Risk factors for injury to the superficial digital flexor tendon and suspensory apparatus in Thoroughbred racehorses in New Zealand

Exogenous interleukin-1 beta stimulation regulates equine tenocyte function and gene expression in three-dimensional culture which can be rescued by pharmacological inhibition of interleukin 1 receptor, but not nuclear factor kappa B, signaling

We investigated how Interleukin 1 beta (IL-1β) impacts equine tenocyte function and global gene expression in vitro and determined if these effects could be rescued by pharmacologically inhibiting nuclear factor-κB (NF-KB) or interleukin 1 signalling. Equine superficial digital flexor tenocytes were cultured in three-dimensional (3D) collagen gels and stimulated with IL-1β for two-weeks, with gel contraction and interleukin 6 (IL6) measured throughout and transcriptomic analysis performed at day 14. The impact of three NF-KB inhibitors on gel contraction and IL6 secretion were measured in 3D culture, with NF-KB-P65 nuclear translocation by immunofluorescence and gene expression by qPCR measured in two-dimensional (2D) monolayer culture. In addition, daily 3D gel contraction and transcriptomic analysis was performed on interleukin 1 receptor antagonist-treated 3D gels at day 14. IL-1β increased NF-KB-P65 nuclear translocation in 2D culture and IL6 secretion in 3D culture, but reduced daily tenocyte 3D gel contraction and impacted > 2500 genes at day 14, with enrichment for NF-KB signaling. Administering direct pharmacological inhibitors of NF-KB did reduce NF-KB-P65 nuclear translocation, but had no effect on 3D gel contraction or IL6 secretion in the presence of IL-1β. However, IL1Ra restored 3D gel contraction and partially rescued global gene expression. Tenocyte 3D gel contraction and gene expression is adversely impacted by IL-1β which can only be rescued by blockade of interleukin 1 receptor, but not NF-KB, signalling.

The Interfascicular Matrix of Energy Storing Tendons Houses Heterogenous Cell Populations Disproportionately Affected by Aging

Energy storing tendons such as the human Achilles and equine superficial digital flexor tendon (SDFT) are prone to injury, with incidence increasing with aging, peaking in the 5th decade of life in the human Achilles tendon. The interfascicular matrix (IFM), which binds tendon fascicles, plays a key role in energy storing tendon mechanics, and aging alterations to the IFM negatively impact tendon function. While the mechanical role of the IFM in tendon function is well-established, the biological role of IFM-resident cell populations remains to be elucidated. Therefore, the aim of this study was to identify IFM-resident cell populations and establish how these populations are affected by aging. Cells from young and old SDFTs were subjected to single cell RNA-sequencing, and immunolabelling for markers of each resulting population used to localise cell clusters. Eleven cell clusters were identified, including tenocytes, endothelial cells, mural cells, and immune cells. One tenocyte cluster localised to the fascicular matrix, whereas nine clusters localised to the IFM. Interfascicular tenocytes and mural cells were preferentially affected by aging, with differential expression of genes related to senescence, dysregulated proteostasis and inflammation. This is the first study to establish heterogeneity in IFM cell populations, and to identify age-related alterations specific to IFM-localised cells.

Risk-Factors for Soft-Tissue Injuries, Lacerations and Fractures During Racing in Greyhounds in New Zealand

Recognition of injuries in racing animals is essential to identify potential risk factors so actions can be taken to reduce or mitigate the cause of the injury to safeguard the animal. Racing greyhounds are subject to musculoskeletal injuries associated with athletic pursuit, in particular soft-tissue injuries, lacerations, and fractures. The objective of this study was therefore to determine risk factors for soft-tissue injuries, lacerations and fractures occurring during racing, using a cohort of greyhounds racing in New Zealand between 10th September 2014 and 31st July 2020. Dog-level, race-level and track-level risk factors for each outcome were assessed using mixed-effects multivariable logistic regression including trainer as a random effect. Throughout the study period there were 218,700 race starts by 4,914 greyhounds, with a total of 4,385 injuries. Of these, 3,067 (69.94%) were classed as soft-tissue injuries, 641 (14.62%) were reported as lacerations, and 458 (10.44%) were fractures. Greyhounds with a low racing frequency (racing more than 7 days apart) had 1.33 [95% confidence interval (CI): 1.06-1.67] times the odds of fracture compared to those racing more frequently. Older greyhounds had a greater odds of fracture compared with younger greyhounds. Racing every 7 days had a lower odds of soft-tissue injury compared with racing more than once a week. Dogs over 39 months had 1.53 (95% CI: 1.35-1.73) times the odds of sustaining a soft-tissue injury compared to the younger dogs. Greyhounds originating from Australia had a higher odds of fracture and laceration compared with New Zealand dogs. Better performing dogs (higher class) had a greater odds of fracture and laceration whilst maiden dogs had a higher odds of soft-tissue injury. Greyhounds starting from the outside box had a higher odds of fracture. There was considerable variation in the odds of soft-tissue injury at different racetracks. In conclusion, although the incidence of soft-tissue injuries was higher than other injury types, the repercussion of such injuries was less than those for fractures. The results from this study will help to inform intervention strategies aimed at reducing the rate of injuries in racing greyhounds, enhancing racing safety and greyhound welfare.

Investigation of Factors Influencing Thoroughbred Horses' Racing Career Length in Turkey

The aim of this research was to determine the average length of a Thoroughbred horse's racing career in Turkey using survival functions of Thoroughbred horses with various characteristics. In addition, the aim was to identify risk factors that could influence the duration of a Thoroughbred horse's racing career and develop a survival model that took these factors into account. A total of 11,721 Thoroughbred horses born in 2007 and later were included in the study population. The horses involved in the study were followed for a minimum of 1 year. Kaplan-Meier analysis was used to calculate the average length of racing career for each factor studied. Extended Cox regression analysis was used to determine the risk factors upon time of career ending and to create a survival model. Results showed that, the mean career length of Thoroughbred horses was 17.79 months (95% CI: 17.41-18.13). Also, "starting age of the race," "number of starts," "type of track where the race started," "racing on a single type racetrack" and "earning status" were found risk factors that affect the length of the racing career. Earnings was the top relative contributor to the established model, and its sole adjusted effect showed that being in the lowest earning group increased the hazard of career ending 2.28 times (95% CI:1.98-2.61) compared to horses with highest earning group. In conclusion, clear differences upon the length of racing career was observed for each investigated factor. Future studies should be considerate of these differences when analyzing population data.

