Extracorporeal Shock Wave Therapy

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Scott McClure, DVM, PhD, of Iowa State, reported on the effects of extracorporeal shock wave therapy (ESWT) on suspensory ligament desmitis. He noted that ESWT is being used for the treatment of equine musculoskeletal diseases. "Recent studies have demonstrated that shock waves induce neovascularization (new blood vessel growth) at the tendon-bone junction, which in turn relieves pain and improves tissue regeneration and repair. ESWT was also found to have a positive effect on the concentration of transforming growth factor-beta 1, a cellular messenger that stimulates cells.

The result of the study was that the horses treated with ESWT had a statistically significant decrease in lesion area and improved fiber alignment and echogenicity of the ligament (indicating more solid tissue and less fluid swelling) when compared with control ligaments.

A major problem in clinical cases of suspensory desmitis is that the horse remains chronically lame with lesions that seem to be slow to heal, said McClure. In this study, researchers induced suspensory ligament desmitis in order to control the damage and monitor healing.

McClure used the same ESWT treatment protocol that he uses in treating clinical cases, which was three treatments at three-week intervals, with 1,500 pulses per treatment at an energy setting of 0.13 mJ/mm2.

"It is well known that ESWT is dose-dependent," said McClure. "Low energy and a low number of pulses may have no effect, whereas excessive energy or pulses may be detrimental. It is possible that refinement of the technique could result in improved healing."​
 
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