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Equine veterinary journal2026; doi: 10.1002/evj.70151

Clinical and research applications of synthetic bone substitutes in equine veterinary medicine: A systematic review.

Abstract: Bone grafting in equine medicine offers a promising contribution to treating orthopaedic developmental diseases and chondral, osteochondral and segmental bone defects. Among grafts, synthetic bone substitutes-alloplastics-show favourable biological properties addressing numerous limitations presented by autografts, xenografts and allografts. Objective: To compile and disseminate clinical data and research findings from existing publications on the use of alloplastics in horses. Methods: Systematic review. Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-analysis 2020 guidelines, literature searches were conducted in PUBMED, Scopus and Web of Knowledge. The inclusion criteria covered case reports and research articles on the use of alloplastics in the horses. The selected research articles were grouped considering clinical and experimental studies. A risk of bias assessment was performed for the research articles. Results: Use of synthetic bone substitutes in horses has been described in 17 publications to date, grouped as 5 case reports and 12 research articles. The latter were subdivided by main study issue-as involved subchondral cystic lesion, aneurysmal bone cyst and chondral, osteochondral or segmental bone defects. The four treatment models were distinguished and described. Conclusions: The lack of clinical and alloplastics data in some records. Clinical evaluation in some studies was inconsistent or incomplete. A risk of bias particularly arises from missing data, outcome measurement and the reported results. Conclusions: In equine medicine, hydroxyapatite, calcium phosphate and β-tricalcium phosphate were the leading alloplastics applied. When applied alone, they demonstrated osteoconductive and osteoinductive properties, while the addition of biologically active additives-especially autologous bone marrow-enhanced these biological properties toward osteogenic and chondrogenic effects. Treatment outcomes were generally favourable, although segmental bone defect treatment requires considering the limitations associated with weight-bearing effects. These findings suggest alloplastics in horses may be particularly beneficial for treating certain bone diseases.
© 2026 The Author(s). Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.
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Publication Date: 2026-02-24 PubMed ID: 41732106DOI: 10.1002/evj.70151Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

Overview

  • This systematic review examines the use of synthetic bone substitutes, known as alloplastics, in equine veterinary medicine for treating various bone-related conditions.
  • It compiles clinical and research data on their effectiveness, biological properties, and potential applications in horses.

Introduction to Synthetic Bone Substitutes in Equine Medicine

  • Bone grafting is an important technique used to treat orthopedic developmental diseases and bone defects in horses.
  • Conventional grafts include autografts (from the same individual), allografts (from another individual of the same species), and xenografts (from different species), but all have limitations such as availability, immune rejection, or disease transmission risk.
  • Alloplastics (synthetic bone substitutes) offer favorable biological properties and avoid many of these issues.
  • This review focuses on clinical and research applications of alloplastics specifically in horses.

Methods

  • The authors conducted a systematic literature search using databases like PUBMED, Scopus, and Web of Knowledge following PRISMA 2020 guidelines.
  • They included published case reports and research articles that involved the use of synthetic bone substitutes in horses.
  • Selected studies were categorized into clinical and experimental groups.
  • A risk of bias assessment was performed focusing on issues like missing data and measurement inconsistencies.

Results

  • A total of 17 publications met inclusion criteria: 5 were case reports and 12 were research articles.
  • The research articles addressed four main types of bone conditions:
    • Subchondral cystic lesions
    • Aneurysmal bone cysts
    • Chondral (cartilage), osteochondral (bone and cartilage), and segmental bone defects
  • Four treatment models using alloplastics were described, although specifics were not detailed in the abstract.
  • Common synthetic materials used in these treatments included:
    • Hydroxyapatite
    • Calcium phosphate
    • β-tricalcium phosphate

Biological Properties and Enhancement Strategies

  • When used alone, these synthetic substitutes demonstrated:
    • Osteoconductive properties – providing a scaffold for new bone growth
    • Osteoinductive properties – encouraging new bone formation by stimulating precursor cells
  • The addition of biologically active substances, especially autologous bone marrow (taken from the same horse), enhanced these effects:
    • Boosted osteogenic activity – formation of new bone cells
    • Promoted chondrogenic effects – cartilage repair or regeneration

Clinical Outcomes and Considerations

  • Treatment outcomes using synthetic bone substitutes generally were favorable across studied conditions.
  • However, segmental bone defects, which involve larger and weight-bearing areas, require special consideration due to mechanical limitations.
  • The review noted inconsistencies and incompleteness in some clinical evaluations, limiting the strength of conclusions.
  • Bias was detected mainly from missing data, varying outcome measurements, and incomplete reporting.

Conclusions and Implications

  • The systematic review highlights that alloplastics are promising materials for treating various bone diseases in horses.
  • These materials offer advantages over traditional grafts, such as reduced immunogenic reaction and availability.
  • Combining synthetic materials with biological additives like bone marrow may further improve bone healing and cartilage repair.
  • More rigorous, standardized clinical studies with complete data are needed to better assess efficacy, especially for weight-bearing segmental defects.
  • Overall, synthetic bone substitutes represent an important, evolving tool in equine orthopedics for addressing developmental and traumatic bone conditions.

Cite This Article

APA
Skierbiszewska K, Turek B, Jasiński T, Kaczorowski M, Kozłowska N, Higuchi J, Domino M. (2026). Clinical and research applications of synthetic bone substitutes in equine veterinary medicine: A systematic review. Equine Vet J. https://doi.org/10.1002/evj.70151

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English

Researcher Affiliations

Skierbiszewska, Katarzyna
  • Department of Large Animal Diseases and Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences (WULS - SGGW), Warsaw, Poland.
Turek, Bernard
  • Department of Large Animal Diseases and Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences (WULS - SGGW), Warsaw, Poland.
Jasiński, Tomasz
  • Department of Large Animal Diseases and Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences (WULS - SGGW), Warsaw, Poland.
Kaczorowski, Michał
  • Private Equine Practice, Grodzisk Mazowiecki, Poland.
Kozłowska, Natalia
  • Department of Large Animal Diseases and Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences (WULS - SGGW), Warsaw, Poland.
Higuchi, Julia
  • Laboratory of Nanostructures and Nanomedicine, Institute of High Pressure Physics, Polish Academy of Sciences (PAS), Warsaw, Poland.
Domino, Małgorzata
  • Department of Large Animal Diseases and Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences (WULS - SGGW), Warsaw, Poland.

Grant Funding

  • The publication was (co)financed by Science development fund of the Warsaw University of Life Sciences - SGGW.

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