Short- and long term follow-up of 150 sports horses diagnosed with tendinopathy or desmopathy by ultrasonographic examination and treated with high-power laser therapy

Blood flow restriction training does not negatively alter the mechanical strength or histomorphology of uninjured equine superficial digital flexor tendons

BACKGROUND

Low load exercise training with blood flow restriction (BFR) has become increasingly used by human physical therapists to prescribe controlled exercise following orthopaedic injury; its effects on the equine superficial digital flexor tendon (SDFT), however, are unknown.

OBJECTIVE

To investigate outcomes of pressure specific BFR walking exercise on uninjured equine SDFT biomechanics and histomorphology.

STUDY DESIGN

Controlled in vivo experiment.

METHODS

Four forelimbs of four horses were exposed to 40 BFR-walk sessions (10-min interval walking) on a treadmill over a 56-day study period with their contralateral forelimbs serving as untreated controls. Similarly, four forelimbs of four control horses were exposed to 40 sham cuff walk sessions. On study Day 56, all horses (n = 8) were humanely euthanised and forelimb SDFTs underwent non-destructive biomechanical testing and corresponding histomorphological analysis. Significance in biomechanical parameters between treatment groups was analysed using a mixed-effects ANOVA with Tukey's post-hoc tests.

RESULTS

Statistically significant differences in SDFT stiffness for both first (p = 0.02) and last cycles (p = 0.03) were appreciated within the BFR treated group only, with BFR exposed forelimbs being significantly stiffer than the contralateral unexposed forelimbs. When normalised to cross-sectional area, no significant differences were appreciated among treatment groups in elastic modulus for the first (p = 0.5) or last cycles (p = 0.4). No histological differences were appreciated among treatment groups according to Bonar, Movin, or musculotendinous junction evaluation criteria.

MAIN LIMITATIONS

Short-term comparisons were performed in a small sample population without correlation to performance outcome measures. Optimal occlusion percentages and walk protocols remain unknown.

CONCLUSIONS

This study demonstrated no negative impact of BFR on mechanical strength of the equine SDFT; however, evidence suggests that BFR results in increased tendon stiffness based on biomechanical testing and subsequent calculations. No consistent detrimental histomorphological changes were seen.

Biocompatibility of hydrogel derived from equine tendon extracellular matrix in horses subcutaneous tissue

Tendinopathies account for a substantial proportion of musculoskeletal injuries. To improve treatment outcomes for partial and total tendon ruptures, new therapies are under investigation. These include the application of mesenchymal stem cells (MSCs) and biocompatible scaffolds derived from the Extracellular Matrix (ECM). Synthetic polymer hydrogels have not demonstrated results as promising as those achieved with ECM hydrogels sourced from the original tissue. This study aimed to evaluate the biocompatibility of a hydrogel formulated from equine tendon ECM. Six horses were administered three subcutaneous doses of the hydrogel, with a saline solution serving as a control. Biopsies were conducted on days 7, 14, and 56 post-application to gauge the hydrogel's impact. Throughout the experiment, the horse's physical condition remained stable. Thermographic analyses revealed a temperature increase in the treated groups compared to the control group within the initial 12 h. The von Frey test, used to measure the mechanical nociceptive threshold, also showed significant differences between the treated group and the control group at 6 h, 21 days, and 28 days. Histopathological analyses identified an inflammatory response on day 7, which was absent on days 14 and 56. Transmission electron microscopy indicated a decrease in inflammatory cellularity, while immunohistochemistry staining suggested an increased presence of inflammatory factors on day 14. In summary, the hydrogel is easily injectable, triggers a temporary local inflammatory response, and integrates into the adjacent tissue from day 14 onwards.

Animal model for tendinopathy

Background

Tendinopathy is a common motor system disease that leads to pain and reduced function. Despite its prevalence, our mechanistic understanding is incomplete, leading to limited efficacy of treatment options. Animal models contribute significantly to our understanding of tendinopathy and some therapeutic options. However, the inadequacies of animal models are also evident, largely due to differences in anatomical structure and the complexity of human tendinopathy. Different animal models reproduce different aspects of human tendinopathy and are therefore suitable for different scenarios. This review aims to summarize the existing animal models of tendinopathy and to determine the situations in which each model is appropriate for use, including exploring disease mechanisms and evaluating therapeutic effects.

