The Equine Hindlimb Proximal Suspensory Ligament: an Assessment of Health and Function by Means of Its Damping Harmonic Oscillator Properties, Measured Using an Acoustic Myography System: a New Modality Study
Injury to the proximal suspensory ligament (PSL) is common in most types of athletic horses and can account for up to 46% of all limb injuries.
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Acoustic myography provides a quantitative assessment of tissue function.
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Acoustic myography sensors can be used to record the shock waves that are transmitted through the suspensory tissue after foot impact, and as such monitor the ability of the suspensory system to act as a damping harmonic oscillator.
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There was a significant difference in CURO score between horses with evidence of PSL injury and all other groups. Correlations showed that PSLs were healthy with a score >5 (60% of SOUND horses; 87% of PSL-TREATED), had low-level injury at scores 2.5–4.5, and had severe injuries at scores <2.
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Acoustic myography is a promising diagnostic tool to detect injuries of the proximal suspensory ligament in horses.
Abstract
Enhanced, objective systems for evaluation of the proximal suspensory ligament are needed to hasten appropriate diagnosis and treatment of injury. This study compared the in vivo acoustic signals generated by healthy and injured hindlimb proximal suspensory ligaments (PSLs) in horses and determined if an acoustic myography (AMG) system was an acceptable tool to aid in diagnosis. Complete lameness evaluations were performed on 96 horses either with a history or suspicion of hindlimb lameness. Acoustic myography signals were acquired with the aid of a CURO from the hindlimbs after a moving evaluation and before additional procedures. For all horses with hindlimb lameness, diagnostic analgesia and appropriate imaging were performed to reach a causative diagnosis for the lameness. The signals obtained were analyzed by blinded evaluators via CURO algorithms and scored from 0 to 10 (poor to optimal). Eighty-five horses in total provided adequate diagnostic data. Of these, 15 (17.7%) horses were clinically sound, 48 (56.5%) horses had clinical evidence of PSL injury, 4 (4.7%) horses were recovering from prior PSL injuries, and 18 (21.1%) horses had another cause of hindlimb lameness. There was a significant difference (P > .001) in the CURO score between horses with evidence of PSL injury and all other groups. Correlations showed that PSLs were healthy with a score >5 (60% of SOUND horses; 87% of PSL-TREATED), had low-level injury at scores 2.5–4.5, and severe injuries at scores <2. It is concluded that AMG is a promising diagnostic tool to detect injuries of the proximal suspensory ligament in horses.
Keywords
CURO
Acoustic myography
Equine
Suspensory desmitis
Lameness
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Animal welfare/ethical statement: The study was approved by the management and ownership of Virginia Equine Imaging and had informed consent of the owners. There was no ethical issue in this study because all the subjects were healthy. Moreover, the measuring equipment used complied with both CE and FCC regulations and was noninvasive in its nature. The study was carried out according to the guidelines laid out in the Helsinki Declaration (https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-human-subjects/) so as to protect owners names, gender, and other personal data.
Conflict of interest statement: A.P.H. is currently trying to commercialize the CURO system (CURO.diagnostics) and is establishing a company to cover the costs of future development. The CURO system was provided to Virginia Equine Imaging at no cost. Virginia Equine Imaging and its staff and doctors were not compensated for this study.
