Equine shock wave therapy - where are we now?

Area of Science:

• Veterinary Medicine
• Biomedical Engineering
• Orthopaedics

Background:

• Electrohydraulic extracorporeal shock wave therapy (ESWT) has gained significant interest in equine orthopaedics over 30 years.
• A current review of modernized equine clinical applications is needed due to rapid advancements.

Purpose of the Study:

• To summarize current ESWT technology, evidence, mechanisms of action, and clinical applications in horses.
• To identify areas requiring further investigation in equine ESWT.

Main Methods:

• Review of current electrohydraulic ESWT technology, focusing on its predominant use due to waveform control.
• Summary of experimental and clinical evidence for ESWT in equine musculoskeletal disorders.
• Analysis of proposed mechanisms of action, including mechanotransduction and cellular activation.

Main Results:

• Electrohydraulic systems dominate ESWT due to superior waveform control.
• ESWT shows experimentally proven effects on osseous, connective tissue, and wound healing.
• Clinical trials have explored ESWT for osteoarthritis, thoracolumbar pain, navicular syndrome, tendinopathy, and proximal suspensory desmopathy.

Conclusions:

• ESWT is a promising modality for equine orthopaedic disorders, with active research in its use with biologics.
• Evidence-based recommendations for ESWT protocols (energy, depth, tissue type) are lacking, with current data being largely anecdotal.
• Technical advancements and safety measures (hearing protection, sedation) are crucial for judicious ESWT use in horses.