Survival Analysis of Training Methodologies and Other Risk Factors for Musculoskeletal Injury in 2-Year-Old Thoroughbred Racehorses in Queensland, Australia

Musculoskeletal injuries remain a global problem for the Thoroughbred racing industry and there is conflicting evidence regarding the effect of age on the incidence of injuries. The ideal time to commence race training is strongly debated, with limited supporting literature. There is also conflicting evidence regarding the effect of high-speed exercise on musculoskeletal injuries. There is a strong interest in developing training and management strategies to reduce the frequency of injuries. The types of musculoskeletal injuries vary between 2-year-old and older horses, with dorsal metacarpal disease the most common injury in 2-year-old horses. It is likely that risk factors for injury in 2-year-old horses are different than those for older horses. It is also likely that the risk factors may vary between types of injury. This study aimed to determine the risk factors for musculoskeletal injuries and dorsal metacarpal disease. We report the findings of a large scale, prospective observational study of 2-year-old horses in Queensland, Australia. Data were collected weekly for 56-weeks, from 26 trainers, involving 535 2-year-old Thoroughbred racehorses, 1, 258 training preparations and 7, 512-weeks of exercise data. A causal approach was used to develop our statistical models, to build on the existing literature surrounding injury risk, by incorporating the previously established causal links into our analyses. Where previous data were not available, industry experts were consulted. Survival analyses were performed using Cox proportional hazards or Weibull regression models. Analysis of musculoskeletal injuries overall revealed the hazard was reduced with increased exposure to high-speed exercise [Hazard ratio (HR) 0.89, 95% Confidence Interval (CI) 0.84, 0.94, p < 0.001], increased number of training preparations (HR 0.58, 95% CI 0.50, 0.67, p < 0.001), increased rest before the training preparation (HR 0.89, 95% CI 0.83, 0.96, p = 0.003) and increased dam parity (HR 0.86, 95% CI 0.77, 0.97, p = 0.01). The hazard of injury was increased with increasing age that training commenced (HR 1.13, 95% CI 1.06, 1.19, p < 0.001). Analyses were then repeated with the outcome of interest dorsal metacarpal disease. Factors that were protective against dorsal metacarpal disease and musculoskeletal injuries overall included: increased total cumulative distance (HR 0.89, 95% CI 0.82, 0.97, p = 0.001) and total cumulative days exercised as a gallop (HR 0.96, 95% CI 0.92, 0.99, p = 0.03), the number of the training preparations (HR 0.43, 95% CI 0.30, 0.61, p < 0.001). The age that training commenced was harmful for both dorsal metacarpal disease (HR 1.17, 95% CI 1.07, 1.28, p < 0.001 and overall musculoskeletal injuries.). The use of non-ridden training modalities was protective for dorsal metacarpal disease (HR 0.89, 95% CI 0.81, 0.97, p = 0.008), but not musculoskeletal injuries overall. The male sex increased the hazard of DMD compared to females (HR 2.58, 95% CI 1.20, 5.56, p = 0.02), but not MSI overall. In summary, the hazard of musculoskeletal injury is greatest for 2-year-old horses that are born from uniparous mares, commence training at a later age, are in their first training preparation, have undertaken little high-speed exercise or had limited rest before their training preparation. The hazard of dorsal metacarpal disease is greatest for 2-year-old horses that are males, commence training at a later age, are in their first training preparation, have undertaken little high-speed exercise or had limited use of non-ridden training modalities. Close monitoring of these high-risk horses during their training program could substantially reduce the impact of MSI. Furthermore, an understanding of how training methodologies affect the hazard of MSI facilitates modification of training programs to mitigate the risk impact of injury. The strengths of this study include a large sample size, a well-defined study protocol and direct trainer interviews. The main limitation is the inherent susceptibility to survival bias.

Association of Thoroughbred Racehorse Workloads and Rest Practices with Trainer Success

Understanding the relationship between the training practices of Thoroughbred racehorses and race performance is important to ensure advice given to trainers for injury prevention or management is practical and consistent. We assessed associations between intended volume and speed of gallop training (i.e., typical workloads for horses free of injury or other performance limiting conditions) and rest practices on official trainer career and previous season success rates (rate of wins and places, prizemoney per start). Sixty-six Australian Thoroughbred trainers were surveyed. Multivariable negative binomial regression models were employed for the outcomes career and previous season wins and places, and linear regression models for prizemoney per start. Intended training workload was not associated with prizemoney. Pre-trial total galloping distances (≥13.3 m/s) between 7500 m and 15,000 m were associated with a higher rate of career wins, and previous season wins and places per start (p < 0.05). Slow-speed (13.3-14.3 m/s) galloping distance to trial between 5000 m to 12,500 m was associated with higher rate of career placings per start, with reduced performance over 12,500 m (p = 0.003). Greater time between race starts was associated with a greater rate of previous season wins and prizemoney per start until three weeks between starts, with decline in performance thereafter (p < 0.05). Greater frequency of rest breaks was associated with greater prizemoney per start earnt in the previous season (p ≤ 0.01). These results suggest that modifications to training programs aimed at injury prevention, such as avoiding long galloping distances, should not adversely affect trainer success.

Fédération Equestre Internationale eventing: Risk factors for horse falls and unseated riders during the cross-country phase (2008-2018)

BACKGROUND

Eventing is an equestrian sport that tests athletes' and horses' skill over three phases: dressage, jumping and cross-country. Falls during the cross-country phase can have very serious outcomes up to and including death for both horse and athlete. Therefore, understanding risk factors associated with falls is essential for improving equine and human welfare.

OBJECTIVES

To provide descriptive statistics and identify risk factors at the horse-, athlete- and course-level affecting horses competing in Fédération Equestre Internationale (FEI) events worldwide.

STUDY DESIGN

Retrospective cohort study.

METHODS

Data collected by the FEI of every horse start worldwide in all international (CI), championship (CH), Olympics (OG) and World Equestrian Games (WEG) competitions between January 2008 and December 2018 were analysed. Descriptive statistics followed by univariable logistic regression to identify risk factor candidates for inclusion in the final multivariable logistic regression model. Models were constructed stepwise using a bi-directional process and assessed using the Akaike information criterion.

RESULTS

Factors associated with increased risk of falls and or unseated rider included: higher event levels, longer course distances, more starters at cross-country phase and less experienced horses and athletes.

MAIN LIMITATIONS

The data set is geographically comprehensive but covers only FEI competitions, not National Federation events, that is not every competition started by every individual horse. Nor does the data set include any prior veterinary information or data on training or schooling.

CONCLUSIONS

This is the first large-scale epidemiological study of cross-country falls in FEI eventing. Results suggest that a potential risk profile can be constructed for each horse-athlete combination prior to entering a given competition, based on individual histories and course-level factors. This could lead to interventions that can reduce the number of falls, thus protecting equine and human welfare.

Microdamage in the equine superficial digital flexor tendon

The forelimb superficial digital flexor tendon (SDFT) is an energy-storing tendon that is highly susceptible to injury during activities such as galloping and jumping, such that it is one of the most commonly reported causes of lameness in the performance horse. This review outlines the biomechanical and biothermal effects of strain on the SDFT and how these contribute to the accumulation of microdamage. The effect of age-related alterations on strain response and subsequent injury risk is also considered. Given that tendon is a slowly healing and poorly regenerative tissue, prompt detection of early stages of pathology in vivo and timely adaptations to training protocols are likely to have a greater outcome than advances in treatment. Early screening tools and detection protocols could subsequently be of benefit in identifying subclinical signs of degeneration during the training programme. This provides an opportunity for preventative strategies to be implemented to minimise incidences of SDFT injury and reduce recovery periods in elite performance horses. Therefore, this review will focus on the modalities available to implement early screening and prevention protocols as opposed to methods to diagnose and treat injuries.

