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Abstract
AIM: To determine the effect of polyester (terylene) fibre implants on normal equine superficial digital flexor (SDF) tendon structure.
METHODS: Normal forelimb SDF tendons (n=24) of 12 horses were divided into unoperated, sham-operated, and implanted (terylene fibre implant) groups. Horses were assessed for lameness and ultrasonographic changes to SDF tendons at intervals up to 48 weeks post-operatively. After euthanasia, SDF tendons were collected for histological and ultrastructural examination. Histological sections were examined for alcian blue staining intensity, cellularity, fibril bundle alignment, fascicle separation and crimp morphology. Mass-average diameters (MADs) of collagen fibrils were calculated from electron micrographs and compared between treatment groups.
RESULTS: Insertion of terylene fibre implants resulted in short-term (<8 weeks) lameness in implanted limbs. Ultrasonographically, the implants could be detected in 50% of implanted tendons, but were associated with tendon swelling and the presence of hypoechoic core lesions in 7/8 implanted limbs. There were significant alterations in alcian blue staining, cellularity and crimp morphology in the central fascicles of sham-operated and implanted tendons, and alteration in fibril alignment in the central fascicles of implanted tendons. Unoperated tendons remained histologically normal. MADs of collagen fibrils did not differ between sham-operated, implanted and unoperated limbs.
CONCLUSIONS: Both the sham procedure and the insertion of terylene fibre implants led to alterations in tendon structure that persisted for up to 48 weeks. Persistence of disorganised connective tissue at the proximal and distal ends of the terylene fibre implants may predispose implanted tendons to continued risk of injury.
CLINICAL RELEVANCE: It is unlikely that terylene fibre implants offer any advantage over standard non-surgical treatments for mild to moderate cases of SDF tendonitis in the horse.