Methods

We reviewed relevant literature in the PubMed database from January 2000 to December 2022 using the specific terms ((tendinopathy) OR (tendinitis)) AND (model) AND ((mice) OR (rat) OR (rabbit) OR (lapin) OR (dog) OR (canine) OR (sheep) OR (goat) OR (horse) OR (equine) OR (pig) OR (swine) OR (primate)). This review summarized different methods for establishing animal models of tendinopathy and classified them according to the pathogenesis they simulate. We then discussed the advantages and disadvantages of each model, and based on this, identified the situations in which each model was suitable for application.

Results

For studies that aim to study the pathophysiology of tendinopathy, naturally occurring models, treadmill models, subacromial impingement models and metabolic models are ideal. They are closest to the natural process of tendinopathy in humans. For studies that aim to evaluate the efficacy of possible treatments, the selection should be made according to the pathogenesis simulated by the modeling method. Existing tendinopathy models can be classified into six types according to the pathogenesis they simulate: extracellular matrix synthesis-decomposition imbalance, inflammation, oxidative stress, metabolic disorder, traumatism and mechanical load.

Conclusions

The critical factor affecting the translational value of research results is whether the selected model is matched with the research purpose. There is no single optimal model for inducing tendinopathy, and researchers must select the model that is most appropriate for the study they are conducting.

The translational potential of this article

The critical factor affecting the translational value of research results is whether the animal model used is compatible with the research purpose. This paper provides a rationale and practical guide for the establishment and selection of animal models of tendinopathy, which is helpful to improve the clinical transformation ability of existing models and develop new models.

A Preliminary Study of the Influence of High Intensity Laser Therapy (HILT) on Skin Surface Temperature and Longissimus Dorsi Muscle Tone Changes in Thoroughbred Racehorses with Back Pain

The reason for undertaking this study was to investigate soft tissue response to high-intensity laser therapy (HILT) by measuring changes in skin surface temperature and longissimus dorsi muscle tone in the thoracolumbar back area in Thoroughbreds with back pain and diagnosed with and without Kissing Spines Syndrome (KSS). Thoroughbreds aged 3-4 years with clinically presented back pain underwent a radiological examination (to assess a lack or presence of KSS) and longissimus dorsi muscle palpation (to assess muscle tone and pain degree). The subjects were divided into two groups, those with KSS (n = 10) and those without KSS (n = 10). A single HILT treatment on the longissimus dorsi muscle, on the left side, was performed. Thermographic examination and palpation were repeated before and after HILT to assess changes in skin surface temperature and muscle pain response. In both groups, HILT caused a significant increase in skin surface temperature of 2.5 °C on average and a palpation score reduction of 1.5 degrees on average (p = 0.005 for both measurements), without differences in any outcome measures between the groups. Furthermore, the correlation between changes in the average skin surface temperature and the average palpation scores in horses with and without KSS were negative (rho = 0.071 and r = -0.180, respectively; p > 0.05). The results of the present study are encouraging, but further studies with larger samples, a longer follow-up period and comparisons with placebo control groups are needed to draw a more valid conclusion.

Effects of High-Intensity Laser Therapy (HILT) on Skin Surface Temperature and Vein Diameter in Healthy Racehorses with Clipped and Non-Clipped Coat

The aim of this study was to investigate the differences in the effects of high-intensity laser therapy (HILT) on skin surface temperature and vein diameter in the carpal joint region in racehorses with clipped and non-clipped treatment areas. The study included 20 Thoroughbreds split into two equal groups: clipped coat and non-clipped coat. Horses underwent thermographic examination to detect changes in skin surface temperature at the medial surface of the carpal joint, followed by ultrasonographic examination to assess changes in the diameter of the medial palmar vein before and after HILT. The increase in skin surface temperature after HILT was significantly lower in the group with clipped coat than in the non-clipped group. The group with clipped coat showed a greater increase in vessel diameter. There was a significantly weak negative correlation between the changes in average skin surface temperature and vein diameter in both groups. In conclusion, an efficient photothermal effect can be achieved in skin with a non-clipped coat and clipping the treatment area increases photobiostimulation of the tissue, while reducing the photothermal effect. Further research is needed to specify the parameters for the treatment of skin with clipped and non-clipped coat in order to perform effective laser therapy.

