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Equine veterinary journal2004; 36(5); 415-419; doi: 10.2746/0425164044868422

Medical management of superficial digital flexor tendonitis: a comparative study in 219 horses (1992-2000).

Abstract: There is a lack of long-term follow-up data for outcome of medical treatment of superficial digital flexor (SDF) tendonitis. Objective: To determine whether intralesional injection of hyaluronan, beta aminoproprionitrile fumarate (BAPN) or polysulphated glycosaminoglycans (PSGAG) or systemic administration of PSGAG yielded better results than a controlled exercise programme alone in the management of SDF tendonitis, with a minimum follow-up period of 2 years after resumption of full work; and to determine whether reinjury rate was related to sports discipline and whether fibre alignment score (FAS) at 4 months could predict outcome. Methods: In Study 1, 50 horses were managed by controlled exercise alone (Group A), 50 were treated with intralesional injection of hyaluronan (Group B), 20 received intralesional and systemic treatment with PSGAG (Group Ci) and 30 received systemic treatment with PSGAG (Group Cii). Horses in Groups B, Ci and Cii followed the same controlled exercise programme as Group A. In Study 2, 69 horses (Group D) were treated by intralesional injection of BAPN and followed a modified controlled exercise programme. Horses were re-examined clinically and ultrasonographically at intervals. Follow-up data were obtained for horses 2 years after resuming full work and for up to 6 years. Results: There was no significant difference in reinjury rate of the treated limb(s) between Groups A, B, Ci and Cii (42.5-44.4%) (P>0.9). The reinjury rate (16%) in the treated limb(s) in Group D was significantly lower than in the other groups (P<0.001). However, when injury rate of the uninjured limb was considered, the results were similar to Study 1. In Study 2, the FAS at 4 months after treatment was a good predictor of outcome (P<0.001). Reinjury rates for different disciplines were similar in the 2 studies, with the risk of reinjury ascending from showjumpers to event horses to National Hunt and flat racehorses. Conclusions: Treatment with BAPN reduced the risk of reinjury in the treated limb, although the overall rate of subsequent injury was not affected. FAS at 4 months after treatment is a good predictor of outcome in the treated limb(s). Conclusions: This study provides long-term follow-up data in horses from a variety of sports disciplines that can be used to provide prognostic information.
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Publication Date: 2004-07-16 PubMed ID: 15253082DOI: 10.2746/0425164044868422Google Scholar: Lookup
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  • Comparative Study
  • Journal Article

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.

The study endeavors to compare several methods of short-term medical treatment for superficial digital flexor (SDF) tendonitis in horses regarding long-term recovery results, and to investigate if certain sports disciplines or initial injury scoring determines reinjury rates. The study finds that a treatment with the use of beta aminoproprionitrile fumarate (BAPN) effectively reduces the risk of reinjury, and that fiber alignment score (FAS) offers indicative predictive value of recovery outcome.

Study Design and Procedure

  • The research features two parts. An initial division of horses into four groups, each receiving different treatments, and a secondary study involving a different method of treatment and controlled exertion.
  • Group A were exposed solely to a regimen of controlled exercise. Group B received the same exercise regimen in addition to intralesional injections of hyaluronan. Group Ci received intralesional and systemic treatment with PSGAG, again adhering to the same exercise regimen. Group Cii were similar to Group Ci but only received systemic treatment with PSGAG.
  • The second part of the study, Group D horses followed a different exercise regimen and were treated with intralesional injections of BAPN.
  • All horses were monitored and periodically reevaluated for up to six years after they resumed full work.

Major Findings of the Study

  • In terms of reinjury rates in the treated limbs, no significant differences were found between the first four groups (Groups A, B, Ci, and Cii).
  • Group D displayed a significantly lower reinjury rate in the treated limb(s) when compared to the other groups.
  • However, if the reinjury rate of the untreated limb was considered, Group D’s results matched those of Study 1.
  • FAS at 4 months after treatment served as a strong predictor of the treatment outcome in Study 2.
  • Reinjury rates for various sports disciplines remained consistent between both studies, with the risk ascending from showjumpers, to event horses, to National Hunt, and finally peaking with flat racehorses.

Implications and Conclusions

  • It was concluded the use of BAPN effectively lowers the risk of reinjury in the treated limb. However, this did not affect the overall rate of subsequent injuries.
  • In addition, the study indicates that the FAS taken 4 months post-treatment offers a strong predictive outlook on recovery.
  • This comprehensive long-term study provides valuable prognostic information to be used in the care and management of horses across different sports disciplines suffering from SDF tendonitis.

Cite This Article

APA
Dyson SJ. (2004). Medical management of superficial digital flexor tendonitis: a comparative study in 219 horses (1992-2000). Equine Vet J, 36(5), 415-419. https://doi.org/10.2746/0425164044868422

Publication

Equine veterinary journal
ISSN: 0425-1644
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 36
Issue: 5
Pages: 415-419

Researcher Affiliations

Dyson, S J
  • Centre for Equine Studies, Animal Health Trust, Lanwades Park, Kentford, Newmarket, Suffolk CB8 7UU, UK.

MeSH Terms

  • Adjuvants, Immunologic / therapeutic use
  • Aminopropionitrile / therapeutic use
  • Animals
  • Exercise Therapy
  • Follow-Up Studies
  • Glycosaminoglycans / therapeutic use
  • Horse Diseases / diagnostic imaging
  • Horse Diseases / drug therapy
  • Horse Diseases / pathology
  • Horses / injuries
  • Hyaluronic Acid / therapeutic use
  • Recurrence
  • Rest / physiology
  • Tendinopathy / diagnostic imaging
  • Tendinopathy / drug therapy
  • Tendinopathy / pathology
  • Tendinopathy / veterinary
  • Time Factors
  • Treatment Outcome
  • Ultrasonography

Citations

This article has been cited 63 times.
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