Radial Extracorporeal Shock Wave Therapy for Chronic Insertion Desmopathy of the Proximal Suspensory Ligament

In human medicine, extracorporeal shock wave lithotripsy is an established therapeutic procedure for treatment of renal calculi. In the last few years extracorporeal shock wave therapy (ESWT) also has been used in human orthopedic treatment, especially chronic insertion tendopathy/desmitis such as “tennis elbow,” tendinosis calcarea, and pseudarthrosis. In the veterinary field, the use of ESWT is at the beginning. So far, there is little information about different indications, treatment regimens and long term results. Since June 1998, at the Tierklinik Telgte, Germany, horses with different orthopedic conditions have been treated with Radial Extracorporeal Shock Wave Therapyt. The aims were 1) to collect first experiences with the new therapy; and 2) to establish the treatment as standard indication for limited indications. Therapy of chronic insertion desmopathy of the proximal suspensory ligament in equine front and hind limb is somewhat frustrating. This condition is characterized by a high rate of recurrence and low success rate. Systemic or local application of antiphlogistics and corticoids, blistering, combined with long periods without work and finally surgery (peripheral neurectomy) are described and documented. Long term follow up information about the treatment of chronic longstanding high suspensory desmitis are still missing in veterinary literature. This condition seemed to be ideal for ESWT treatment evaluation, for ESWT is known as a safe, alternative, non-invasive therapy without serious side effects.