A Case Series of 11 Horses Diagnosed with Bone Spavin Treated with High Intensity Laser Therapy (HILT)

The aim of this work was to characterize and describe the effect of High Intensity Laser Therapy (HILT) used in the treatment of chronic osteoarthritis in horses. Over a 2 year period, 11 horses with diagnosed bone spavin were treated with HILT as a monotherapy. The horses chosen for this report presented hind limb lameness, were positive in a spavin flexion test and showed improvement after intra-articular anesthesia of the tarsometatarsal joint. Additionally, all the horses presented radiological signs of tarsus osteoarthritis and had not been treated for bone spavin for a minimum of 6 months. Each horse received 10 HILT therapies over 14 days' treatment time with the same laser protocol. At post-treatment orthopedic examination, 4 horses (36%) had improved 2 lameness grades (in the 5 grade American Association of Equine practitioners lameness scale), 4 horses (36%) had improved 1 lameness grade and 3 horses (28%) did not improve. Additionally, 3 horses were totally sound after HILT. Post-treatment spavin test result improvement was observed in 5 horses (45%), and 6 horses (55%) showed the same spavin test grade as before treatment. There were no horses that were sound in the spavin test performed after HILT. Therefore, it seems probable that the application of HILT in horses suffering from bone spavin may decrease joint pain, which influences visual lameness reduction.

Visual lameness assessment in comparison to quantitative gait analysis data in horses

BACKGROUND

Quantitative gait analysis offers objective information to support clinical decision-making during lameness workups including advantages in terms of documentation, communication, education, and avoidance of expectation bias. Nevertheless, hardly any data exist comparing outcome of subjective scoring with the output of objective gait analysis systems.

OBJECTIVES

To investigate between- and within-veterinarian agreement on primary lame limb and lameness grade, and to determine relationships between subjective lameness grade and quantitative data, focusing on differences between (1) veterinarians, (2) live vs video assessment, (3) baseline assessment vs assessment following diagnostic analgesia.

STUDY DESIGN

Clinical observational study.

METHODS

Kinematic data were compared to subjective lameness assessment by clinicians with ≥8 years of orthopaedic experience. Subjective assessments and kinematic data for baseline trot-ups and response to 48 diagnostic analgesia interventions in 23 cases were included. Between and within-veterinarian agreement was investigated using Cohen's Kappa (κ). Asymmetry parameters for kinematic data ('forelimb lame pattern', 'hindlimb lame pattern', 'overall symmetry', 'vector sum head', 'pelvic sum') were determined, and used as outcome variables in mixed models; explanatory variables were subjective lameness grade and its interaction with (1) veterinarian, (2) live or video evaluation and (3) baseline or diagnostic analgesia assessment.

RESULTS

Agreement on lame limb between live and video assessment was 'good' between and within veterinarians (median κ = 0.64 and κ = 0.53). There was a positive correlation between subjective scoring and measured asymmetry. The relationship between lameness grade and objective asymmetry differed slightly between (1) veterinarians (for all combined parameters, p-values between P < .001 and 0.04), (2) between live and video assessments ('forelimb lame pattern', 'overall symmetry', both P ≤ .001), and (3) between baseline and diagnostic analgesia assessment (all combined parameters, between P < .001 and .007).

MAIN LIMITATIONS

Limited number of veterinarians (n = 4) and cases (n = 23), only straight-line soft surface data, different number of subjective assessments live vs from video.

