Pathobiology of Tendon and Ligament Injuries

Tendon and ligament injuries are common in athletic horses and can be difficult to treat successfully. Tendons and ligaments are characterized by sparse fibroblasts embedded in a complex structural hierarchy of collagen-rich extracellular matrix (ECM) organized along lines of tension. This precise organizational scheme imparts the necessary mechanical properties for tendons and ligaments to function under high loads. The etiology of tendon and ligament injuries remains the subject of numerous ongoing research projects; however, acute overloading and accumulated microtrauma are the two predominant theories. Under normal physiologic loading, a balance is maintained between the degeneration of ECM and its repair by the resident fibroblast population. When damage occurs faster than it can be repaired, clinical signs of tendonitis or desmitis develop. The molecular and cellular responses that occur during tendon and ligament healing are important to understand, as they provide key points of control that may be targeted for new therapies.