Orthobiology for joint problems in sport horses

Corticosteroids remain a popular treatment for joint disease in horses, primarily for their potent anti-inflammatory effects, our collective experience through decades of use and the fact that they are relatively inexpensive and readily accessible. These medications keep horses comfortable, but they also have risks associated to their use. Infection at the injection site (a risk with any joint injection) and laminitis-inducing reactions to corticosteroids can occur. Once joint injections commence, they often need to be continued to maintain a horse’s comfort throughout his life. Furthermore, corticosteroids can mask pain, allowing the horse to load the affected joint more than he would if unmedicated thus increasing the risk for a catastrophic injury such as a fracture, or ongoing articular cartilage damage. In the past decade, veterinarians have begun to drift away from corticosteroids towards non-steroidal intra-articular drugs (NSAID’s) and orthobiologics, as a first-choice treatment earlier on in the disease process, because of their disease modifying potential. Whilst we further recognize that different clients may have varying expectations and financial constraints, it is our responsibility as veterinarians to offer all the alternative treatment options available for a specific disease. The use of orthobiologics for preventive or therapeutic purposes has become mainstay in equine orthopedics and the number of treatment options available to equine practitioners has significantly increased. We will try to compare the different types of biologics. What advantages and disadvantages does each one has? Are some better suited for certain types of conditions? What treatment protocols promise the best results?