Combination Therapy is Superior to Conventional or Laser Therapy Alone for Equine Tendon and Ligament Injuries: A Comparison of 61 Clinical Cases

Introduction: Laser therapy is often combined with conventional therapies but there are no studies to justify this. The aim was to compare laser therapy, with or without conventional treatment, to conventional treatment alone.

Materials and Methods: All clinical cases receiving high-power, multiple-frequency laser therapy in a referral center were divided into groups that received laser therapy only (Laser) or conventional treatments in addition (Combination); these were compared with cases receiving conventional therapies without laser treatment (Conventional). Horses were hospitalized for treatment with a Class IV laser (15W, 4 frequencies: 630–1064 nm) (FP4; TLX International) twice daily for 10 to 14 days. Return to previous level of exercise was assessed, with a minimum follow-up of 1 year.

Results: There were 61 cases, including all SDFT and suspensory cases treated with laser 2014–2016. All were mature sport horses. There were no statistical significances between groups in structures affected or chronicity. Conventional treatments included soft-tissue optimized hyaluronic acid, autologous conditioned serum, platelet-rich plasma, mesenchymal stem cells, therapeutic ultrasound, shockwave therapy and surgery.

No significant complications were noted with laser treatment. On censured analysis, 12/23 (52%) of the Conventional group returned to full function, compared with 10/16 (63%) of the Laser group and 12/13 (92%) of the Combination group. Success was increased with Laser compared with Conventional treatment, but not significantly. Combination treatment was significantly superior to Conventional treatment (p = 0.025).

Discussion/Conclusion: This study supports the use of combination therapy in a clinical setting. These results may not be applicable to other types of lasers.

Acknowledgement: No proprietary interest or funding was provided for this project.