CONCLUSIONS

Overall, between- and within-veterinarian agreement on lame limb was 'good', whereas agreement on lameness grade was 'acceptable' to 'poor'. Quantitative data and subjective assessments correlated well, with minor though significant differences in the number of millimetres, equivalent to one lameness grade between veterinarians, and between assessment conditions. Differences between baseline assessment vs assessment following diagnostic analgesia suggest that addition of objective data can be beneficial to reduce expectation bias. The small differences between live and video assessments support the use of high-quality videos for documentation, communication, and education, thus, complementing objective gait analysis data.

Photothermal Effects of High-Intensity Laser Therapy on the Superficial Digital Flexor Tendon Area in Clinically Healthy Racehorses

The aim of the present study was to assess the photothermal effects of high-intensity laser therapy (HILT) on the superficial digital flexor tendon (SDFT) of the hindlimb in racehorses. It was conducted on 18 clinically healthy thoroughbreds that were subjected to thermographic examination to measure surface temperature changes in the SDFT. This was performed before and immediately after HILT. This revealed statistically significant differences in the temperature of the skin surface overlying the flexor tendons (p < 0.001). The surface temperature of the area examined was higher by an average of 3.5 °C after HILT, compared with the temperature measured before HILT. Our results prove that HILT has a photothermal effect in treating soft tissue. This finding can be helpful in determining the appropriate parameters for monitoring the short- and long-term effects of HILT.

Histological tissue healing following high-power laser treatment in a model of suspensory ligament branch injury

BACKGROUND

High-power laser therapy gained popularity recently as a regenerative treatment for tendinitis and desmitis in the horse. However, studies evaluating effects of laser therapy on tissue repair at histological level in large mammals are lacking.

OBJECTIVES

To evaluate effects of high-power laser therapy on suspensory desmitis healing, using a model of suspensory ligament branch injury.

STUDY DESIGN

In vivo experiments.

METHODS

Standardised lesions were surgically induced in all 4 lateral suspensory branches of twelve healthy Warmblood horses. Laser therapy (class 4, 15W) was applied daily on 2 of 4 induced lesions for 4 consecutive weeks. Horses were randomly assigned to either short-term study (horses were sacrificed after 4 weeks) or long-term study (6 months). Suspensory ligament samples were scored after staining with haematoxylin-eosin and immunostaining for collagen 1- collagen 3- and factor VIII.

RESULTS

In the short-term study, significantly better (lower) scores for variation in density (17% above cut-off score in treated lesions vs. 31% above cut-off score in controls, p=0.03), shape of nuclei (54% vs. 92%, p=0.02), fibre alignment (32% vs. 75%, p=0.003) and fibre structure (38% vs. 71%, p=0.02) were found in laser treated lesions when compared to controls. Collagen 3 expression was significantly higher (32% vs. 19%, p=0.006) in control lesions. In both short- and long-term studies combined, parameters lesion size (44% vs. 56%, p=0.02) and shape of nuclei (53% vs. 84%, p=0.05) scored significantly better in treated lesions. Long-term, significantly better (lower) scores were found in the laser-treated group for lesion size (15% vs. 45%, p=0.008) and a higher percentage above cut-off score for density of the nuclei (27% vs. 9%, p=0.02), compared to controls.

MAIN LIMITATIONS

The model of suspensory branch injury is not an exact representation of clinical overstrain lesions.

CONCLUSIONS

These results suggest that high-power laser therapy enables better lesion healing than conservative treatment.

Comparison of the Effect of High-Intensity Laser Therapy (HILT) on Skin Surface Temperature and Vein Diameter in Pigmented and Non-Pigmented Skin in Healthy Racehorses

Simple Summary

High-intensity laser therapy (HILT) is used in the treatment of horses, but little is known about the differences in the impact of HILT performed on pigmented and non-pigmented skin. The aim of this study was to assess differences in the influence of HILT on skin surface temperature and vein diameter in a group of healthy racehorses with pigmented and non-pigmented skin in the treatment area. The hypothesis was that HILT would cause a greater increase in skin surface temperature and vein diameter in horses with pigmented skin compared to non-pigmented skin. Ten Thoroughbreds with pigmented skin and ten Thoroughbreds with non-pigmented skin in the treatment area received HILT. Changes in the vein diameter and skin surface temperature of the irradiated area were measured before and after HILT. The HILT treatment caused an increase in the pigmented skin surface temperature and a decrease in the non-pigmented skin surface temperature, while the vein diameter increased in both groups. In conclusion, melanin content in the epidermis plays an important role in light energy absorption and photothermal effects. Determining the physiological and clinical effects of HILT performed on pigmented and non-pigmented skin will help clinicians choose appropriate HILT parameters.

