","guid":{"rendered":"https:\/\/equicare.vet\/?p=4555"},"modified":"2025-12-29T15:37:37","modified_gmt":"2025-12-29T14:37:37","slug":"nouvelles-therapies-pour-le-traitement-des-tendinites-chez-le-cheval","status":"publish","type":"post","link":"https:\/\/equicare.vet\/en\/2025\/12\/16\/nouvelles-therapies-pour-le-traitement-des-tendinites-chez-le-cheval\/","title":{"rendered":"New therapies for the treatment of tendonitis in horses"},"content":{"rendered":"
\n\t\t\t\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t\t
\n\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t

New therapies for the treatment of tendonitis in horses<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t
\n\t\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t\t\t\t\t

<\/p>


Introduction\u00a0<\/b><\/span><\/h2>
  • tendon disorders:\u00a0<\/b><\/li><\/ul>

    \u2013 common in racehorses and sport horses\u00a0<\/span><\/p>

    \u2013 overload due to hyperextension of the fetlock during the stance phase\u00a0\u00a0<\/span><\/p>

    \u00a0(Genovese et al. 1990)\u00a0<\/span><\/p>

    • consequences :\u00a0<\/b><\/li><\/ul>

      \u2013 temporary cessation of sports operations for 9 to 15 months\u00a0<\/span><\/p>

      \u2013 possibly permanent cessation in case of recurrence\u00a0<\/span><\/p>

      • scarring:\u00a0<\/b><\/li><\/ul>

        \u2013 repair according to the fibrositis process\u00a0<\/span><\/p>

        \u2013 tissue obtained that is functionally deficient compared to the initial tissue\u00a0<\/span><\/p>

        \u00a0(Crevier-Denoix et al. 1997)\u00a0<\/span><\/p>

        \u2013 tendon generally stiffer than initially\u00a0<\/span><\/p>

        \u2013 predisposes to the creation of a new lesion above or below\u00a0<\/span><\/p>

        \u00a0of the initial lesion = recurrence<\/span><\/p>

        • New therapeutic approaches:\u00a0<\/b><\/li><\/ul>

          \u2013 originate from regenerative medicine\u00a0<\/span><\/p>

          \u2013 aim to obtain a fabric very similar to the original fabric\u00a0<\/span><\/p>

          \u2013 stimulus provided by PRP, stem cells or other substances\u00a0<\/span><\/p>

          • Validation of treatments:\u00a0<\/b><\/li><\/ul>

            \u2013 numerous treatments\u00a0<\/span><\/p>

            \u2013 some relatively empirical\u00a0<\/span><\/p>

            \u2013 scientific validation:\u00a0<\/span><\/p>

            • experimental in vitro studies (on an isolated tendon)\u00a0<\/span><\/li>
            • experimental in vivo studies (on lesions created experimentally on live horses) \u2022 clinical studies\u00a0<\/span><\/li><\/ul>

              <\/p>


              Basic treatments\u00a0<\/b><\/span><\/h2>
              • Ultrasound examination:\u00a0<\/b><\/li><\/ul>

                \u2013 between 3 and 10 days after the accident\u00a0<\/span><\/p>

                \u2013 choice of treatments to be carried out and convalescence\u00a0<\/span><\/p>

                \u2013 to give a prediction\u00a0<\/span><\/p>

                \u2013 assistance with monitoring and changing activity levels\u00a0<\/span><\/p>

                • Inflammation management:\u00a0<\/b><\/li><\/ul>

                  \u2013 anti-inflammatory treatment as soon as it appears\u00a0<\/span><\/p>

                  - ice\u00a0<\/span><\/p>

                  • Immobilization :\u00a0<\/b><\/li><\/ul>

                    \u2013 natural enlargement of the lesion during the first two weeks\u00a0<\/span><\/p>

                    \u2013 Proper immobilization during the first 10 days significantly limited this increase in lesion size (David et al. 2011)\u00a0<\/span><\/p>

                    \u2013 Robert-Jones dressing at a minimum, or even with a plaster cast, particularly if the fetlock has descended \u2013 splint limiting hyperextension of the fetlock (Equistride)\u00a0<\/span><\/p>

                    • Hardware:\u00a0<\/b><\/li><\/ul>

                      \u2013 fitting with a covered clamp and narrow sponges:\u00a0<\/span><\/p>

                      • superficial flexor tendon\u00a0<\/span><\/li>
                      • suspensory ligament of the fetlock\u00a0<\/span><\/li><\/ul>

