Medical management of superficial digital flexor tendonitis: a comparative study in 219 horses (1992-2000).
BACKGROUND
There is a lack of long-term follow-up data for outcome of medical treatment of superficial digital flexor (SDF) tendonitis.


OBJECTIVE
To determine whether intralesional injection of hyaluronan, beta aminoproprionitrile fumarate (BAPN) or polysulphated glycosaminoglycans (PSGAG) or systemic administration of PSGAG yielded better results than a controlled exercise programme alone in the management of SDF tendonitis, with a minimum follow-up period of 2 years after resumption of full work; and to determine whether reinjury rate was related to sports discipline and whether fibre alignment score (FAS) at 4 months could predict outcome.


METHODS
In Study 1, 50 horses were managed by controlled exercise alone (Group A), 50 were treated with intralesional injection of hyaluronan (Group B), 20 received intralesional and systemic treatment with PSGAG (Group Ci) and 30 received systemic treatment with PSGAG (Group Cii). Horses in Groups B, Ci and Cii followed the same controlled exercise programme as Group A. In Study 2, 69 horses (Group D) were treated by intralesional injection of BAPN and followed a modified controlled exercise programme. Horses were re-examined clinically and ultrasonographically at intervals. Follow-up data were obtained for horses 2 years after resuming full work and for up to 6 years.


RESULTS
There was no significant difference in reinjury rate of the treated limb(s) between Groups A, B, Ci and Cii (42.5-44.4%) (P>0.9). The reinjury rate (16%) in the treated limb(s) in Group D was significantly lower than in the other groups (P<0.001). However, when injury rate of the uninjured limb was considered, the results were similar to Study 1. In Study 2, the FAS at 4 months after treatment was a good predictor of outcome (P<0.001). Reinjury rates for different disciplines were similar in the 2 studies, with the risk of reinjury ascending from showjumpers to event horses to National Hunt and flat racehorses.


CONCLUSIONS
Treatment with BAPN reduced the risk of reinjury in the treated limb, although the overall rate of subsequent injury was not affected. FAS at 4 months after treatment is a good predictor of outcome in the treated limb(s).


CONCLUSIONS
This study provides long-term follow-up data in horses from a variety of sports disciplines that can be used to provide prognostic information.
Dyson
S J
SJ
Centre for Equine Studies, Animal Health Trust, Lanwades Park, Kentford, Newmarket, Suffolk CB8 7UU, UK.
D000276:Adjuvants, Immunologic / Q000627:therapeutic use; D000629:Aminopropionitrile / Q000627:therapeutic use*; D000818:Animals; D005081:Exercise Therapy; D005500:Follow-Up Studies; D006025:Glycosaminoglycans / Q000627:therapeutic use*; D006734:Horse Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D006736:Horses / Q000293:injuries; D006820:Hyaluronic Acid / Q000627:therapeutic use*; D012008:Recurrence; D012146:Rest / Q000502:physiology; D052256:Tendinopathy / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology / Q000662:veterinary*; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography
D000276:Adjuvants, Immunologic; D006025:Glycosaminoglycans; D000629:Aminopropionitrile; C013786:A73025; D006820:Hyaluronic Acid