Abstract

The aim of the study was to assess differences in the influence of high-intensity laser therapy (HILT) on the skin surface temperature and vein diameter of the lateral fetlock joint region in a group of racehorses with pigmented and non-pigmented skin in the treatment area. Twenty Thoroughbreds were divided into two equal groups: pigmented and non-pigmented skin groups. Each horse received the same HILT treatment. Just before and immediately after HILT, thermographic examination was performed to measure the skin surface temperature and ultrasonographic examination assessed the lateral digital palmar vein diameter. After HILT, the pigmented skin surface temperature increased, while the non-pigmented skin surface temperature decreased, and the difference between both groups was significant (p < 0.001). The vein diameter increased after HILT in horses with pigmented and non-pigmented skin, but the difference between both groups was not significant (p = 0.14). In conclusion, melanin content in the epidermis plays an important role in light energy absorption and photothermal effects. The vein diameter changes after HILT application indicated that the increase in vessel diameter may partly depend on photothermal mechanisms occurring in irradiated tissue. Further research is necessary to describe the physiological and clinical effects of HILT performed on pigmented and non-pigmented skin.

Effectiveness of Platelet-Rich Plasma and Bone Marrow Aspirate Concentrate as Treatments for Chronic Hindlimb Proximal Suspensory Desmopathy

This retrospective study aimed to evaluate the clinical effect of bone marrow aspirate concentrate (BMAC) and leukocyte rich PRP (LR-PRP) compared to horses undergoing controlled exercise alone in horses with >3 months proximal suspensory desmopathy in hindlimbs (HPSD). Nighty-three horses were divided into three groups according to the treatment: a control (n = 22), LR-PRP (n = 46), and BMAC (n = 25) group. Lameness and ultrasound scores were recorded before treatment (T0) and at 6 months (T1) post-treatment. Records horses considered sound at evaluation and level of performance were additionally registered at 12 months (T2) and 18 months (T3) after treatment. The BMAC cytology profiles from 22 horses were also analysed and compared to clinical outcomes. The results at T1 showed that 9% (2/22) of the horses in the control group were sound compared to 59% (25/46) and 84% (21/25) in the LR-PRP and BMAC groups, respectively. Additionally, ultrasound scores at T1 in the BMAC and LR-PRP groups were improved in comparison with the control group (p = 0.02). At T2, 68% of the horses in the BMAC group and 39% of the horses in the LR-PRP group had returned to the previous performance level. At T3, a significantly higher percentage of horses in the LR-PRP (43%) and BMAC (72%) group were sound when compared to the control (4.6%) group (p = 0.02). Similarly, at T3, significantly more horses of the BMAC (16/25) and of the LR-PRP (15/46) group had returned to the previous or a higher performance level compared to the control (1/22) group (p = 0.01). No correlation was found between long-term clinical outcome and cytology profiles in the BMAC group. In conclusion, long-term outcomes of treatment with LR-PRP or BMAC are significantly better than conventional treatment of the hindlimb chronic PSD in horses. Additionally, BMAC yielded better lameness scores than LR-PRP at short- and long-term follow-up.

Differences in equine spinal kinematics between straight line and circle in trot

Work on curved tracks, e.g. on circles, is commonplace within all forms of horse training. Horse movements in circles are naturally asymmetric, including the load distribution between inner and outer limbs. Within equestrian dressage the horse is expected to bend the back laterally to follow the circle, but this has never been studied scientifically. In the current study 12 horses were measured (optical motion capture, 100 Hz) trotting on left and right circles and on the straight without rider (soft surface). Data from markers placed along the spine indicated increased lateral bending to the inside (e.g. left bending on the left circle) of the thoracolumbar back (difference left circle vs. straight − 3.75°; right circle + 3.61°) and the neck (left − 5.23°; right + 4.80° vs. straight). Lateral bending ROM increased on the circle (+ 0.87° and + 0.62°). Individual variation in straight-circle differences was evident, but each horse was generally consistent over multiple trials. Differences in back movements between circle and straight were generally small and may or may not be visible, but accompanying changes in muscle activity and limb movements may add to the visual impression.

