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  Discussion on Treatment of chronic pr. suspensory desmitis with shockwave therapy
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DrO

Posted on Monday, Nov 27, 2006 - 10:01 am:

This study seemed to find a benefit to treating proximal suspensory desmitis with shockwave. Unfortunately there was no control group to compare with and as always hindlimb involvement showed problems with recurrence but worth a look if you have not had luck with more conservative therapy.
DrO

Schweiz Arch Tierheilkd. 2006 Oct;148(10):561-8.
Treatment of chronic proximal suspensory desmitis in horses using focused electrohydraulic shockwave therapy.

Lischer CJ, Ringer SK, Schnewlin M, Imboden I, Furst A, Stockli M, Auer J.
Weipers Centre for Equine Welfare, University of Glasgow, Scotland, UK.

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.
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