Survey of veterinarians' usage and satisfaction with intra-articular polyacrylamide gel in horses

Polyacrylamide gel is increasingly used in equine veterinary medicine for osteoarthritis and other joint disorders. This study aimed to document the indications, treatment protocols, rehabilitation plans, outcomes, and satisfaction with intra-articular polyacrylamide gel in horses, as reported by equine veterinarians. An online questionnaire was distributed to practitioners through the European and American Colleges of Veterinary Sports Medicine and Rehabilitation mailing lists, social media, and direct contact. Of 197 respondents, 160 completed the survey, forming the basis for the descriptive statistical analysis. The primary indications for polyacrylamide gel use were chronic synovitis/osteoarthritis (87.1%) and failure of prior joint treatment (83.6%). Treatment protocols, post-treatment rehabilitation plans, and clinical outcomes varied among practitioners and respondent groups based on experience and disciplinary focus (assessed using automated A/B or Kruskal-Wallis with post-hoc Dunn's test). Most respondents reported return to full exercise from week 4 post-treatment. Complications, worsening, or lack of improvement following treatment were rare, while complete recovery, partial improvement, or transient improvement were commonly observed. Median satisfaction score among respondents was rated 8/10. As expected with the study design, the responses limited detailed insights into individual experiences and may reflect response bias, with most respondents being specialized or focused on equine orthopedics. Despite these limitations, the survey highlights a general good satisfaction with intra-articular polyacrylamide gel, mainly for chronic synovitis/osteoarthritis and use after failure of prior joint treatment, with low reported complication rates and favorable outcomes. These findings support developing standardized guidelines for intra-articular polyacrylamide gel treatment and post-treatment rehabilitation protocols in horses.