Equine Rehabilitation: A Scoping Review of the Literature

Simple Summary

When a horse is diagnosed with a locomotor disorder, the veterinarian treats the specific injury to restore the horse to soundness. Even after the injury has healed, however, the horse may not be fully functional due to persistent limitations in movement or strength in specific areas of the body. As in people, rehabilitation seeks to optimize function and reduce any existing disability using a variety of methods including manual therapy, the use of physical and mechanical agents, and specialized exercise regimes. This study has reviewed the scientific literature with the goal of identifying which types of physical therapy have been described in horses over the past 20 years. The most frequently reported techniques were exercise, electrotherapy, and hydrotherapy but there are relatively few publications describing details of their use and outcomes in clinical cases. This study reviews the methodology and outcomes of rehabilitation in clinical cases. The results highlight the paucity of clinically-based reports on the practical applications of equine rehabilitation and physical therapy.

Abstract

Injuries to the locomotor system are a common problem in athletic horses. Veterinarians address these injuries using appropriate medical, surgical, and pharmacological treatments. During or after recovery from the initial injury, horses may be treated for functional locomotor deficits using specific rehabilitation techniques aimed at restoring full athletic performance. This study reviews the literature to identify which rehabilitative techniques have been used most frequently in horses over the past 20 years, the protocols that were used, and the outcomes of the treatments in naturally occurring injuries and diseases. Publications were identified using keyword selection (Equine Athlete OR Equine OR Horse) AND (Rehabilitation OR Physiotherapy OR Physical Therapy). After removing duplicates and screening papers for suitability, 49 manuscripts were included in the study. The majority of publications that met the inclusion criteria were narrative reviews (49%) in which the authors cited the relatively small number of published evidence-based studies supplemented by personal experience. Observational/descriptive studies were also popular (35%). Randomized control trials accounted for only 10%. The most frequently reported rehabilitation techniques were exercise, electrotherapy, and hydrotherapy. The findings highlight the need for further information regarding type of intervention, parameterization, and outcomes of equine rehabilitation in clinical practice.

High-Power Laser Therapy Improves Healing of the Equine Suspensory Branch in a Standardized Lesion Model

High-power laser therapy is often used as a treatment for human sport injuries but controlled standardized studies on its efficacy are lacking. The technique has also been introduced in the equine field and recently promising results were reported in a retrospective study focusing on 150 sporthorses suffering from tendinopathy and desmopathy of the SDFT, DDFT, suspensory ligament, and suspensory branches. The goal of the present study was to evaluate the effect of high-power laser in a standardized lesion model in horses. Lesions were created in all lateral suspensory branches of 12 warmblood horses. In each horse, 2 of the 4 lesioned branches were treated daily with a multi-frequency high-power laser for 4 weeks. Color Doppler ultrasonography was performed during and after the treatment period. Six horses were euthanized 4 weeks post-surgery (short-term) and 6 were further rehabilitated until 6 months and then euthanized (long-term). High-field MRI evaluation was performed on all cadaver limbs. On ultrasound, transverse size of the lesion was significantly smaller after 2- and 3 months (p = 0.026 and p = 0.015) in the treated branches. The expected post-surgery enlargement of the lesion circumference and cross-sectional area (CSA) over time, was significantly lower in the short-term laser treated group (p = 0.016 and p = 0.010). Treated lesions showed a significantly increased Doppler signal during treatment (p < 0.001) compared with control. On MRI, in the short and long-term group, the CSA of the lesions was significantly smaller (p = 0.002), and the mean signal significantly lower in the treatment groups (p = 0.006). This standardized controlled study shows that multi-frequency high-power laser therapy significantly improves healing of a suspensory branch ligament lesion.

