Intrabursal Polyacrylamide Hydrogel for the Treatment of Nonresponsive Navicular Apparatus Pathology in Three Horses

Introduction: Polyacrylamide hydrogel (PAAG) is a novel joint treatment, increasingly used in distal limb joints. The aim of this case report is to describe its use in cases of navicular bursal (NB) pathology, which has not previously been described. All cases underwent thorough orthopaedic evaluation, standing MRI, and had ongoing corrective farriery.

Case Descriptions and Results Case 1:: 18-year-old dressage gelding with chronic, intermittent, severe LF lameness due to a DDFT split and protrusion into the navicular bursa. Blocked to NB but failed to respond to medication of DIP and NB with triamcinolone over 5 months. The NB was medicated with 1 mL PAAG. There was improvement over 2 months and the horse was still competing 2 years later.

Case 2: A 10-year-old dressage gelding with moderate LF lameness for 2 months due to chronic dorsal DDFT tear with tendon fibre prolapse into NB. No response to medication of DIP and NB with triamcinolone over 3 months. Lameness improved over 2 to 3 months after PAAG treatment, and the horse was competing successfully 18 months later

Case 3: An 8-year-old Eventer Gelding with intermittent chronic moderate RF lameness. Blocked to NB with NB and bone pathology. No response to NB medication with triamcinolone. Lameness improved after PAAG, and the horse competing successfully for two seasons.

Discussion: These are encouraging results and PAAG should be considered in nonresponsive NB cases, with no adverse reactions and good long-term results. The study is limited by the lack of controls but medical treatment options were exhausted.