Are matrix and vascular changes involved in the pathogenesis of deep digital flexor tendon injury in the horse?

It was hypothesised that there is increased blood vessel frequency and proteoglycan staining intensity within the distal aspect of the deep digital flexor tendon (DDFT) in horses with chronic foot pain. Samples of the DDFT from three standardised sites from 10 age-matched mature horses, with chronic foot pain (Group L) or with no history of forelimb lameness (Group N), were collected for this study. A histological analysis of haematoxylin and eosin-stained sections focussed on the frequency and location of blood vessels, while safranin 0 fast green staining was used for semi-quantitative assessment of matrix proteoglycan. The frequency and immunoreactivity of endothelial cell-labelled blood vessels were determined using factor VIII immunolocalisation. There was increased frequency of blood vessels (P=0.048) and increased proteoglycan staining intensity (P=0.028) in Group L, compared with Group N. Qualitative micro-anatomical differences in the matrix and tenocytes were noted between Groups N and L. There was reduced factor VIII staining within the vasculature of horses from Group L, compared with Group N. The results suggested that chronic foot pain may be associated with altered DDFT matrix composition, which could be a potential indicator of degenerative change. The increased vascularity may represent a reparative response to a degenerative tendonopathy.