Treatment of chronic proximal suspensory desmitis in horses using focused electrohydraulic shockwave therapy.
Abstract: The objective of the present clinical report was to investigate the short- and long-term outcomes of chronic proximal suspensory desmitis (PSD) treated with Extracorporeal Shockwave Treatment (ESWT). Fifty-two horses with chronic PSD in the forelimb (34 cases) or hindlimb (22 cases) were included in the study. Three horses had lesions in both hindlimbs and one in both forelimbs. The origin of the suspensory ligament was treated every three weeks for a total of three treatments using 2000 impulses applied by a focused ESWT device (Equitron) at an energy flux density of 0.15 mJ/ mm2. This treatment regime was followed by box rest and a controlled exercise program of 12 weeks duration. The horses were assessed 3, 6, 12, 24 weeks and one year after the first treatment. Of the 34 cases with forelimb PSD, 21 (61.8%) had returned to full work by six months after diagnosis and 19 cases (55.9%) were still in full work one year after ESWT. Of the 22 horses with hindlimb PSD, 9 (40.9%) had returned to full work by six months and 4 (18.2%) were still in full work one year after diagnosis. There was no association (chi-square test) between the outcome and the severity of the initial ultrasonographic and/or radiographic findings. Compared with the results of other clinical studies, these findings suggest that in horses with PSD of fore- and hindlimb, the prognosis for returning to full work six months after diagnosis can be improved when ESWT and a controlled exercise program are used. However, a high rate of recurrence occurred in the hindlimb despite treatment.
Publication Date: 2006-11-02 PubMed ID: 17076464DOI: 10.1024/0036-7281.148.10.561Google Scholar: Lookup
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- Clinical Trial
- Comparative Study
- Journal Article
Summary
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This research investigates the effectiveness of using Extracorporeal Shockwave Treatment (ESWT) in treating chronic proximal suspensory desmitis (PSD) in horses, illustrating a general improvement in prognosis but also a significant recurrence rate, especially in the hindlimb.
Study Design and Procedure
- The study was carried out on fifty-two horses suffering from chronic PSD in either their forelimbs (34 cases) or hindlimbs (22 cases). Three horses had lesions in both hindlimbs and one in both forelimbs.
- The treatment consisted of aiming the origin of the suspensory ligament with 2000 impulses every three weeks, for a total of three treatments. This was carried out using a focused ESWT device named Equitron with an energy flux density of 0.15 mJ/mm2.
- In addition to the ESWT, a controlled exercise program and box rest of 12 weeks duration were implemented.
Assessment and Results
- Assessments were carried out at intervals of 3, 6, 12, 24 weeks, as well as one year after commencing the treatment.
- Among the cases of forelimb PSD, 21 (61.8%) had returned to full work by six months after diagnosis and 19 (55.9%) remained in full work one year post-treatment.
- The results were less encouraging for the hindlimb cases, where 9 (40.9%) had returned to full work within six months and only 4 (18.2%) were still functioning at maximum capacity after a year.
- The severity of initial indications such as radiographic and ultrasonographic findings did not seem to influence the eventual outcome of the treatment (determined via a chi-square test).
Conclusions
- The findings indicate that using ESWT and a controlled exercise program together can enhance the prognosis for horses with PSD in both fore- and hindlimbs, in terms of returning to full work within six months of diagnosis.
- However, the study also reveals a significant recurrence rate, especially in cases dealing with the hindlimb. More research is needed to improve treatment strategy and reduce this reoccurrence of chronic PSD.
Cite This Article
APA
Lischer CJ, Ringer SK, Schnewlin M, Imboden I, Fürst A, Stöckli M, Auer J.
(2006).
Treatment of chronic proximal suspensory desmitis in horses using focused electrohydraulic shockwave therapy.
Schweiz Arch Tierheilkd, 148(10), 561-568.
https://doi.org/10.1024/0036-7281.148.10.561 Publication
Researcher Affiliations
- Weipers Centre for Equine Welfare, University of Glasgow, Scotland, UK. C.Lischer@vet.gla.ac.uk
MeSH Terms
- Animals
- Female
- Forelimb / diagnostic imaging
- Hindlimb / diagnostic imaging
- Horse Diseases / classification
- Horse Diseases / diagnosis
- Horse Diseases / therapy
- Horses
- Lameness, Animal / classification
- Lameness, Animal / diagnosis
- Lameness, Animal / therapy
- Ligaments / diagnostic imaging
- Ligaments / pathology
- Lithotripsy / veterinary
- Male
- Radiography
- Time Factors
- Treatment Outcome
- Ultrasonography
Citations
This article has been cited 8 times.- Toner S, Crosby C. Pro-stride and extracorporeal shockwave therapy as treatment of lateral collateral desmopathy of the proximal interphalangeal joint in a Dutch Warmblood gelding. Can Vet J 2023 Mar;64(3):268-274.
- Boström A, Bergh A, Hyytiäinen H, Asplund K. Systematic Review of Complementary and Alternative Veterinary Medicine in Sport and Companion Animals: Extracorporeal Shockwave Therapy. Animals (Basel) 2022 Nov 12;12(22).
- Maleas G, Mageed M. Effectiveness of Platelet-Rich Plasma and Bone Marrow Aspirate Concentrate as Treatments for Chronic Hindlimb Proximal Suspensory Desmopathy. Front Vet Sci 2021;8:678453.
- Seabaugh KA, Thoresen M, Giguère S. Extracorporeal Shockwave Therapy Increases Growth Factor Release from Equine Platelet-Rich Plasma In Vitro. Front Vet Sci 2017;4:205.
- Raabe O, Shell K, Goessl A, Crispens C, Delhasse Y, Eva A, Scheiner-Bobis G, Wenisch S, Arnhold S. Effect of extracorporeal shock wave on proliferation and differentiation of equine adipose tissue-derived mesenchymal stem cells in vitro. Am J Stem Cells 2013;2(1):62-73.
- Qiu Z, Wang J, Zhang Y, Liu X, Wei C, Ma T. Extracorporeal shock wave therapy for equine musculoskeletal disorders: from biological mechanisms to clinical applications. Front Vet Sci 2025;12:1719123.
- Jacobs C, Schnabel LV, Redding Horne C, Tufts S, Martin EGM, Love K. Postoperative management following equine orthopedic surgery: a survey of diplomates of the ACVS and ACVSMR. Front Vet Sci 2025;12:1708401.
- Guest DJ, Birch HL, Thorpe CT. A review of the equine suspensory ligament: Injury prone yet understudied. Equine Vet J 2025 Sep;57(5):1167-1182.
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