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  Discussion on Shock wave therapy
Author Message
Member:
Terivc

Posted on Monday, Feb 24, 2003 - 9:14 pm:

Am looking for information on shock wave therapy in ringbone (between proximal and middle phalanx of pastern--hind leg). I have a 10month old filly that due to trauma has developed ringbone according to vet x-rays. They have done one treatment of shock wave on her so far(today) and I want to know if anyone else has used this and is it successful? She is their first patient with the shock wave tx, vet just got back from training last week,new machine and she was a candidate, so I was told, and they said it would not hurt her, could only help and did it dirt cheap due to new therapy for them. Any info out there?? Thanks, Teri
Moderator:
DrO

Posted on Wednesday, Feb 26, 2003 - 10:20 am:

What is the logic of using this modality, Teri, are you trying to stimulate fusion of the joint? As far as I can tell Shockwave is not studied as a treatment for degenerative joint disease. I presume this is because its actions will stimulate inflammation in the joint not calm it down.
DrO
Member:
Garnet

Posted on Wednesday, Feb 26, 2003 - 12:32 pm:

I don't know if it is related to the treatment in question but they use ultrasound (?) shock waves to break up kidney stones. My SIL had it done about 15 years ago and it was a new technique back then. It worked very well for her and she did not have to undergo a more invasive surgery for her stones. It was done through a catheter.

Good luck finding help for your horse!
Moderator:
DrO

Posted on Wednesday, Feb 26, 2003 - 8:17 pm:

Yes it is related Garnet. Extra-corpreal shockwave therapy was first designed for breaking up uroliths to avoid surgery. It is exactly this type force that seems to me contraindicated in a joint environment. However a pastern joint with painful DJD can be sucessfully fused with aggressive surgical debridement or caustic drugs. I wonder if that is the plan in this case? I do not know of any research into this use of shockwave therapy.
DrO
Member:
Dres

Posted on Wednesday, Feb 26, 2003 - 8:25 pm:

i don't know if this is of any use but.. UCD is using this method a lot now adays.... there might be some research there...

Ann
Moderator:
DrO

Posted on Saturday, Mar 1, 2003 - 8:57 am:

Hello Ann,
Not on joints and there is very little research anywhere at this time. Currently the clinical trials and research are directed at soft tissue and bony injuries, high suspensory and chronic check ligamament come to mind. I do not know anyone recommending the use on a joint...yet and will be surprised if it has a use in joints, other than stimulating fusion of a joint.
DrO
Member:
Terivc

Posted on Tuesday, Mar 4, 2003 - 12:14 am:

Hello Dr.Oglesby and others, The filly had a deep digital flexor injury and one inch wire burn(barbless), that turned into a pcn resistant staph,clostridium sack under tendon sheath, surgery to sequester the dead bone and put in a drain for the clostridium. She was casted three times, and they believe to all the tendon immobility and then mobility, she injured herself, probably due to a weakened joint. 86 days in the equine hospital total. Home two weeks without the cast and back to being lame with her joint (pp and Mp) looking "popped", xrays revealed the degeneration. My vets believed another long lay-up with surgery and possible problems from steroids going down into the coffin bone would be counter productive so had decided on pasture turnout for the bones to fuse whenever (they said maybe 2 years??) and then thought they would try this new investigational procedure on the area with shock wave therapy to move this along and "heal" faster by fusing quicker. Is this possible then?? Will she ever be sound, as in running barrels sound or broodmare sound?? They wouldn't commit but I'm searching anyways, always looking for hope, it's not even the money wasted but the fact of a potential losing her potential so young.Thanks for all input, Teri
Moderator:
DrO

Posted on Tuesday, Mar 4, 2003 - 6:31 am:

Theoretically it would be Teri. Shockwave is very tissue disruptive and may worsen the arthritis so as to hasten the fusion. In this case healing consists of making things worse first.

IF the pastern joint appears popped forward (subluxated) it may also indicate disruption of the SDF tendon or distal sesmoidean ligaments. This will worsen the prognosis considerably.
DrO
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