A Prospective Study of Training Methods for Two-Year-Old Thoroughbred Racehorses in Queensland, Australia, and Analysis of the Differences in Training Methods between Trainers of Varying Stable Sizes

Simple Summary

Musculoskeletal injuries present significant concerns for the global Thoroughbred racing industry. The development of training and management strategies to reduce injuries has been challenging due to conflicting findings about the risk factors for injury, and limited understanding of the role of different training methodologies. There is little published data on patterns of rest periods and exercise data and how these vary between trainers and between different racing jurisdictions. We describe training methodologies for 535 two-year-old horses providing 1258 training preparations and 7512 weeks of exercise. We investigated the variation in training methodologies between trainers from small, medium and large stable sizes. Significant differences were observed between trainers, with horses from larger stables accumulating a greater high-speed exercise volume, attaining training milestones more frequently and taking less time to reach their training milestones. We also highlight similarities and differences in training methods used in Queensland, Australia, and those previously reported from other geographic locations. A better understanding of training methods is an essential step towards reducing the impact of injuries.

Abstract

Worldwide, musculoskeletal injuries remain a major problem for the Thoroughbred racing industry. There is a strong interest in developing training and management strategies to reduce the impact of musculoskeletal injuries, however, progress has been limited by studies reporting conflicting findings, and a limited understanding of the role of different training methods in preventing injury. There is little data on patterns of rest periods and exercise data and how these vary between trainers. This prospective study of two-year-old racehorses was conducted in Queensland, Australia and involved weekly personal structured interviews with 26 trainers over 56 weeks. Detailed daily exercise data for 535 horses providing 1258 training preparations and 7512 weeks at risk were collected. Trainers were categorised into three groups by the mean number of two-year-old horses that they had in work each week over the study duration: (1) Small stables with five or less, (2) Medium stables with 6 to 15 and (3) Large stables with greater than 15 horses in training. Differences between trainers with small, medium and large stable sizes were evaluated using linear regression, Kruskal–Wallis equality-of-populations rank test if linear models were mis-specified or Chi-squared tests for categorical variables. Significant differences were observed between trainers, with horses from larger stables accumulating a greater high-speed exercise volume (p < 0.001), attaining training milestones more frequently (p = 0.01) and taking less time to reach their training milestones (p = 0.001). This study provides detailed data to which training practices from other locations can be compared. Presenting actual training data rather than trainers’ estimation of a typical program provides a more accurate assessment of training practices. Understanding how training practices vary between regions improves comparability of studies investigating risk factors and is an important step towards reducing the impact of musculoskeletal injuries.

Association between the administration of phenylbutazone prior to racing and musculoskeletal and fatal injuries in Thoroughbred racehorses in Argentina

OBJECTIVE

To examine the association between prerace administration of phenylbutazone and the risk of musculoskeletal injury (MSI) and fatal injury in Thoroughbred racehorses that raced between 2006 and 2015 at 2 of the 4 official racetracks in Argentina.

SAMPLE

Data from racetrack databases and veterinary reports on 283,193 race starts.

PROCEDURES

Data were collected relating to race performance and injury outcomes for starts at these tracks. The incidence of MSI and fatal injury was calculated for each year, stratified by the declared prerace administration of phenylbutazone. Univariable logistic regression, followed by multivariable logistic regression, was used to identify significant risk factors for both MSI and fatal injury.

RESULTS

Analyses identified associations between the declared prerace administration of phenylbutazone and the risk of MSI and fatal injury during racing. Horses with declared prerace phenylbutazone administration had greater odds of MSI (OR, 1.45 [95% CI, 1.03 to 2.04]) and fatal injury (OR, 1.59 [95% CI, 1.1 to 2.27]) than did horses racing without prerace phenylbutazone administration. These associations remained significant when other risk factors were accounted for in both multivariable models.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested an association between the prerace administration of phenylbutazone and the risk of MSI and fatal injury in Thoroughbred racehorses during racing. Although these results did not imply a direct causal relationship between prerace phenylbutazone administration and injury, they may be considered in the development of more conservative medication policies to optimize racehorse welfare in North and Latin America.

The Risk Factors for Musculoskeletal Injuries in Thoroughbred Racehorses in Queensland, Australia: How These Vary for Two-Year-Old and Older Horses and with Type of Injury

Simple Summary

Musculoskeletal injuries (MSI) continue to affect Thoroughbred racehorses internationally, despite over thirty years of research into this problem. Studies of risk factors for musculoskeletal injuries report inconsistent findings. Consequently, developing training strategies to mitigate the risk of MSI is difficult. We identified factors associated with particularly high odds of injury in this population of racehorses. Two-year-old horses from primiparous mares (first foals born) are at increased odds of MSI, particularly dorsal metacarpal disease (“shinsoreness”). Two-year-old horses that have had a total preparation length of between 10 and 14 weeks also have increased odds of injury. Horses of all ages that travelled a total distance of 2.4–3.8 km (12–19 furlongs) at a gallop (faster than 15 m/s; 13 s/furlong; 900 m/min; 55 km/h) in the last four weeks and horses three years and older that travelled 3.0–4.8 km (15–24 furlongs) at three-quarter pace and above (faster than 13 m/s; 15 s/furlong; 800 m/min; 48 km/h) also have increased odds of injury. We recommend that these horses should be monitored closely for impending signs of injury. We also observed a non-linear relationship between high-speed exercise and musculoskeletal injuries. This highlights the importance of high-speed exercise to enable tissue adaptation to training. Finally, in some situations, increasing the number of days worked at a slow pace may be more effective for preventing MSI, if horses are perceived at a higher risk, than resting the horse altogether. Early identification of horses at increased risk of injury and appropriate intervention could substantially reduce the impact of musculoskeletal injuries in Thoroughbred racehorses.

Abstract

Musculoskeletal injuries (MSI) continue to affect Thoroughbred racehorses internationally. There is a strong interest in developing training and management strategies to reduce their impact, however, studies of risk factors report inconsistent findings. Furthermore, many injuries and fatalities occur during training rather than during racing, yet most studies report racing data only. By combining racing and training data a larger exposure to risk factors and a larger number of musculoskeletal injuries are captured and the true effect of risk factors may be more accurately represented. Furthermore, modifications to reduce the impact of MSI are more readily implemented at the training level. Our study aimed to: (1) determine the risk factors for musculoskeletal injuries and whether these are different for two-year-old and older horses and (2) determine whether risk factors vary with type of injury. This was performed by repeating analyses by age category and injury type. Data from 202 cases and 202 matched controls were collected through weekly interviews with trainers and analysed using conditional logistic regression. Increasing dam parity significantly reduced the odds of injury in horses of all age groups because of the effect in two-year-old horses (odds ratio (OR) 0.08; 95% confidence interval (CI) 0.02, 0.36; p < 0.001). Increasing total preparation length is associated with higher odds of injury in horses of all ages (OR 5.56; 95% CI 1.59, 19.46; p = 0.01), but particularly in two-year-old horses (OR 8.05; 95% CI 1.92, 33.76; p = 0.004). Increasing number of days exercised at a slow pace decreased the odds of injury in horses of all ages (OR 0.09; 95% CI 0.03, 0.28; p < 0.001). The distance travelled at three-quarter pace and above (faster than 13 m/s; 15 s/furlong; 800 m/min; 48 km/h) and the total distance travelled at a gallop (faster than 15 m/s; 13 s/furlong; 900 m/min; 55 km/h) in the past four weeks significantly affected the odds of injury. There was a non-linear association between high-speed exercise and injury whereby the odds of injury initially increased and subsequently decreased as accumulated high-speed exercise distance increased. None of the racing career and performance indices affected the odds of injury. We identified horses in this population that have particularly high odds of injury. Two-year-old horses from primiparous mares are at increased odds of injury, particularly dorsal metacarpal disease. Two-year-old horses that have had a total preparation length of between 10 and 14 weeks also have increased odds of injury. Horses of all ages that travelled a total distance of 2.4–3.8 km (12–19 furlongs) at a gallop in the last four weeks and horses three years and older that travelled 3.0–4.8 km (15–24 furlongs) at three-quarter pace and above also have increased odds of injury. We recommend that these horses should be monitored closely for impending signs of injury. Increasing the number of days worked at a slow pace may be more effective for preventing injury, if horses are perceived at a higher risk, than resting the horse altogether. Early identification of horses at increased risk and appropriate intervention could substantially reduce the impact of musculoskeletal injuries in Thoroughbred racehorses.