                        \u2013 inverted shoeing or shoeing with a narrow clamp and enlarged sponges:\u00a0<\/span><\/p>

                        • deep flexor tendon of the finger.\u00a0<\/span><\/li><\/ul>

                          \u2013 shoe both front hooves or both hind hooves with the same shoe\u00a0<\/span><\/p>

                          <\/p>

                          • Convalescence:\u00a0<\/b><\/li><\/ul>

                            \u2013 75 % of horses put out to pasture show a relapse (Gillis 1997)\u00a0<\/span><\/p>

                            \u2013 50 % of horses receiving controlled convalescence develop a recurrence following superficial digital flexor tendonitis in steeplechase horses (Dyson 1994, OMeara 2010)\u00a0<\/span><\/p>

                            • Duration :\u00a0<\/b><\/li><\/ul>

                              \u2013 well-defined protocol for managing tendinitis of the superficial digital flexor tendon in thoroughbreds <\/span>(Godwin et al. 2012) <\/span>\u2013 Thoroughbred: 11 months\u00a0<\/span><\/p>

                              \u2013 walker: 9 months?\u00a0<\/span><\/p>

                              \u2013 sport horse: 9 months?\u00a0<\/span><\/p>

                              \u2013 reducing this period increases the risk of relapse\u00a0

                              <\/span><\/p>

                              Platelet-rich plasma\u00a0<\/b><\/span><\/h2>

                              (PRP = platelet-rich plasma)\u00a0<\/b><\/p>

                              • Definition :\u00a0<\/b><\/li><\/ul>

                                \u2013 blood = several cell lines diluted in blood plasma\u00a0<\/span><\/p>

                                \u2013 Platelets: numerous growth factors that aid in the healing of various tissues\u00a0<\/span><\/p>

                                • Platelet isolation:\u00a0<\/span><\/li><\/ul>

                                  \u2013 centrifugation techniques\u00a0<\/span><\/p>

                                  \u2013 platelet-rich plasma\u00a0<\/span><\/p>

                                  • Results :\u00a0<\/b><\/li><\/ul>

                                    \u2013 In vitro:\u00a0<\/span><\/p>

                                    • Effects of PRP on the superficial flexor tendon of the digit and on the suspensory ligament of the fetlock: increased production of COMP and type 1 collagen, thus a significantly higher increase in a growth factor (Schnabel et al. 2007, McCarrel et al. 2009)\u00a0<\/span><\/li><\/ul>

                                      \u2013 In vivo:\u00a0<\/span><\/p>

                                      • experimental model of superficial flexor tendonitis of the finger performed seven days after the onset of the lesion\u00a0<\/span><\/li>
                                      • higher cellularity, higher collagen and glucosaminoglycan content, better histological organization and more developed neovascularization than in the control group\u00a0<\/span><\/li>
                                      • tendons stronger than in the control group (Bosch et al. 2010)\u00a0<\/span><\/li><\/ul>

                                        \u2013 Clinical study:\u00a0<\/span><\/p>

                                        • severe desmitis of the suspensory ligament of the fetlock in 9 trotters\u00a0<\/span><\/li>
                                        • All the horses returned to racing 8 months after the accident and raced for at least two years; they had the same number of starts as the 9 uninjured horses.\u00a0<\/span><\/li>
                                        • lack of real control and a small number of cases\u00a0<\/span><\/li>
                                        • a single injection of PRP (Waselau et al. 2008)\u00a0<\/span><\/li>
                                        • Advantage : <\/b>a single session\u00a0<\/span><\/li>
                                        • Injection administered 7 and 10 days after the accident\u00a0<\/span><\/li><\/ul>

                                          \u2022 Summary : <\/b>T<\/span>VALIDATED TECHNIQUE<\/span><\/p>

                                          <\/p>


                                          Stem cells\u00a0<\/b><\/span><\/h2>
                                          • Definition :\u00a0<\/b><\/li><\/ul>

                                            \u2013 cells capable of differentiating into different cell lineages:\u00a0<\/span><\/p>

                                            • embryonic stem cells\u00a0<\/span><\/li>
                                            • mesenchymal stem cells\u00a0<\/span><\/li><\/ul>

                                              \u2013 in horses, studies are mainly carried out on stem cells of mesenchymal origin: \u2022 bone marrow\u00a0<\/span><\/p>

                                              • adipose tissue (fat)\u00a0<\/span><\/li>
                                              • umbilical vein (taken from the fetus immediately after birth)\u00a0<\/span><\/li>
                                              • Origins:\u00a0<\/b><\/li><\/ul>

