Conservative management of equine tarsal collateral ligament injuries may allow return to normal performance

Abstract

OBJECTIVE To describe type and distribution of tarsal collateral ligament (CL) injuries and to assess the long-term outcome in horses treated conservatively. ANIMALS 78 horses (median age, 7 years [IQR, 4 to 9.75 years]) of different breeds and disciplines. PROCEDURES Retrospective analysis (2000 through 2020) of horses with tarsal CL lesions diagnosed on ultrasound. The resting time, ability to return to work, and performance level after the injury were compared between horses having a single ligament (group S) or multiple ligaments (group M) affected and according to the case severity. RESULTS Most of the horses (57/78) presented a single CL injury, while 21 had multiple CLs affected simultaneously, for a total of 108 CLs injured and 111 lesions. In both groups, the short lateral CL (SLCL) was the most commonly affected (44/108), followed by the long medial CL (LMCL; 27/108). Enthesopathies (72.1%) were more frequent than desmopathies alone (27.9%) and involved mostly the proximal insertion of the SLCL and the distal attachment of the LMCL. Conservative treatment (n = 62) consisted mainly of stall rest. The median resting time (120 days [IQR, 60 to 180 days]) did not significantly differ between the 2 groups (group S vs M) or according to the severity. Most horses (50/62) were able to return to work within 6 months. Horses that did not return (12/62) were more likely to have severe lesions (P = .01). Thirty-eight horses were able to perform at a level equal to or higher than before the injury. CLINICAL RELEVANCE This study highlights the importance of thorough ultrasound assessment of tarsal CL injuries and demonstrates that conservative management is a viable option to allow these horses to return to previous performance level.

Treatment of Equine Tarsus Long Medial Collateral Ligament Desmitis with Allogenic Synovial Membrane Mesenchymal Stem/Stromal Cells Enhanced by Umbilical Cord Mesenchymal Stem/Stromal Cell-Derived Conditioned Medium: Proof of Concept

“…A study referred to the treatment of this type of lesion with platelet-rich plasma (PRPs), achieving a return to the same level of work in 180 days in 81% of the horses versus 90 days with this combination product [18]. The recovery times obtained in the current case remain a great attainment compared with those described by others concerning equine clinical trials of desmitis of collateral ligament of tarsus and equine tendonitis [5][6][7][8][9].…”

“…On the other hand, in the present case, there was a significative reduction in the rest period. In 2 days, this horse started the rehabilitation program versus 30-180 days of rest, and it returned to full work after 90 days versus 180 days presented in other studies, which accounts for almost 50% of the reduction in the total recovery time [6,9,18]. A study referred to the treatment of this type of lesion with platelet-rich plasma (PRPs), achieving a return to the same level of work in 180 days in 81% of the horses versus 90 days with this combination product [18].…”

“…Medial tarsal collateral desmitis has been rarely described in the veterinary literature; however, it is one of the most common soft tissue injuries of the tarsus. Conventional treatments are often referred to in the literature, but the outcome is not very advantageous, since there is a guarded prognosis to return to the same performance level, and osteoarthritis (OA) is usually secondarily associated with these approaches [4][5][6][7][8][9].…”

Case report: Equine metacarpophalangeal joint partial and full thickness defects treated with allogenic equine synovial membrane mesenchymal stem/stromal cell combined with umbilical cord mesenchymal stem/stromal cell conditioned medium

“…The rehabilitation program may have played a crucial role in the overall treatment protocol, ensuring that the horse remained consistently active and received a continuous and progressive stimulus on its cartilage, joints, ligaments, and muscles. In contemporary equine sports medicine, it is well-established that physical rehabilitation is a pivotal component, emphasizing the importance of keeping the horse engaged in exercise ( 37 , 38 , 53 , 54 ). The incorporation of early mobilizations is recommended as long as rehabilitation protocols are followed carefully.…”

Equine Musculoskeletal Pathologies: Clinical Approaches and Therapeutical Perspectives—A Review

“…Nonetheless, when dealing with cases involving joint or limb distension, radiography is recommended as an initial diagnostic procedure. In instances of acute tendinopathy, desmopathy, or enthesopathy without fragmentation of the insertional surface, radiography may primarily indicate the presence of soft tissue swelling [15].…”