Risk Factors for the Occurrence of Desmopathy of the Collateral Ligaments of the Distal Interphalangeal Joint in Equines – A Cross-Sectional Study

Desmopathy of the collateral ligaments of the distal interphalangeal joint (CL-DIPJ) has been increasingly relevant in equine sports medicine. However, the risk factors for the development of such desmopathy are not well established. In the literature, what has been described about it, is based on the clinical conditions observed in animals diagnosed with this disorder. Considering this scenario, the aim of this study was to verify which possible extrinsic or intrinsic risk factors may influence the occurrence of disorders in the collateral ligaments of the distal interphalangeal joint in polo horses. Twenty-five horses from the same equestrian team, all competing in polo, were evaluated via ultrasonography. The outcome was defined as changes in echogenicity and/or boundaries of the CL-DIPJ of the thoracic limbs of the horses evaluated. The intrinsic factors considered in this study were age, the presence of angular deviations and gender. As extrinsic factors, the parameters taken into consideration were the handicap in which the animals played and the type of training to which these horses were previously submitted in their professional athletic career. The prevalence ratio was used to verify the association between risk factor and outcome. The result of this evaluation was considered significant when the confidence interval value did not involve the value 1. Positive and significant association was observed only for age. Playing in different handicaps did not influence the presence of ligament disorders. The other factors evaluated revealed a positive but not significant association. Thus, it was concluded that animals aged nine years or older present a higher risk of CL-DIPJ disorders.

The Effect of Combined Training and Racing High-Speed Exercise History on Musculoskeletal Injuries in Thoroughbred Racehorses: A Systematic Review and Meta-Analysis of the Current Literature

Simple Summary

Despite extensive international research, musculoskeletal injuries remain a key problem for the Thoroughbred racing industry, with multiple welfare and ethical consequences. High-speed exercise (HSE) history is an important risk factor for injury. However, studies report conflicting findings concerning the effect of HSE on the risk of injury. Although most injuries and fatalities occur during training rather than racing, many research studies only evaluate injuries reported on race day, which likely underrepresents the injuries acquired by these horses. This study aimed to determine the effect of combined training and racing HSE on injuries in racehorses. We performed a systematic search of the relevant literature and evaluated the effect of seven measures of HSE on injury through meta-analyses. The total career HSE distance significantly affected the odds of musculoskeletal injuries (MSI). With every 5-furlong (1 km) increase in career HSE distance, the odds of MSI increased by 2%. The average HSE distance per day also affected the odds of MSI. With every additional furlong (200 m) of average HSE per day, the odds of MSI increased by 73%. However, the strength of the available evidence is restricted by methodological limitations, which will need to be addressed in the future, to explore the level of risk and mechanisms for injury in more detail.

Abstract

Despite over three decades of active research, musculoskeletal injuries (MSI) remain a global problem for the Thoroughbred (TB) racing industry. High-speed exercise history (HSEH) has been identified as an important risk factor for MSI. However, the nature of this relationship remains unclear, with an apparent protective effect of HSE against injury, before it becomes potentially harmful. Many MSI cases and fatalities occur during training rather than during racing, resulting in an underestimation of injury from studies focused on race day. The objective of this study was to examine the current evidence of the effect of combined training and racing HSEH on MSI in TB flat racehorses, through a systematic review and meta-analysis. A systematic search of the relevant literature was performed using PubMed^®, Scopus^®, Web of Science^®, and Embase^® online databases and the gray literature using sites containing “.edu” or “.edu.au”. Studies included in the review had explored seven different measures of HSE, including total career HSE distance, cumulative HSE distance in the 30 and 60 days before MSI, average HSE distance per day, per event and per 30 days, and the total number of HSE events. The total cumulative career HSE distance significantly affected the odds of MSI, with every 5-furlong increase, the odds of MSI increased by 2% (OR = 1.02; 95% CI 1.01, 1.03; p = 0.004). The average HSE distance per day also affected the odds of MSI, with every additional furlong increasing the odds of MSI by 73% (OR = 1.73; 95% CI 1.29, 2.31; p < 0.001). Other measures of HSE were not found to be consistently associated with risk of MSI, but these results should be interpreted with caution. Significant methodological limitations were identified and influence the comparability of studies. Standardizing the measures of HSE in studies of MSI, and describing training conditions in more detail, would support a more thorough investigation of the relationship between HSE and MSI. An improved understanding of this relationship is critical to mitigating the impact of MSI in the Thoroughbred racehorse.

Risk factors for superficial digital flexor tendinopathy in Thoroughbred racing horses in Japan

Thoroughbred racehorses are commonly affected with superficial digital flexor (SDF) tendinopathy. This study aimed to identify risk factors for SDF tendinopathy in racing horses. The authors selected racehorses (n=292) with SDF tendinopathy from the medical records of a racetrack. As a risk factor associated with track-related variables, the SDF tendinopathy odds ratio (OR) was significantly high for a sloppy track surface compared with a standard track surface. Regarding risk factors associated with race-related variables, the SDF tendinopathy OR was significantly high in the following cases: when the order of arrival was worse than or equal to the 10th place; when the racehorses started to run a short race and when the racehorses' favourites were worse than or equal to the 8th place. Regarding risk factors associated with racehorse-related variables, the body weight of racehorses with SDF tendinopathy was significantly heavier than that of control horses. When there was a decrease in body weight since previous racing, the SDF tendinopathy OR was significantly high. Regarding risk factors associated with race career-related variables, when the charge in the race distance was short, the SDF tendinopathy OR was significantly high. As a countermeasure to prevent SDF tendinopathy, a sloppy track surface should be avoided during the race by guiding the horse toward to more solid track surface. Selecting long-distance races with slow speed, if possible, could reduce the risk of SDF tendinopathy.

Ultrasonographic-based predictive factors influencing successful return to racing after superficial digital flexor tendon injuries in flat racehorses: A retrospective cohort study in 469 Thoroughbred racehorses in Hong Kong

BACKGROUND

Superficial digital flexor tendon (SDFT) injury is an important health and welfare concern in racehorses. It is generally diagnosed with ultrasonography, but predictive ultrasonographic features have not been reported.

OBJECTIVES

To determine ultrasonographic features of forelimb SDFT injury at initial presentation in Thoroughbred racehorses that could predict a successful return to racing (completing ≥5 races).

STUDY DESIGN

Retrospective cohort study.

METHODS

Digitised ultrasonographic images of 469 horses with forelimb SDFT injuries from the Hong Kong Jockey Club (2003-2014) were evaluated, using a previously validated ultrasonographic scoring system. Six ultrasonographic parameters were evaluated (type and extent of the injury, location, echogenicity, cross-sectional area and longitudinal fibre pattern of the maximal injury zone [MIZ]), as well as horse signalment, retirement date and number of races before and after injury. Data were analysed by generalised linear regression with significance at P<0.05.

