Case 2: Managing Grade 4 LF Lameness with Tendon Injury and Structured Rehabilitation

OVERVIEW

The horse presented with

• Grade 4 LF lameness, a DDF tendon tear.
• Ultrasound showing fibrosis alongside the new tear, indicating both chronic and acute injury in the same limb.

Day 0 · Grade 4 LF lameness, visible swelling at suspensory branch

TREATMENT APPROACH

The plan, in order

• equicenta® CTM injection at the tear site
• Corrective shoeing to reduce tendon strain
• Stall rest followed by controlled rehabilitation
• Ongoing monitoring and progressive load

OUTCOME AT 30 DAYS

Day 30 — Early Response

Day 30 · Reduced swelling, early improvement in symmetry

At early re-evaluation, gait analysis indicated an early positive response to treatment. Symmetry and movement patterns showed measurable improvement. The horse remained within a controlled rehabilitation phase.

OUTCOME AT 90 DAYS

Day 90 — Cleared for Work

Full Day 30 vs. Day 90 gait comparison

At follow-up, the horse was cleared for return to under-saddle work. Symmetry was restored and limb function had improved significantly. The horse progressed back toward performance and was preparing for transition to Wellington.

WHY THIS CASE MATTERS

Several considerations in equine musculoskeletal tissue injury

1. Chronic and acute injury often coexist

Ultrasound showing fibrosis alongside a new tear demonstrates how past tissue changes and new injury often present in the same limb, requiring a layered approach to care.

2. Structured rehabilitation is critical

Recovery was not driven by intervention alone, but by the combination of:

• Mechanical support
• Controlled loading
• Progressive rehabilitation

3. Biologic support enhances the environment for recovery

In cases like this, biologic therapies can:

• Support local tissue structure
• Modulate inflammatory response
• Contribute to a more favorable healing environment

CLINICAL TAKEAWAY

Complex musculoskeletal tissue injury rarely responds to single-modality intervention. This case demonstrates the value of biologic support within a structured, multimodal recovery plan.¹

For horses presenting with

• Severe lameness
• Tendon injury with concurrent chronic fibrosis
• Evidence of both chronic and acute tissue damage

A comprehensive, multimodal approach is essential. This case demonstrates that even in complex musculoskeletal tissue injuries, it is possible to:

• Improve movement symmetry
• Progress safely through rehabilitation
• Return to performance activity

FINAL THOUGHT

Horse First. Sport Second.

At Equine Performance Labs, cases like this reinforce our core belief: because meaningful recovery isn’t just about returning to work — it’s about restoring stability, function, and confidence in every step forward.