Microvasculature of the suspensory ligament of the forelimb of horses

Megan R. Williams Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824.

Search for other papers by Megan R. Williams in
Current site
Google Scholar
PubMed
Close
 DVM
,
Steven P. Arnoczky Laboratory for Comparative Orthopaedic Research, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824.

Search for other papers by Steven P. Arnoczky in
Current site
Google Scholar
PubMed
Close
 DVM
,
Anthony P. Pease Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824.

Search for other papers by Anthony P. Pease in
Current site
Google Scholar
PubMed
Close
 DVM
, and
John A. Stick Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824.

Search for other papers by John A. Stick in
Current site
Google Scholar
PubMed
Close
 DVM

Abstract

Objective—To determine the microvascular anatomy of the suspensory ligament of the forelimb of horses.

Sample—17 cadaveric forelimbs from 9 adult horses with no known history of forelimb lameness.

Procedures—The median artery of the forelimb was cannulated proximal to the antebrachiocarpal joint and injected with contrast medium for CT evaluation of the gross vasculature (n = 2) or India ink to evaluate the microvasculature (12). Routine histologic evaluation was performed on an additional 3 forelimbs to confirm the microvascular anatomy.

Results—The vascular supply of the suspensory ligament of the forelimb originated from branches of the medial and lateral palmar and palmar metacarpal vessels as well as the proximal and distal deep palmar arches. An abundant, longitudinally oriented microvascular supply was evident throughout the length of the suspensory ligament without distinct variation among the proximal, midbody, and distal regions. The intraligamentous blood supply originated from a periligamentous vascular plexus that surrounded the suspensory ligament throughout its length. Histologic findings indicated the presence of a periligamentous connective tissue plexus, which contained vessels that penetrated and anastomosed with an extensive network of intraligamentous vessels throughout the length of the suspensory ligament.

Conclusions and Clinical Relevance—The suspensory ligament of the equine forelimb had an abundant intraligamentous microvascular supply throughout its entire length. The absence of an obvious hypovascular area suggested that regional variations in healing rates of the suspensory ligament are not associated with the microvascular anatomy.

Abstract

Objective—To determine the microvascular anatomy of the suspensory ligament of the forelimb of horses.

Sample—17 cadaveric forelimbs from 9 adult horses with no known history of forelimb lameness.

Procedures—The median artery of the forelimb was cannulated proximal to the antebrachiocarpal joint and injected with contrast medium for CT evaluation of the gross vasculature (n = 2) or India ink to evaluate the microvasculature (12). Routine histologic evaluation was performed on an additional 3 forelimbs to confirm the microvascular anatomy.

Results—The vascular supply of the suspensory ligament of the forelimb originated from branches of the medial and lateral palmar and palmar metacarpal vessels as well as the proximal and distal deep palmar arches. An abundant, longitudinally oriented microvascular supply was evident throughout the length of the suspensory ligament without distinct variation among the proximal, midbody, and distal regions. The intraligamentous blood supply originated from a periligamentous vascular plexus that surrounded the suspensory ligament throughout its length. Histologic findings indicated the presence of a periligamentous connective tissue plexus, which contained vessels that penetrated and anastomosed with an extensive network of intraligamentous vessels throughout the length of the suspensory ligament.

Conclusions and Clinical Relevance—The suspensory ligament of the equine forelimb had an abundant intraligamentous microvascular supply throughout its entire length. The absence of an obvious hypovascular area suggested that regional variations in healing rates of the suspensory ligament are not associated with the microvascular anatomy.

Contributor Notes

Address correspondence to Dr. Arnoczky (arnoczky@cvm.msu.edu).

Supported by the Laboratory for Comparative Orthopaedic Research and the Wade O. Brinker Endowment, College of Veterinary Medicine, Michigan State University.

The authors thank Keri Gardner, Seana Schade, and Stephanie Halley for technical assistance.

  • 1. Dyson S. Proximal suspensory desmitis: clinical, ultrasonographic and radiographic features. Equine Vet J 1991; 23:2531.

  • 2. Dyson SJ, Arthur RM, Palmer SE, et al. Suspensory ligament desmitis. Vet Clin North Am Equine Pract 1995; 11:177215.

  • 3. Crowe OM, Dyson SJ, Wright IM, et al. Treatment of chronic or recurrent proximal suspensory desmitis using radial pressure wave therapy in the horse. Equine Vet J 2004; 36:313316.

    • Search Google Scholar
    • Export Citation
  • 4. Gibson KT, Steel CM. Conditions of the suspensory ligament causing lameness in horses. Equine Vet Educ 2002; 14:3950.

  • 5. Singer ER, Barnes J, Saxby F, et al. Injuries in the event horse: training versus competition. Vet J 2008; 175:7681.

  • 6. McIlwraith CW. Diseases of joints, tendons, ligaments, and related structures. In: Stashak TS, ed. Adams' lameness in horses. 5th ed. Baltimore: Lippincott Williams & Wilkins, 2002;459644.