                                                \u2013 adipose tissue: appear to differentiate less well than cells from bone marrow (Toupadakis et al. 2007, Im et al. 2005, Vidal et al. 2007)\u00a0<\/span><\/p>

                                                \u2013 few studies on the umbilical cord (Guest et al. 2010, Bi et al. 2007)\u00a0<\/span><\/p>

                                                \u2013 more knowledge of bone marrow\u00a0<\/span><\/p>

                                                <\/p>

                                                • Results :\u00a0<\/b><\/li>
                                                • In vitro:\u00a0<\/b><\/li><\/ul>

                                                  \u2013 stem cells injected into sections of tendon\u00a0<\/span><\/p>

                                                  \u2013 survive, proliferate and migrate into the matrix to express several extracellular matrix genes (Stewart et al. 2009, Richardson et al. 2007)\u00a0<\/span><\/p>

                                                  • In vivo:\u00a0<\/b><\/li><\/ul>

                                                    \u2013 survival in the tendon for up to four months after implantation (Guest et al. 2008)\u00a0<\/span><\/p>

                                                    \u2013 tendinitis experimentally induced with collagenases\u00a0<\/span><\/p>

                                                    \u2013 significant improvements in tendon healing (Schnabel et al. 2009, Nixon et al. 2008) for bone marrow and adipose tissue\u00a0<\/span><\/p>

                                                    • Recent clinical study (Godwin et al. 2011):\u00a0<\/b><\/li><\/ul>

                                                      \u2013 141 horses treated with follow-up for 113 horses\u00a0<\/span><\/p>

                                                      \u2013 Recurrence rate: 27.4% (%)\u00a0<\/span><\/p>

                                                      \u2013 25.7 % for steeplechase horses (105 horses)\u00a0<\/span><\/p>

                                                      \u2013 50 % for flat racing horses (8 horses)\u00a0<\/span><\/p>

                                                      \u2013 significantly lower than with conservative treatment alone\u00a0<\/span><\/p>

                                                      \u2013 no relationship with age, discipline, number of stem cells injected, or time of implantation after the accident\u00a0<\/span><\/p>

                                                      • Inconvenience : <\/b>two visits\u00a0<\/span><\/li><\/ul>

                                                        \u2013 bone marrow sampling\u00a0<\/span><\/p>

                                                        \u2013 injection of the prepared stem cells into the lesion\u00a0<\/span><\/p>

                                                        • Injection within 6 weeks of the accident\u00a0<\/span><\/li><\/ul>

                                                          \u2022 summary : <\/b>VALIDATED TECHNIQUE <\/span><\/p>

                                                          • Definition :\u00a0<\/b><\/li><\/ul>

                                                            \u2013 bone marrow:\u00a0<\/span><\/p>

                                                            • produces the majority of blood cells\u00a0<\/span><\/li>
                                                            • stem cells capable of differentiating into different lineages\u00a0<\/span><\/li><\/ul>

                                                              \u00a0cellular (but only from 0.01 % to 0.01 %)\u00a0<\/span><\/p>

                                                              • numerous growth factors\u00a0<\/span><\/li>
                                                              • Bone marrow sampling:\u00a0<\/b><\/li><\/ul>

                                                                \u2013 on the sternum\u00a0<\/span><\/p>

                                                                \u2013 on the ilium (pelvis)\u00a0<\/span><\/p>

                                                                • Centrifugation:\u00a0<\/b><\/li><\/ul>

                                                                  \u2013 bone marrow concentrate\u00a0<\/span><\/p>

                                                                  \u2013 contains up to 15 % stem cells (Nixon, 2010)\u00a0<\/span><\/p>

                                                                  • Administration of bone marrow concentrate and PRP.\u00a0<\/b><\/li>
                                                                  • Clinical study:\u00a0<\/b><\/li><\/ul>

                                                                    \u2013 PRP and bone marrow concentrate\u00a0<\/span><\/p>

                                                                    \u2013 Tendinitis and desmitis of the superficial flexor tendon of the finger\u00a0<\/span><\/p>

                                                                    \u00a0and the suspensory ligament of the fetlock\u00a0<\/span><\/p>

                                                                    \u2013 13 sport horses\u00a0<\/span><\/p>

                                                                    \u2013 controlled convalescence\u00a0<\/span><\/p>

                                                                    \u2013 85% of horses returned to competition (Torricelli et al. 2011)\u00a0<\/span><\/p>