RESULTS

Cases were divided into two groups: 1) For cases of SDFT tendonitis with core lesions, cross-sectional area at the MIZ was the most significant factor determining a successful return to racing (P = 0.03). If the lesion was <50% of the total cross-sectional area, horses had 29-35% probability of successfully racing again, but if it was ≥50% this decreased to 11-16%. 2) For cases of SDFT tendonitis without a core lesion, longitudinal fibre pattern at the MIZ best predicted a successful return to racing (P = 0.002); if the affected longitudinal fibre pattern was <75% of the total, horses had 49-99% probability of successfully return to racing, but if it was ≥75% this decreased to 14%.

MAIN LIMITATIONS

Prognostic information may not be applicable to other breeds/disciplines.

CONCLUSIONS

This is the first study to describe ultrasonographic features of forelimb SDFT injuries at initial presentation that were predictive of successful return to racing. The outcomes will assist with early, evidence-based decisions on prognosis in Thoroughbred racehorses.

Clinical findings and prognosis of interference injuries to the palmar aspect of the forelimbs in Standardbred racehorses: A study on 74 cases

BACKGROUND

Information on interference injuries in racehorses is lacking.

OBJECTIVE

To describe clinical findings and prognosis of palmar forelimb interference injuries in Standardbreds.

STUDY DESIGN

Retrospective cohort study.

METHODS

Records of 74 racehorses sustaining palmar forelimb interference injuries were studied; 7 occurred during training and 67 during racing. The number of starts before injury, hind shoeing status, gait penalties and racing speeds in cases occurring during racing were compared with negative controls (67 age, sex and speed category matched horses) from the same races. The number of starts and racing speed in 30 racing days preceding recruitment were compared with those following recruitment (negative controls) or return to racing (cases). Clinical aspects and outcome in interference-induced superficial digital flexor (SDF) tendonitis were compared with 77 horses with overstrain-induced SDF tendonitis.

RESULTS

In 89% of cases, there was SDF tendonitis and this was associated with a longer time to return to racing (6 months vs. 1 months; P<0.001). The presence of gait penalties (odds ratio (OR) 11.13; 95% CI 3.74, 41.64; P<0.001) and unshod hind feet (OR = 6.26, 95% CI 2.26, 19.62; P<0.001) increased risk of interference injuries. After recruitment/return to racing, horses with interference injuries participated in a lower number of races (24 starts per racing day, interquartile range [IQR] 20-32) compared with controls (49, IQR 43-55, P<0.0001). Interference-induced tendonitis cases (n = 58) had a shorter time to return to racing (245 ± 137 days) than overstrain-induced tendonitis cases (331 ± 118 days, P<0.001).

MAIN LIMITATIONS

Data were collected retrospectively; time of ultrasonographic assessment varied and health status of the racing controls is unknown.

CONCLUSIONS

SDF tendonitis is common with palmar forelimb interference injuries in Standardbreds and increases time to return to racing. Interference-induced SDF tendonitis has a better prognosis than overstrain-induced tendonitis.

Ultrasonographic scoring system for superficial digital flexor tendon injuries in horses: intra- and inter-rater variability

Superficial digital flexor tendon (SDFT) tendinopathy is an important musculoskeletal problem in horses. The study objective was to validate an ultrasonographic scoring system for SDFT injuries. Ultrasonographic images from 14 Thoroughbred racehorses with SDFT lesions (seven core; seven diffuse) and two controls were blindly assessed by five clinicians on two occasions. Ultrasonographic parameters evaluated were: type and extent of the injury, location, echogenicity, cross-sectional area and longitudinal fibre pattern of the maximal injury zone (MIZ). Inter-rater variability and intra-rater reliability were assessed using Kendall's coefficient of concordance (KC) and Lin's concordance correlation coefficient (LC), respectively. Type of injury (core vs. diffuse) had perfect inter/intra-rater agreement. Cases with core lesions had very strong inter-rater agreement (KC ≥0.74, P<0.001) and intra-rater reliability (LC ≥0.73) for all parameters apart from echogenicity. Cases with diffuse lesions had strong inter-rater agreement (KC ≥0.62) for all parameters, but weak agreement for echogenicity (KC=0.22); intra-rater reliability was excellent for MIZ location and fibre pattern (LC ≥0.82), and moderate (LC ≥0.58) for cross-sectional area and number of zones affected. This scoring system was reliable and repeatable for all parameters, except for echogenicity. A validated scoring system will facilitate reliable recording of SDFT injuries and inter-study meta-analyses.

Epidemiology of Musculoskeletal Injury during Racing on New Zealand Racetracks 2005-2011

The objective of the study was to determine the incidence of veterinary events that resulted in a horse failing to finish a race and identify risk factors for musculoskeletal injury (MSI) during a race. Data were obtained on Thoroughbred flat race starts in New Zealand between 1 August 2005 and 31 July 2011 (six racing seasons). Stipendiary Steward's reports were key-word searched to identify veterinary events that prevented a horse from finishing a race. Race data were used calculate the incidence of veterinary events per 1000 horse starts and Poisson regression was used to investigate risk factors for MSI. There were 188,616 race starts and 177 reported veterinary events. The incidence of MSI on race day was 0.72 per 1000 starts, whilst the incidence of respiratory events was 0.21 per 1000 starts. The rate of MSI was significantly lower on 'dead' and 'slow' tracks compared with 'good' tracks and significantly greater in longer races (≥1671 m) compared with races of ≤1200 m. The rate of MSI during flat races in New Zealand appears lower than that reported worldwide, which may be due to the management and training of horses in New Zealand or differences in case definitions used in comparable studies.

Analysis of Failure to Finish a Race in a Cohort of Thoroughbred Racehorses in New Zealand

The objective was to describe the incidence of failure to finish a race in flat-racing Thoroughbreds in New Zealand as these are summary indicators of falls, injuries and poor performance. Retrospective data on six complete flat racing seasons (n = 188,615 race starts) of all Thoroughbred flat race starts from 1 August 2005 to 31 July 2011 were obtained. The incidence of failure to finish events and binomial exact 95% confidence intervals were calculated per 1000 horse starts. The association between horse-, rider- and race-level variables with the outcomes failure to finish, pulled-up/fell and lost rider were examined with a mixed effects Poisson regression model. A total of 544 horses failed to finish in 188,615 race starts with an overall incidence of 2.88 per 1000 horse starts (95% CI 2.64-3.12). The incidence of failure to finish horses across each race year showed little variability. In the univariable analysis race distance, larger field size, season, and ratings bands showed association with failing to finish a race. The overall failure to finish outcome was associated with season, race distance and ratings bands (horse experience and success ranking criteria). In the multivariable analysis, race distance and ratings bands were associated with horses that pulled-up/fell; season, apprentice allowances and ratings bands were associated with the outcome lost rider. The failure to finish rate was lower than international figures for race day catastrophic injury. Racing and environmental variables were associated with failure to finish a race highlighting the multifactorial nature of race-day events. Further investigation of risk factors for failure to finish is required to better understand the reasons for a low failure to finish rate in Thoroughbred flat races in New Zealand.

