NAVLE Musculoskeletal

Equine Tendon and Ligament Rupture – NAVLE Study Guide

March 28, 2026 25 min read 14 views
Tendon and ligament injuries are among the most common causes of lameness and early retirement in performance horses, accounting for approximately 43-54% of all musculoskeletal injuries in equine athletes.

Overview and Clinical Importance

Tendon and ligament injuries are among the most common causes of lameness and early retirement in performance horses, accounting for approximately 43-54% of all musculoskeletal injuries in equine athletes. Complete rupture represents the most severe form of these injuries and carries significant implications for athletic soundness and prognosis.

The majority of tendon injuries (75-93%) involve the superficial digital flexor tendon (SDFT), with the mid-metacarpal region of the forelimb affected in 97-99% of cases. The prevalence of SDF tendinopathy is particularly high in racing Thoroughbreds (11-30%), making this topic highly relevant for the NAVLE examination.

Aspect Details
Etiology Acute overload injury during high-speed exercise, accumulated microdamage, age-related stiffening (older horses at higher risk for proximal rupture)
Common Location Mid-metacarpal region (97-99% of cases); proximal rupture at carpus more common in older horses
Clinical Signs Acute onset lameness (moderate to severe) 'Bowed tendon' appearance - swelling on palmar metacarpus Heat and pain on palpation Fetlock hyperextension (dropped fetlock) with complete rupture Proximal rupture: swelling over back of knee, reluctance to extend carpus
Diagnosis Clinical examination (palpation, observation) Ultrasonography: hypoechoic lesions, fiber disruption, increased cross-sectional area; perform at 7 days post-injury for optimal prognostic value MRI for intra-thecal lesions or when ultrasound is inconclusive
Treatment Acute phase: Cold therapy, bandaging, NSAIDs, stall rest Regenerative: PRP, mesenchymal stem cells (best evidence for SDFT injuries) Rehabilitation: Controlled exercise program over 9-12 months Surgical: Superior check ligament desmotomy (reduces reinjury in racehorses)
Prognosis Guarded for return to high-level performance; 56% reinjury rate with rest alone. Stem cell therapy may reduce reinjury to approximately 18%

Functional Anatomy

Understanding the anatomy and biomechanical function of equine tendons and ligaments is essential for recognizing injury patterns and determining prognosis.

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