PRP for Suspensory Ligament Injuries

Athletic or racehorses are most susceptible to suspensory ligament injuries. The injury often occurs when horses, running at a high rate of speed, begin to become fatigued.  When they become the latter over-extension injuries such as the suspensory ligament injuries, are more likely to occur. Though athletic horses are more prone to this type of injury, all horses are at risk.

The suspensory ligament runs behind the knee and reaches to the fetlock joint. It helps to absorb shock and also supports the horse’s weight. The ligament is a broad, elastic band that is situated between the canon bone and flexor tendons. When it is injured, it becomes impossible for the horse to perform athletically. If the injury is severe enough, it may derail a horse’s racing career permanently.

Horses that suffer from a suspensory ligament injuries will often experience a great deal of pain. This will often show itself as performance-related lameness. The point of injury may not swell, or at least not substantially, because of where the ligament is located. However, a lack of swelling or visible symptoms doesn’t diminish its severity or seriousness. If the injury is not diagnosed and treated or if it doesn’t respond to treatment, the horse may never be able to race again.

Suspensory ligament injuries heal slowly and are subsequently, oftentimes of great concern to a horse’s owner.   A horse with this type of injury will be unable to race or compete. Rest is generally required as are the use of anti-inflammatory medications and in severe cases, surgery. However, newer forms of treatment are growing in popularity, one of them being PRP therapy.

Suspensory ligament injuries are very common amongst racehorses. In fact, they are the most common type of injury for racehorses. The failure rate for traditional treatments is between 30 and 50 percent. This injury is thus a very serious one and if an effective treatment is not found, it might spell the end to a once promising career for a racehorse.

Suspensory Tendon Injury: Causes 

Veterinarians contend that the biggest factors in suspensory injuries are fatigue and speed. Though they can occur in all types of horses, racehorses are especially susceptible to them because of the aforementioned. They run at high rates of speed and are more likely to experience speed and endurance-related fatigue.

A lack of conditioning can also contribute to these types of injuries. If a horse has not been properly conditioned, they are more likely to experience extreme fatigue and their legs more likely to give out. Those that are in-shape are less likely to get hurt in this manner.

Even the most highly conditioned horses, experience devastating injuries. However, horses which are most susceptible are those that are not physically prepared for the vigor of racing. Conditioning, along with stretching, is key in preventing injuries and staying healthy.

In addition to speed and fatigue, the hoof balance or lack of proper balance in this regard, can cause the horse’s leg to become stressed or strained. This makes the animal more susceptible to suspensory ligament injuries.

It is impossible to control each of the factors that contribute to a horse’s injuries. However, there are actions that trainers can take to minimize them and these actions should be taken. However, even horses trained by the very best and most conscientious trainers will get hurt. When they do, it they should be provided the best care possible.  It may, in some cases, become necessary to utilize forms of care that aren’t considered traditional. This may prove to be the case when normal treatments aren’t proving to be effective.

Suspensory tendon injuries most often occur when a horse has poor hoof balance and experiences fatigue when traveling at high rates of speed. Athletic or race horses are most susceptible to developing these types of injuries. Proper conditioning and hoof balance are keys to helping prevent these injuries of this type, though neither is fool-proof.

Suspensory Tendon Injury: Symptoms

Suspensory tendon injury symptoms will vary depending on the severity of the injury. Horses that have only strained or bruised the ligament may only experience a mild-to-moderate amount of lameness. The lameness may not be evident at all times. It may be sporadic, coming and going for a few days or weeks.

A more serious suspensory tendon injury may swell, cause a noticeable amount of pain and heat. Chronic instances of the injury will often result in lameness. The ligament may also become noticeably thicker. If the ligament ruptures, the fetlock ligament will fall whenever the horse places any weight on the injured leg. This sort of injury will cause the horse a great deal of pain and the inflammation of the area is likely to be more evident.