The interfascicular matrix enables fascicle sliding and recovery in tendon, and behaves more elastically in energy storing tendons

While the predominant function of all tendons is to transfer force from muscle to bone and position the limbs, some tendons additionally function as energy stores, reducing the cost of locomotion. Energy storing tendons experience extremely high strains and need to be able to recoil efficiently for maximum energy storage and return. In the equine forelimb, the energy storing superficial digital flexor tendon (SDFT) has much higher failure strains than the positional common digital extensor tendon (CDET). However, we have previously shown that this is not due to differences in the properties of the SDFT and CDET fascicles (the largest tendon subunits). Instead, there is a greater capacity for interfascicular sliding in the SDFT which facilitates the greater extensions in this particular tendon (Thorpe et al., 2012). In the current study, we exposed fascicles and interfascicular matrix (IFM) from the SDFT and CDET to cyclic loading followed by a test to failure. The results show that IFM mechanical behaviour is not a result of irreversible deformation, but the IFM is able to withstand cyclic loading, and is more elastic in the SDFT than in the CDET. We also assessed the effect of ageing on IFM properties, demonstrating that the IFM is less able to resist repetitive loading as it ages, becoming stiffer with increasing age in the SDFT. These results provide further indications that the IFM is important for efficient function in energy storing tendons, and age-related alterations to the IFM may compromise function and predispose older tendons to injury.

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Fascicle sliding enables high levels of extension in energy storing tendons.

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Sliding mechanics are governed by the interfascicular matrix (IFM).

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We assessed IFM extension and recovery.

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IFM elasticity and recovery are greater in energy storing tendons.

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The IFM plays an important role in the function of energy storing tendons.

Achilles tendon injuries in elite athletes: lessons in pathophysiology from their equine counterparts

Superficial digital flexor tendon (SDFT) injury in equine athletes is one of the most well-accepted, scientifically supported companion animal models of human disease (i.e., exercise-induced Achilles tendon [AT] injury). The SDFT and AT are functionally and clinically equivalent (and important) energy-storing structures for which no equally appropriate rodent, rabbit, or other analogues exist. Access to equine tissues has facilitated significant advances in knowledge of tendon maturation and aging, determination of specific exercise effects (including early life), and definition of some of the earliest stages of subclinical pathology. Access to human surgical biopsies has provided complementary information on more advanced phases of disease. Importantly, equine SDFT injuries are only a model for acute ruptures in athletes, not the entire spectrum of human tendonopathy (including chronic tendon pain). In both, pathology begins with a potentially prolonged phase of accumulation of (subclinical) microdamage. Recent work has revealed remarkably similar genetic risk factors, including further evidence that tenocyte dysfunction plays an active role. Mice are convenient but not necessarily accurate models for multiple diseases, particularly at the cellular level. Mechanistic studies, including tendon cell responses to combinations of exercise-associated stresses, require a more thorough investigation of cross-species conservation of key stress pathway auditors. Molecular evidence has provided some context for the poor performance of mouse models; equines may provide better systems at this level. The use of horses may be additionally justifiable based on comparable species longevity, lifestyle factors, and selection pressure by similar infectious agents (e.g., herpesviruses) on general cell stress pathway evolution.

Survey-based analysis of risk factors for injury among dogs participating in agility training and competition events

OBJECTIVE

To identify potential risk factors for agility-related injuries among dogs.

DESIGN

Internet-based, retrospective, cross-sectional survey.

ANIMALS

3,801 privately owned dogs participating in agility training or trials.

PROCEDURES

A retrospective electronic survey was used to investigate potential risk factors for injury among dogs participating in agility-related activities. Respondents were handlers recruited through member lists of large canine agility associations in Canada and the United Kingdom and through promotion on an agility blog site. Variables evaluated included demographic information for handlers and dogs, exposure variables (eg, frequency of agility practice and competition in the past year), and use of preventive measures intended to keep dogs fit for agility (warmup, cooldown, or conditioning exercises; alternative therapeutic treatments [eg, acupuncture, massage, or chiropractic care]; or dietary supplement products).

RESULTS

Data were collected from 1,669 handlers of 3,801 agility dogs internationally; 1,209 (32%) dogs incurred ≥ 1 injury. Previous injury (OR, 100.5), ≤ 4 years of agility experience for dogs (OR, 1.5), use of alternative therapeutic treatments (OR, 1.5), and Border Collie breed (OR, 1.7) were associated with increased odds of injury. Handlers having 5 to 10 or > 10 years of experience (OR, 0.8 and 0.6, respectively) and dogs having > 4 years of experience in the sport (OR, 0.6) were associated with decreased odds of injury.

CONCLUSIONS AND CLINICAL RELEVANCE

Specific factors were associated with agility-related injuries in dogs. Educational prevention strategies should target at-risk populations in an effort to reduce potential injuries. Future research should focus on the biomechanical factors associated with agility-related injuries.

Generation and characterization of leukemia inhibitory factor-dependent equine induced pluripotent stem cells from adult dermal fibroblasts

In this study we have reprogrammed dermal fibroblasts from an adult female horse into equine induced pluripotent stem cells (equiPSCs). These equiPSCs are dependent only on leukemia inhibitory factor (LIF), placing them in striking contrast to previously derived equiPSCs that have been shown to be co-dependent on both LIF and basic fibroblast growth factor (bFGF). These equiPSCs have a normal karyotype and have been maintained beyond 60 passages. They possess alkaline phosphatase activity and express eqNANOG, eqOCT4, and eqTERT mRNA. Immunocytochemistry confirmed that they produce NANOG, REX1, SSEA4, TRA1-60, and TRA1-81. While our equiPSCs are LIF dependent, bFGF co-stimulates their proliferation via the PI3K/AKT pathway. EquiPSCs lack expression of eqXIST and immunostaining for H3K27me3, suggesting that during reprogramming the inactive X chromosome has likely been reactivated to generate cells that have two active X chromosomes. EquiPSCs form embryoid bodies and in vitro teratomas that contain derivatives of all three germ layers. These LIF-dependent equiPSCs likely reflect a more naive state of pluripotency than equiPSCs that are co-dependent on both LIF and bFGF and so provide a novel resource for understanding pluripotency in the horse.

Estimates of genetic parameters of distal limb fracture and superficial digital flexor tendon injury in UK Thoroughbred racehorses

A retrospective cohort study of distal limb fracture and superficial digital flexor tendon (SDFT) injury in Thoroughbred racehorses was conducted using health records generated by the British Horseracing Authority (BHA) between 2000 and 2010. After excluding records of horses that had both flat and jump racing starts, repeated records were reduced to a single binary record per horse (n = 66,507, 2982 sires), and the heritability of each condition was estimated using residual maximum likelihood (REML) with animal logistic regression models. Similarly, the heritability of each condition was estimated for the flat racing and jump racing populations separately. Bivariate mixed models were used to generate estimates of genetic correlations between SDFT injury and distal limb fracture. The heritability of distal limb fracture ranged from 0.21 to 0.37. The heritability of SDFT injury ranged from 0.31 to 0.34. SDFT injury and distal limb fracture were positively genetically correlated. These findings suggest that reductions in the risk of the conditions studied could be attempted using targeted breeding strategies.

Performance selection for Thoroughbreds racing in Hong Kong

REASONS FOR PERFORMING STUDY

Different indicators of racing performance are commonly used in the racing industry to assess the genetic superiority of racing Thoroughbreds. However, how well these indicators predict the performance of future progeny or siblings varies depending on the population and circumstances in which the indicators were recorded or achieved.

