Ultrasound-guided intralesional tendon and ligament injections in the horse.

Ultrasound-guided intralesional injection optimizes precision and safety of orthobiologic delivery in equine tendon/ligament injuries.

This article describes ultrasound-guided intralesional injection techniques for delivering regenerative orthobiologics into equine tendon and ligament lesions. The protocol involves sedation and perineural anesthesia of the affected limb, followed by ultrasonographic identification of the lesion in transverse and longitudinal planes. Under sterile conditions, the needle is advanced to the hypoechoic core or region of fiber disruption while visualized on ultrasound. Common injectates include platelet-rich plasma (PRP), bone marrow aspirate concentration (BMAC), mesenchymal stem cells (MSCs), and autologous conditioned serum/protein solution (ACS/APS), with volumes determined by product type and lesion size. Real-time ultrasound monitoring confirms intralesional placement and injectate dispersion throughout the procedure. Clinical recommendations suggest treating tendon and ligament injuries during the sub-acute phase or within weeks of injury. The technique minimizes iatrogenic trauma, improves delivery accuracy, and enhances the therapeutic success of orthobiologic treatments in equine patients.

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