    • Search Google Scholar
    • Export Citation
  • 7. Dyson S, Genovese RL. The suspensory apparatus. In: Ross MW, Dyson S, eds. Diagnosis and management of lameness in the horse. St Louis: Saunders Co, 2003;654672.

    • Search Google Scholar
    • Export Citation
  • 8. Dyson S. Diagnosis and management of common suspensory lesions in the forelimbs and hindlimbs of sport horses. Clin Tech Equine Pract 2007; 6:177188.

    • Search Google Scholar
    • Export Citation
  • 9. Kraus-Hansen AE, Fackelman GE, Becker C, et al. Preliminary studies on the vascular anatomy of the equine superficial digital flexor tendon. Equine Vet J 1992; 24:4651.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10. Kraus BL, Kirker-Head CA, Kraus KH, et al. Vascular supply of the tendon of the equine deep digital flexor muscle within the digital sheath. Vet Surg 1995; 24:102111.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11. Bales CP, Placzek JD, Malone KJ, et al. Microvascular supply of the lateral epicondyle and common extensor origin. J Shoulder Elbow Surg 2007; 16:497501.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12. Carr AJ, Norris SH. The blood supply of the calcaneal tendon. J Bone Joint Surg Br 1989; 71:100101.

  • 13. Chen TM, Rozen WM, Pan WR, et al. The arterial anatomy of the Achilles tendon: anatomical study and clinical implications. Clin Anat 2009; 22:377385.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14. Cheng NM, Pan WR, LeRoux CM, et al. The arterial supply of the long head of biceps tendon: anatomical study with implications for tendon rupture. Clin Anat 2010; 23:683692.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15. Lohr JF, Uhthoff HK. The microvascular pattern of the supraspinatus tendon. Clin Orthop Relat Res 1990; 254:3538.

  • 16. Rathbun JB, Macnab I. The microvascular pattern of the rotator cuff. J Bone Joint Surg Br 1970; 52:540553.

  • 17. Rothman RH, Parke WW. The vascular anatomy of the rotator cuff. Clin Orthop Relat Res 1965; 41:176186.

  • 18. Yepes H, Tang M, Morris SF, et al. Relationship between hypovascular zones and patterns of ruptures of the quadriceps tendon. J Bone Joint Surg Am 2008; 90:21352141.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19. Trumble TN, Arnoczky SP, Stick JA, et al. Clinical relevance of the microvasculature of the equine proximal sesamoid bone. Am J Vet Res 1995; 56:720724.

    • Search Google Scholar
    • Export Citation
  • 20. Tran DN, Straka M, Roos JE, et al. Dual-energy CT discrimination of iodine and calcium: experimental results and implications for lower extremity CT angiography. Acad Radiol 2009; 16:160171.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21. Budras KD, Sack WO, Rock S. The thoracic limb. In: Anatomy of the horse. 5th ed. Hannover, Germany: Schlütersche Verlagsgesellschaft mbH & Co KG, 2009;415.

    • Search Google Scholar
    • Export Citation
  • 22. Ghoshal NG. Equine heart and arteries. In: Getty R, ed. Sisson and Grossman's the anatomy of the domestic animals. 5th ed. Philadelphia: WB Saunders Co, 1975;584595.

    • Search Google Scholar
    • Export Citation
  • 23. Kainer RA. Functional anatomy of equine locomotor organs. In: Stashak TS, ed. Adams' lameness in horses. 5th ed. Baltimore: Lippincott Williams & Wilkins, 2002;172.

    • Search Google Scholar
    • Export Citation
  • 24. M'Fadyean J. Dissection of the anterior limb. In: The anatomy of the horse: a dissection guide. 2nd ed. London: W & AK Johnston Ltd, 1902;156.

    • Search Google Scholar
    • Export Citation
  • 25. Arnoczky SP, Rubin RM, Marshall JL. Microvasculature of the cruciate ligaments and its response to injury. An experimental study in dogs. J Bone Joint Surg Am 1979; 61:12211229.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 26. Arnoczky SP, Warren RF. The microvasculature of the meniscus and its response to injury. An experimental study in the dog. Am J Sports Med 1983; 11:131141.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 27. Rhinelander FW, Wilson JW. Blood supply to developing mature and healing bone. In: Sumner-Smith G, ed. Bone in clinical orthopaedics. Philadelphia: WB Saunders Co, 1982;81158.

    • Search Google Scholar
    • Export Citation
  • 28. Dunlap J, McCarthy JA, Joyce ME, et al. Quantification of the perfusion of the anterior cruciate ligament and the effects of stress and injury to supporting structures. Am J Sports Med 1989; 17:808810.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 29. Strömberg B, Tufvesson G. Lesions of the superficial flexor tendon in race horses: a microangiographic and histologic study. Clin Orthop 1969; 62:113123.

    • Search Google Scholar
    • Export Citation
  • 30. Souza MV, Van Weeren PR, Schie HTM, et al. Regional differences in biochemical, biomechanical, and histomorphological characteristics of the equine suspensory ligament. Equine Vet J 2010; 42:611620.

    • Crossref
    • Search Google Scholar
    • Export Citation

Advertisement