OBJECTIVES

To identify heritable indicators of racing performance for horses racing in Hong Kong.

STUDY DESIGN

Heritability analysis of racing performance traits.

METHODS

Performance data on the population of Thoroughbreds racing in Hong Kong between 3 September 2000 and 12 March 2011 (n = 4947) were acquired and used to estimate the heritabilities and probability values of fixed effects and covariates for a range of racing performance traits. Heritabilities for all performance traits were estimated using a single trait animal model. Each model included, as a minimum, the effects of sex, region of origin and trainer.

RESULTS

Heritability estimates for traits relating to finish position ranged from 0.01 to 0.06. Average handicap weight had a heritability of 0.07 ± 0.03. The effects of sex (fixed) and trainer (random) were significant (P<0.05) for all performance traits relating to earnings measures, handicap weights and finish positions. The heritability of win time at 1600 m was 0.52 ± 0.06 and was the only significant estimate of heritability for win time in the current study.

CONCLUSIONS

Although significantly affected by multiple environmental factors, certain indicators of Hong Kong racing performance can be reliably used to predict the performance of the individual's progeny or siblings. However, despite Hong Kong's controlled racing environment, these indicators appear to be no more heritable than in other less controlled racing environments.

Epidemiology of musculoskeletal injuries in a population of harness Standardbred racehorses in training

Background

There is a substantial paucity of studies concerning musculoskeletal injuries in harness Standardbred racehorses. Specifically, little is known about the epidemiology of exercise-related musculoskeletal injuries. Most studies on this subject involve Thoroughbred racehorses, whose biomechanics and racing speed differ from Standardbred, making comparisons difficult. Here, a population of Standardbred racehorses trained at the same racecourse was studied over four years and a classification system for exercise-related musculoskeletal injuries was designed. The incidence rates of musculoskeletal injuries causing horses’ withdrawal from training for 15 days or longer were investigated. A mixed-effects Poisson regression model was used to estimate musculoskeletal injury rates and to describe significance of selected risk factors for exercise-related injuries in this population.

Results

A total of 356 trotter racehorses from 10 different stables contributed 8961 months at risk of musculoskeletal injuries. Four-hundred-and-twenty-nine injuries were reported and classified into 16 categories, based on their aetiology and anatomical localisation. The overall exercise-related injury rate was 4.79 per 100 horse months. When considering risk factors one by one in separate univariable analyses, we obtained the following results: rates did not differ significantly between genders and classes of age, whereas one driver seemed to cause fewer injuries than the others. Racing speed and racing intensity, as well as recent medical history, seemed to be significant risk factors (p < 0.001), while being shod or unshod during racing was not. On the other hand, when pooling several risk factors in a multivariable approach, only racing intensity turned out to be significant (p < 0.001), since racing speed and the racing intensity were partially confounded, being strongly correlated to one another.

Conclusion

Characterizing epidemiology of exercise-related musculoskeletal injuries in trotter racehorses provides baseline incidence rate values. Incidence rates of stress fracture are lower in Standardbreds compared to Thoroughbreds, whereas the opposite is true for tendon and suspensory ligament injuries. In addition to identification of risk factors for musculoskeletal injuries among Standardbred racehorses, results suggest that racing intensity seems to be a protective predictor of risk and recent medical history could be used to identify horses at risk of injury.

Improving the odds? How to pick the winner of the English Derby

Many consider the English Derby on Epsom Downs to be ‘The Blue Riband of the Turf’. The Epsom Derby has been run annually since 1780 and the colt Diomed was the first winner. Today the Epsom Derby, run over 1.5 miles, is one of five classic races and is the second leg of the English Triple Crown, preceded by the 2,000 Guineas and followed by the St Leger. The prize money for 2010 has been in excess of £1.25 million. To the best of our knowledge, whilst epidemiological techniques have previously been applied in an attempt to identify risk factors for injury, the purpose of the present study, which we believe is unique, was to use an epidemiological approach to analyse factors that may be predictive of success (or failure) in a single race over the course of a number of consecutive years: The Epsom Derby. Information on the horses competing in the last 22 runnings of the Epsom Derby between 1988 and 2009. Univariate and multivariable single-level and mixed effects logistic regression models were developed using winning the Epsom Derby as the dependent variable. Between 1988 and 2009 in 22 runnings of the Derby, a total of 344 horses started the Epsom Derby. The number of runners in the race has varied between 12 and 25 over the same time period. On average the probability of winning the Derby between 1988 and 2009 was approximately 6% (22/344), without accounting for any potentially predictive variables. Variables that were related to an increased chance of success were being the favourite (odds ratio (OR) 4.75; 95 % confidence interval (CI) 1.58-14.3; P=0.006), the number of 2-year old wins (OR 1.45; CI 1.03-2.04; P=0.03), being foaled in Ireland (OR 2.80; CI 1.12-7.04; P=0.041) and having the same jockey in all races throughout the horses career up to and including the Derby (OR 2.53; CI 1.0-6.41; P=0.05). The highest predictive probability was for horses that started the race as a favourite, were Irish bred, had been ridden by a single jockey and had won twice as a 2-year old. Although the point estimate for this probability was 52% the degree of uncertainty around this estimate was wide, i.e. the 95% CI was 17.5 to 86.5%. Nevertheless even at the lower confidence interval this still represents a significant improvement on the approximately 6% chance of picking a winner at random. In conclusion, using mixed effects logistic regression models would allow one to improve the odds of picking the winner of the Epsom Derby over the past 22 runnings.

Helical sub-structures in energy-storing tendons provide a possible mechanism for efficient energy storage and return

The predominant function of tendons is to position the limb during locomotion. Specific tendons also act as energy stores. Energy-storing (ES) tendons are prone to injury, the incidence of which increases with age. This is likely related to their function; ES tendons are exposed to higher strains and require a greater ability to recoil than positional tendons. The specialized properties of ES tendons are thought to be achieved through structural and compositional differences. However, little is known about structure-function relationships in tendons. This study uses fascicles from the equine superficial digital flexor (SDFT) and common digital extensor (CDET) as examples of ES and positional tendons. We hypothesized that extension and recoil behaviour at the micro-level would differ between tendon types, and would alter with age in the injury-prone SDFT. Supporting this, the results show that extension in the CDET is dominated by fibre sliding. By contrast, greater rotation was observed in the SDFT, suggesting a helical component to fascicles in this tendon. This was accompanied by greater recovery and less hysteresis loss in SDFT samples. In samples from aged SDFTs, the amount of rotation and the ability to recover decreased, while hysteresis loss increased. These findings indicate that fascicles in the ES SDFT may have a helical structure, enabling the more efficient recoil observed. Further, the helix structure appears to alter with ageing; this coincides with a reduction in the ability of SDFT fascicles to recoil. This may affect tendon fatigue resistance and predispose aged tendons to injury.

The role of the non-collagenous matrix in tendon function

Tendon consists of highly ordered type I collagen molecules that are grouped together to form subunits of increasing diameter. At each hierarchical level, the type I collagen is interspersed with a predominantly non-collagenous matrix (NCM) (Connect. Tissue Res., 6, 1978, 11). Whilst many studies have investigated the structure, organization and function of the collagenous matrix within tendon, relatively few have studied the non-collagenous components. However, there is a growing body of research suggesting the NCM plays an important role within tendon; adaptations to this matrix may confer the specific properties required by tendons with different functions. Furthermore, age-related alterations to non-collagenous proteins have been identified, which may affect tendon resistance to injury. This review focuses on the NCM within the tensional region of developing and mature tendon, discussing the current knowledge and identifying areas that require further study to fully understand structure-function relationships within tendon. This information will aid in the development of appropriate techniques for tendon injury prevention and treatment.

