🐴 Suspensory Ligament Injuries in Horses: Advanced Treatment Options in 2025 🧬🦵

By Dr Duncan Houston BVSc

Suspensory ligament injuries are one of the most common and career-threatening issues for performance horses. Located at the back of the cannon bone, the suspensory ligament provides critical support to the fetlock joint and absorbs high-impact forces during motion. In 2025, new surgical and regenerative techniques offer fresh hope for horses that previously faced poor prognosis. 🐎🧠

📍 What Is the Suspensory Ligament?

This major ligament runs from the top of the cannon bone to the sesamoid bones near the fetlock. It splits into branches near the bottom and helps stabilize the lower limb during weight-bearing. 🦵

💥 How Injuries Happen

Suspensory ligament injuries may occur in two ways:

• 🧩 Chronic degeneration over time with microtears
• ⚡ Acute rupture during high-intensity movement or jumping

They are common in show jumpers, dressage horses, reiners, and eventers. Hindlimb injuries are especially difficult to treat due to poor blood supply and proximity to bony structures. ⚠️

🧪 Why These Injuries Heal Poorly

Ligaments heal slowly and poorly because:

• ⏳ They have limited blood flow
• 🧱 Healing occurs with scar tissue that lacks elasticity
• 📉 Scarred ligaments are prone to re-injury

Traditional rest and rehab yield only 20–40% full return to work rates—especially for hindlimb injuries. 🧠📊

🛠️ Fasciotomy: A Surgical Breakthrough

One of the most promising advancements is the fasciotomy with neurectomy procedure. Developed in the UK and now used in the U.S., including at Washington State University, it involves:

• ✂️ Cutting the fascia surrounding the ligament to reduce internal pressure
• 🔪 Neurectomy—removing or cutting the nerve supplying sensation to the ligament

These procedures help reduce chronic pain and improve the healing environment, allowing for more effective recovery. 🏥🧠

🧬 Stem Cell Therapy for Ligament Healing

Washington State and other equine clinics also now incorporate bone marrow-derived stem cell therapy to regenerate ligament tissue:

1. 🦴 Bone marrow is harvested from the horse
2. 🧪 Stem cells are cultured over 2–3 weeks
3. 💉 Injected directly into the injured ligament site

Stem cells stimulate the body’s repair processes, promoting tissue more similar to normal ligament fiber rather than scar. 🧬💡

📋 Diagnosis & Imaging

Suspensory injuries are diagnosed with:

• 📸 Ultrasound—to evaluate fiber damage and enlargement
• 🧲 MRI—for chronic or deep branch lesions
• 📍 Nerve blocks—to confirm the source of lameness

Baseline imaging is crucial for monitoring healing and making surgical decisions. 🎯

🛌 Recovery Timeline

Recovery from suspensory injuries, even with advanced treatments, is slow:

• 📆 Conservative therapy: 6–12 months
• 🔪 Surgical + stem cell: 4–8 months (with faster tissue regeneration)

Rehabilitation must be progressive and monitored—starting with stall rest and leading to hand walking, then light exercise. ⏳🏃‍♂️

⚠️ Complications & Risk Factors

Factors that worsen prognosis:

• 🐎 Chronic degeneration before treatment
• ⚙️ Improper hoof balance or shoeing
• 🔄 Previous suspensory injury

Working closely with your vet and farrier is essential for long-term success. 🧠🔧

📲 Ask A Vet for Treatment Guidance

Suspensory injuries can end a horse’s career—or become a manageable condition with the right care. Visit AskAVet.com or use the Ask A Vet App to connect with professionals who can evaluate your horse’s ultrasound, recommend rehab schedules, and assess surgical options. 📱🐴

Dr Duncan Houston and the team can help you navigate new therapies like stem cells and fasciotomy for optimal recovery. 🧬💬

🏁 Final Thoughts

Suspensory ligament injuries are serious—but not hopeless. In 2025, the combination of fasciotomy, regenerative medicine, and customized rehab is changing outcomes for horses previously written off. 🧠💪

Looking to bring your horse back from a suspensory injury? Visit AskAVet.com for expert care planning today 🐎🧬