Conservative management of equine tarsal collateral ligament injuries may allow return to normal performance.
Authors: Claudia Fraschetto, Michaël Dancot, M. Vandersmissen, J. Denoix, V. Coudry
Journal: Journal of the American Veterinary Medical Association
Summary
Tarsal collateral ligament injuries in horses have historically carried guarded prognoses, yet a 20-year retrospective analysis of 78 horses treated conservatively suggests that many animals can return to their previous level of performance without surgical intervention. The study identified 108 ligament injuries across the cohort, with the short lateral and long medial collateral ligaments most frequently affected; enthesopathies (insertion site pathology) were notably more common than isolated ligament damage, comprising 72% of all lesions. Conservative management—primarily stall rest for a median of 120 days—resulted in successful return to work in 81% of horses, with 61% achieving their pre-injury performance level or better, though horses with severe lesions were significantly less likely to recover satisfactorily. The critical finding that outcome did not differ significantly between single and multiple ligament injuries suggests that conservative protocols may be more forgiving than previously thought, provided thorough ultrasound evaluation guides clinical decision-making. For equine practitioners, this evidence supports a measured approach to tarsal collateral ligament injuries, reserving surgical options for severe cases whilst counselling owners that extended rest periods (typically 4–6 months) offer reasonable prospects for return to work and competition.
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Practical Takeaways
- •Conservative stall rest (median 120 days) is effective for most tarsal collateral ligament injuries, with 81% of horses returning to work within 6 months
- •Severity of lesions on ultrasound is the primary predictor of failure to return to work; enthesopathies (72% of cases) have better prognoses than isolated desmopathies
- •Many horses return to their previous performance level or better, making conservative management a reasonable first-line approach before considering surgical intervention
Key Findings
- •Short lateral collateral ligament was most commonly affected (44/108 ligaments), followed by long medial collateral ligament (27/108)
- •Enthesopathies were more frequent than desmopathies alone (72.1% vs 27.9%)
- •81% of conservatively managed horses (50/62) returned to work within 6 months with median rest of 120 days
- •61% of horses achieved equal or higher performance level after injury; horses with severe lesions were significantly less likely to return (P = 0.01)