Abstract
There are several non-steroidal intra-articular therapeutics (NSIATs) available for use by equine practitioners for the treatment of performance-limiting joint-related pathology. Information is limited on perceived clinical efficacy, recommended treatment protocols, and associated complications. Our objective with this cross-sectional survey was to investigate the current clinical usage of NSIATs by equine practitioners. An electronic cross-sectional convenience survey inquiring about the use of steroidal and NSIATS (platelet-rich plasma, autologous conditioned serum, autologous protein solution, cellular therapies, and polyacrylamide hydrogel) was distributed internationally to equine practitioners. A total of 353 surveys were completed. NSIATs were used by 87.5% of the participants. Corticosteroids and hyaluronic acid remain the intra-articular therapeutic of choice among practitioners, followed by autologous conditioned serum, platelet-rich plasma and autologous conditioned protein. Polyacrylamide hydrogel was the least used. Practitioners were more likely to use NSIATs if their caseload was > 50% equine (P < 0.001), they treated more than 10 horses intra-articularly per month (P < 0.001), and horses treated were considered English sport horses (P = 0.02). Years in practice and practice location did not influence the use of NSIATs. One of the most common reasons why NSIATs were chosen was to treat acute articular pathologies. As survey limitations, answers to questions regarding clinical response and complication rates were based on subjective estimation and practitioners recall, not clinical records. In conclusion, corticosteroids remain the most widely used intra-articular therapeutic. Among the NSIATs, blood-based products are more commonly used by practitioners, followed by cellular and synthetic products. Equine practitioners frequently use NSIATs, choosing to treat acute joint pathology more than previously reported.
Highlights
Within the equine industry, lameness as a result of musculoskeletal pain, osteoarthritis (OA), has significant economic impact and is one of the top reasons for veterinary evaluation and treatment [1, 2]
The survey would provide information as to which non-steroidal intraarticular therapies (NSIATs) are more commonly used by equine practitioners as well as subjective clinical efficacy, treatment protocols commonly employed, and complications associated with product use
English sport horse practitioners were more likely to use NSIATs compared to other disciplines (P = 0.02)
Summary
Lameness as a result of musculoskeletal pain, osteoarthritis (OA), has significant economic impact and is one of the top reasons for veterinary evaluation and treatment [1, 2]. Several different intra-articular medications are available to equine practitioners to help alleviate musculoskeletal pain, especially when initial rest and systemic anti-inflammatory therapy is unsuccessful [3]. There is limited information regarding the clinical experience of practitioners with these products, such as their product preference and treatment protocol [4, 12]. This survey was not a hypothesis-driven study. The survey would provide information as to which NSIATs are more commonly used by equine practitioners as well as subjective clinical efficacy, treatment protocols commonly employed, and complications associated with product use
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