Evaluating treatment choices for tendon, ligament injury and joint disease in the horse
Apr 01, 2009
This multitude of choices has produced some confusion, and many equine veterinarians have been looking for some research or clinical evidence that will help clarify the issue.
But there is a lack of comparative studies with head-to-head testing, making correct and efficacious choices from among the many options difficult. Similar cases referred to different veterinary schools or to different clinical centers often are treated with differing modalities, furthering the confusion. Published research tends to evaluate an individual therapy itself without comparison or contrast to other methods of healing.Dr. Rodger Smith of the Department of Veterinary Clinical Sciences at the Royal Veterinary College, University of London, makes this point in an article in the British Journal of Sports Medicine.
Studies comparing different treatment options for tendon injuries with good rest/rehabilitation programs are not available, and it is questionable if they will even be done.
There is little commercial benefit in proving that "rest works best," and the practical issues of doing tendon injury and healing studies may make such clinical trials realistically impossible.
Clients have heard the claims of faster, stronger healing with various treatments, so getting "control" horses in a study that do not receive these treatments or comparative horses treated conservatively is very difficult.
Without comparative research to guide the decision-making process for the average practitioner, it may be beneficial to look at current treatments used for various cases and problems from the standpoint of clinicians, researchers and practitioners who are more familiar with these therapy options and have found some "comfort zone" through their application to numerous cases.
While this cannot be an exhaustive review and there certainly is room for other opinions, this is the current state of knowledge for use of these treatments in the athletic horse.