Derivation and characterization of induced pluripotent stem cells from equine fibroblasts

Pluripotent stem cells offer unprecedented potential not only for human medicine but also for veterinary medicine, particularly in relation to the horse. Induced pluripotent stem cells (iPSCs) are particularly promising, as they are functionally similar to embryonic stem cells and can be generated in vitro in a patient-specific manner. In this study, we report the generation of equine iPSCs from skin fibroblasts obtained from a foal and reprogrammed using viral vectors coding for murine Oct4, Sox2, c-Myc, and Klf4 sequences. The reprogrammed cell lines were morphologically similar to iPSCs reported from other species and could be stably maintained over more than 30 passages. Immunostaining and polymerase chain reaction analyses revealed that these cell lines expressed an array of endogenous markers associated with pluripotency, including OCT4, SOX2, NANOG, REX1, LIN28, SSEA1, SSEA4, and TRA1-60. Furthermore, under the appropriate conditions, the equine iPSCs readily formed embryoid bodies and differentiated in vitro into cells expressing markers of ectoderm, mesoderm, and endoderm, and when injected into immunodeficient mice, gave raise to tumors containing differentiated derivatives of the 3 germ layers. Finally, we also reprogrammed fibroblasts from a 2-year-old horse. The reprogrammed cells were similar to iPSCs derived from neonatal fibroblasts in terms of morphology, expression of pluripotency markers, and differentiation ability. The generation of these novel cell lines constitutes an important step toward the understanding of pluripotency in the horse, and paves the way for iPSC technology to potentially become a powerful research and clinical tool in veterinary biomedicine.

Risk factors for interruptions to training occurring before the first trial start of 2-year-old Thoroughbred racehorses

AIM

To quantify the time from the start of training to the first interruption and to identify horse and training risk factors for voluntary interruptions and interruptions due to musculoskeletal injury occurring before the first trial.

METHODS

A prospective cohort study was used to collect data on the training activity of 2-year-old racehorses, from 14 trainers in the Northern and Central Districts of New Zealand, over two racing seasons (2008/09 and 2009/10). Daily training data were recorded for each horse, including, distances worked at canter (>15 seconds/200 m), three measures of high-speed exercise (15, 13, and <12 seconds/200 m) and reasons why horses were not working. Competing risks survival analysis was used to investigate associations between risk factors and voluntary interruptions (no known condition or disease present), or interruptions due to musculoskeletal injury occurring before the first official trial.

RESULTS

A total of 205 horses spent 11,051 training days at risk of an interruption before the first trial. There were 134/205 (65.4%) cases of interruptions, of which 115/134 (85.8%) were voluntary interruptions and 19/134 (14.2%) were due to musculoskeletal injury. In the final multivariable models, the risk of voluntary interruptions decreased with increasing age at the start of training, and increased with the number of days off during training, but was not associated with gender. Females had a decreased risk of interruptions due to musculoskeletal injury compared with males. There was no association between the number of high-speed events and either voluntary interruptions or interruptions due to musculoskeletal injury.

CONCLUSIONS AND CLINICAL RELEVANCE

The study highlighted horse and training risk factors associated with two types of interruptions occurring during training. Identification of modifiable risk factors may help to reduce the proportion of horses experiencing an interruption before the first trial start, reducing the number of lost training days and the associated cost.

Risk factors for superficial digital flexor tendinopathy in Thoroughbred racehorses in steeplechase starts in the United Kingdom (2001-2009)

The objective of this study was to identify risk factors for superficial digital flexor (SDF) tendinopathy in Thoroughbred horses in steeplechase races in the United Kingdom. Potential risk factors for SDF tendinopathy were studied between 1st January 2001 and 31st December 2009 using a cohort study design with 648 injuries sustained in 102,894 starts. Potential risk factors were screened using univariable logistic regression prior to multivariable model building. In the final multivariable model, 12 statistically significant risk factors were identified. Variables that increased the odds of SDF tendinopathy included firmer going, increased horse age, and racing in the summer compared to other seasons. Variables that decreased the odds included having a higher official rating and the number of starts in the preceding days. Fewer and different risk factors were identified than in an equivalent model of SDF tendinopathy in hurdle racing, highlighting potential differences between these disciplines. Further collection of training and racecourse information would be beneficial and may help to explain further some of the associations identified in this study. The results will facilitate the development of strategies to improve overall safety of horses in UK steeplechase racing.

The pathogenesis of tendon microdamage in athletes: the horse as a natural model for basic cellular research

The equine superficial digital flexor tendon (SDFT) is a frequently injured structure that is functionally and clinically equivalent to the human Achilles tendon (AT). Both act as critical energy-storage systems during high-speed locomotion and can accumulate exercise- and age-related microdamage that predisposes to rupture during normal activity. Significant advances in understanding of the biology and pathology of exercise-induced tendon injury have occurred through comparative studies of equine digital tendons with varying functions and injury susceptibilities. Due to the limitations of in-vivo work, determination of the mechanisms by which tendon cells contribute to and/or actively participate in the pathogenesis of microdamage requires detailed cell culture modelling. The phenotypes induced must ultimately be mapped back to the tendon tissue environment. The biology of tendon cells and their matrix, and the pathological changes occurring in the context of early injury in both horses and people are reviewed, with a particular focus on the use of various tendon cell and tissue culture systems to model these events.

Comparison of equine tendon- and bone marrow-derived cells cultured on tendon matrix with or without insulin-like growth factor-I supplementation

OBJECTIVE

To compare in vitro expansion, explant colonization, and matrix synthesis of equine tendon- and bone marrow-derived cells in response to insulin-like growth factor-I (IGF-I) supplementation.

SAMPLE

Cells isolated from 7 young adult horses.

PROCEDURES

Tendon- and bone marrow-derived progenitor cells were isolated, evaluated for yield, and cultured on autogenous cell-free tendon matrix for 7 days. Samples were analyzed for cell viability and expression of collagen type I, collagen type III, and cartilage oligomeric matrix protein mRNAs. Collagen and glycosaminoglycan syntheses were quantified over a 24-hour period.

RESULTS

Tendon- and bone marrow-derived cells required 17 to 19 days of monolayer culture to reach 2 passages. Mean ± SE number of monolayer cells isolated was higher for tendon-derived cells (7.9 ± 0.9 × 10(6)) than for bone marrow-derived cells (1.2 ± 0.1 × 10(6)). Cell numbers after culture for 7 days on acellular tendon matrix were 1.6- to 2.8-fold higher for tendon-derived cells than for bone marrow-derived cells and 0.8- to 1.7-fold higher for IGF-I supplementation than for untreated cells. New collagen and glycosaminoglycan syntheses were significantly greater in tendon-derived cell groups and in IGF-I-supplemented groups. The mRNA concentrations of collagen type I, collagen type III, and cartilage oligomeric matrix protein were not significantly different between tendon- and bone marrow-derived groups.

CONCLUSIONS AND CLINICAL RELEVANCE

In vitro results of this study suggested that tendon-derived cells supplemented with IGF-I may offer a useful resource for cell-based strategies in tendon healing.