                                                                    • Advantage : <\/b>a single session\u00a0<\/span><\/li>
                                                                    • summary : <\/b>VALIDATED TECHNIQUE<\/span><\/li><\/ul>

                                                                      <\/p>


                                                                      IRAP (=ACS)\u00a0<\/b><\/span><\/h2>


                                                                      Definition :\u00a0<\/b><\/span><\/h3>

                                                                      \u2013 culturing blood on syringes containing glass beads marketed by the companies Orthokine and Arthrex\u00a0<\/span><\/p>

                                                                      \u2013 IRAP-enriched serum: anti-inflammatory properties, used for the treatment of numerous joint problems\u00a0<\/span><\/p>


                                                                      Results :\u00a0<\/b><\/span><\/h3>

                                                                      \u2013 not recommended for the treatment of tendinitis\u00a0<\/span><\/p>

                                                                      \u2013 studies are underway to verify its potential effectiveness\u00a0<\/span><\/p>


                                                                      Shock waves\u00a0<\/b><\/span><\/h3>
                                                                      • tendon and ligament insertions with interesting clinical effects\u00a0<\/span><\/li>
                                                                      • Use on the tendon alone is a subject of controversy:\u00a0<\/span><\/li><\/ul>

                                                                        \u00a0\u2013 adverse effects on tendon repair in the medium term (Bosch et al. 2007)\u00a0<\/span><\/p>

                                                                        • Summary : <\/b>not recommended\u00a0<\/span><\/li><\/ul>


                                                                          Nuclear medicine\u00ab\u00a0<\/b><\/span><\/h3>
                                                                          • No studies conducted\u00a0<\/span><\/li>
                                                                          • Effective on bone lesions, but not on tendinitis.\u00a0<\/span><\/li>
                                                                          • Summary : <\/b>not recommended\u00a0<\/span><\/li><\/ul>


                                                                            Conclusion\u00a0<\/b><\/span><\/h3>
                                                                            • Satisfactory results but 25% recurrence rate (%)\u00a0<\/b><\/li>
                                                                            • Do not neglect the basic principles:\u00a0<\/span><\/li><\/ul>

                                                                              \u00a0- immobilization\u00a0<\/span><\/p>

                                                                              \u00a0\u2013 convalescence\u00a0<\/span><\/p>

                                                                              • maintain a critical perspective on some currently proposed treatments:\u00a0<\/span><\/li><\/ul>

                                                                                \u00a0\u2013 some have no proven effectiveness\u00a0<\/span><\/p>

                                                                                By Dr. Matthieu COUSTY, ECVS Diplomate <\/strong><\/p>

                                                                                Specialist in equine surgery\u00a0<\/strong><\/p>

                                                                                Any use of this document for commercial purposes\u00a0is not permitted. Any partial or complete reproduction\u00a0<\/span>Total is not allowed.\u00a0<\/span><\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"

                                                                                Introduction\u00a0 affections des tendons :\u00a0 \u2013 fr\u00e9quentes chez les chevaux de course et de sport\u00a0 \u2013 surcharge en raison de l’hyperextension du boulet durant la phase d’appui\u00a0\u00a0 \u00a0(Genovese et al. 1990)\u00a0 cons\u00e9quences :\u00a0 \u2013 arr\u00eat temporaire de l’exploitation sportive de 9 \u00e0 15 mois\u00a0 \u2013 arr\u00eat possiblement d\u00e9finitif en cas de r\u00e9cidive\u00a0 cicactrisation :\u00a0 \u2013 […]<\/p>","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"elementor_header_footer","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-4555","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/equicare.vet\/en\/wp-json\/wp\/v2\/posts\/4555","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/equicare.vet\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/equicare.vet\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/equicare.vet\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/equicare.vet\/en\/wp-json\/wp\/v2\/comments?post=4555"}],"version-history":[{"count":13,"href":"https:\/\/equicare.vet\/en\/wp-json\/wp\/v2\/posts\/4555\/revisions"}],"predecessor-version":[{"id":4702,"href":"https:\/\/equicare.vet\/en\/wp-json\/wp\/v2\/posts\/4555\/revisions\/4702"}],"wp:attachment":[{"href":"https:\/\/equicare.vet\/en\/wp-json\/wp\/v2\/media?parent=4555"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/equicare.vet\/en\/wp-json\/wp\/v2\/categories?post=4555"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/equicare.vet\/en\/wp-json\/wp\/v2\/tags?post=4555"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}