Effects of High Intensity Laser Therapy in the Treatment of Tendon and Ligament Injuries in Performance Horses

Simple Summary

High intensity laser therapy (HILT) has been introduced as a non-invasive therapy for musculoskeletal diseases in horses, but little is known about the impact of HILT in the treatment of tendon and ligament injuries. The aim of this study was to evaluate the effects of HILT on tendon and ligament injury treatment in horses. Twenty six horses with tendinopathies and desmopathies were randomly assigned to a HILT treated or to a non-treated group. Each horse from the treatment group underwent a series of fifteen HILT treatments. Clinical and ultrasound assessments were carried out. Clinical evaluation included: pain, swelling and lameness of the affected limb. The ultrasound examination evaluated lesion echogenicity and lesion percentage. In our study, HILT promoted analgesic and anti-oedema effects, with visual lameness reduction in horses with tendon and ligament injuries, and reduced lesion percentage but did not influence change in lesion echogenicity. HILT appears justifiable for its anti-inflammatory effects and can be used as a physiotherapeutic technique for supportive treatment of tendon and ligament injuries in horses. The introduction of laser therapy to veterinary medicine, particularly to analgesic therapy in horses, gives hope of improving the quality of life of patients with chronic musculoskeletal pain.

Abstract

The aim of this study was to evaluate the effects of high intensity laser therapy (HILT) on tendon and ligament injury treatment in horses. Twenty six horses with tendinopathies were randomly assigned to a HILT treated or to a non-treated group. Each horse was subjected to the same rehabilitation programme. Horses from the treatment group underwent a series of fifteen HILT treatments with the same parameters. Clinical and ultrasound assessments were performed by the same veterinarian and were carried out before (day 0), during (day 13–15) and after treatment (day 38–40). Clinical evaluation included: pain, swelling and lameness of the affected limb. The ultrasound examination evaluated lesion echogenicity and lesion percentage. After the treatment, pain, swelling and lameness were significantly improved by HILT compared with the control group (p = 0.023, 0.008 and 0.044, respectively). No significant changes were found in lesion echogenicity degree between both groups in measurements taken during treatment (p = 0.188) and after treatment (p = 0.070). For lesion percentage reduction, the statistical modelling showed a significant improvement in the HILT group compared with the control group during (p = 0.038) and after treatment (p = 0.019). In conclusion, HILT promoted analgesic and anti-oedema effects, with visual lameness reduction in horses with tendon and ligament injuries, and reduced lesion percentage but did not influence change in lesion echogenicity.

Assessment of Vein Diameter and Body Surface Temperature after High-Intensity Laser Therapy (HILT) on the Tarsal Joint in Healthy Horses

The aim of the study was to assess the influence of high-intensity laser therapy (HILT) on vein diameter and on body surface temperature changes in the tarsal joint area in a group of clinically healthy racehorses. The hypothesis of the study was that HILT increases vein diameter and body surface temperature in healthy tissue. The study involved 16 Thoroughbreds being subjected to ultrasonographic examination to assess changes of diameter of the cranial branch of the medial saphenous vein and thermographic examination to indicate temperature change of the dorsal surface of the tarsal joint, just before and immediately after HILT treatment. Vein diameter and mean surface temperature of the tarsal joint significantly increased after HILT treatment. In addition, the study was the first to describe the photothermal effect of HILT in healthy horses. More studies are necessary to specify the parameters of the procedure, that is, wavelength, energy density, or time of the procedure, depending on the patient's individual characteristics and type of tissue.

Management of Primary Injuries of the Medial Collateral Ligament of the Carpus in Two Horses

This case report describes the successful management of two horses with medial carpal collateral ligament injury. This is a rare cause of forelimb lameness and existing reports indicate a poor prognosis for return to athletic function with conservative management. Both horses were treated with a combination of box rest with controlled exercise and high-intensity laser therapy (HILT). Both horses returned to previous athletic function, one at Grand Prix level dressage and one at Novice level eventing. With appropriate management, the prognosis for carpal collateral ligament injury may be good. From this report, it is unclear whether a rehabilitation program including HILT offers improved prognosis compared with a rehabilitation program alone.