Being knowledgeable of Suspensory tendon injuries is extremely important.  Horse owners or trainers are in a better position to take the necessary precautions if they know what they are looking for and recognize it when they see it. The sooner they are able to make a determination about the problem, the sooner they will be able to get the horse help or make changes, for example as it relates to hoof balance, which may prevent a very severe and difficult-to-treat suspensory tendon injury.

Not being aware of suspensory tendon injury symptoms places the horse at a heightened risk for developing an injury that becomes so severe that they are no longer able to compete. Most horses will exhibit some sort of lameness which will alert the owner or trainer that a problem exists. However, being able to figure out the problem as early as possible can be very helpful.

Suspensory Tendon Injury: Diagnosis 

Suspensory ligament injuries are unfortunately, quite common. In fact, they are the most common injury to race or athletic horses. Because this is the case, Veterinarians are adept at diagnosing them. X-ray and/or ultrasound are commonly used to diagnose this particular injury. A nerve block, used for diagnostic purposes, may also be utilized .This helps vets pinpoint the general area of the injury, while X-rays, bone scans, thermography or ultrasound may be used to determine exactly where the injury is located.

Palpation is generally performed before more invasive or in-depth diagnostic tools are used. Palpation involves deeply feeling the injured area. The vet is looking for any visible evidence of pain and whether or not the ligament has thickened. Further testing is usually done to confirm the vet’s diagnosis. Further damage, in addition to the suspensory ligament injury, may have occurred. If it has, it will also need to be treated. Any degenerative injuries, related to suspensory ligament injury, may be found as well using ultrasound or radiographic imaging.

Most veterinarians won’t have a problem diagnosing a suspensory ligament injury. This is in large part because they are so common.  The diagnostic protocols have been well established so that determining whether or not a horse has a suspensory ligament injury is pretty simple and straightforward.

PRP as a Treatment Mechanism for Suspensory Ligament Injuries

PRP therapy as a form of treatment for suspensory ligament injuries is gaining respect among veterinarians. The therapy has gained a lot of attention as of late, as an effective form of treatment for soft tissue injuries in human beings. It has been proven to significantly decrease the amount of time it takes for such injuries to heal. It success has sparked a more than a bit of curiosity amongst veterinarians.

One of the most attractive things about PRP therapy is its simplicity. The process is extremely simple. A small amount of blood is drawn from the patient. It is placed into a centrifuge machine and then spun until all of its components are separated. Once they are, the platelets are removed and then injected into the point of injury. Platelets contain growth factors which help jumpstart the healing process in both human beings and animals. When a concentrated amount of platelets are used, as is the case with PRP therapy, the healing process is even further accelerated. In addition to the platelets, several other proteins in the blood are believed to cause an inflammatory response which can be helpful in the healing process.

When a horse sustains a suspensory ligament injury, it will typically be forced to rest and administered anti-inflammatory medications. Depending on how severe the injury is, it may have to undergo surgery. The latter is quite invasive and risky as it relates to whether or not the horse will ever be able to perform on a competitive level. The former, rest, may or may not be effective. It depends on how the horse’s body responds to the injury. PRP increases the likelihood that the injury will heal because of the growth factors utilized in the process.  PRP therapy is far less invasive than surgery, thus there is no painful rehabilitation or long recovery time.

PRP therapy can be performed in the vet’s office, on a farm or ranch. A veterinarian will draw 52 ml of whole blood, which has been preloaded with an ACD or CPD anticoagulant (8ml). They will then place it into a centrifuge tube and then a centrifuge machine to separate the horse’s blood components. The platelets will be drawn out and injected into the suspensory ligament injury shortly thereafter. No ultrasound guidance is typically needed.

 The complications associated with PRP therapy are minimal. This is largely because all of the components used in the procedure are the horse’s own. The platelets and the growth factors and proteins they contain, come from the horse. This minimizes any chance of the horse’s body rejecting the aforementioned or related-complications arising.