Does high-intensity laser therapy speed return to primary function in horses with suspensory ligament desmopathy?



Open Access Logo



PICO question

In horses with a suspensory ligament branch injury, does high-intensity laser therapy (energy output greater than 500 mW) combined with conservative management, compared to conservative management alone, result in a faster return to primary function?


Clinical bottom line

Category research


Number and type of study deisgns reviewed

The number and type of study designs that were critically appraised were two peer-reviewed studies: a non-randomised controlled clinical trial and a randomised controlled experimental study.

Strength of evidence


Outcomes reported

The outcomes reported are summarised as follows: the two appraised studies report positive effects of high-intensity laser therapy (HILT) on equine tendon and ligament injuries as measured by pain to palpation, lameness, swelling and ultrasonographic and magnetic resonance imaging (MRI) evaluation of HILT-treated lesions.


In view of the strength of evidence and the outcomes from the studies the following conclusion is made: the two appraised studies provide only weak evidence to show that horses treated with high-intensity laser therapy (HILT) and conservative management return to primary function sooner than horses treated with conservative management alone. Issues of design, methodology, statistical analysis and reporting reduce the reliability and external validity of these studies.


How to apply this evidence in practice

The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.

Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.


Ahmad, M., Hamid, M. & Yusof, A. (2021). Effects of low-level and high-intensity laser therapy as adjunctive to rehabilitation exercise on pain, stiffness and function in knee osteoarthritis: a systematic review and meta-analysis. Physiotherapy. 114, 85–95. DOI:

Christley, R. & French, N. (2018). Validity in epidemiological studies. In: M. Thrusfield & R. Christley, eds., Veterinary Epidemiology, 4th Hoboken, NJ, USA: John Wiley, 383–396.

Dyson, S. (2007). Diagnosis and Management of Common Suspensory Lesions in the Forelimbs and Hindlimbs of Sport Horses. Clinical Techniques in Equine Practice. 6(3), 179–188. DOI:

Dyson, S. (2018). Suspensory branch injuries in sports horses and racehorses. UK-Vet Equine. 2(3), 90–96. DOI:

Estrada, R., van Weeren, P., van de Lest, C., Boere, J., Reyes, M., Ionita, J., Estrada, M. & Lischer, C. (2014). Comparison of healing in forelimb and hindlimb surgically induced core lesions of the equine superficial digital flexor tendon. Veterinary and Comparative Orthopaedics and Traumatology. 27(5), 358–365. DOI:

Fortuna, D. (2017). High‐Intensity Laser Therapy for the Equine Patient. In: R. Riegel & J. Godbold, Jr., eds., Laser Therapy in Veterinary Medicine: Photobiomodulation, 1st Chichester, West Sussex, UK: John Wiley and Sons, 415–421.

Fortuna, D., Rossi, G., Paolini, C., Magi, A., Losani, F., Fallaci, S., Pacini, F., Porciani, C., Sandler, A., Torre, R., Pinna, S. & Venturini, A. (2002). Nd:YAG pulsed-wave laser as support therapy in the treatment of teno-desmopathies of athlete horses: a clinical and experimental trial. Laser Florence 2001: A Window on the Laser Medicine World. SPIE. 4903, 105–118. DOI:

Jaafar, S., Al-Bayti, A. & Abdullah, S. (2021). Using Short Term of High Power Laser Therapy in Horse’s Tendon Injuries. Archives of Razi Institute. 76(5), 1437–1444. DOI:

Mongkolrat, N., Arsakit, N., Kidtiwong, A., Issariyodom, P., Pirunsan, U., Lampang, K. & Rungsri, P. (2021). Comparison of High Intensity Laser Stimulation of Acupuncture Points and Therapeutic Ultrasound for Relief of Chronic Lower Back Pain in Horses. American Journal of Traditional Chinese Veterinary Medicine. [online]. 16(2), 31–40. Available at: [Accessed December 2021].

Pluim, M., Martens, A., Vanderperren, K., Sarrazin, S., Koene, M., Luciani, A., van Weeren, P. R. & Delesalle, C. (2018). Short- and long term follow-up of 150 sports horses diagnosed with tendinopathy or desmopathy by ultrasonographic examination and treated with high-power laser therapy. Research in Veterinary Science. 119, 232–238. DOI:

Pluim, M., Martens, A., Vanderperren, K., van Weeren, R., Oosterlinck, M., Dewulf, J., Kichouh, M., Van Thielen, B., Koene, M., Luciani, A., Plancke, L. & Delesalle, C. (2020). High-Power Laser Therapy Improves Healing of the Equine Suspensory Branch in a Standardized Lesion Model. Frontiers in Veterinary Science. 7, 600. DOI:

Pluim, M., Heier, A., Plomp, S., Boshuizen, B., Gröne, A., van Weeren, R., Vanderperren, K., Martens, A., Dewulf, J., Chantziaras, I., Koene, M., Luciani, A., Oosterlinck, M., Van Brantegem, L. & Delesalle, C. (2022). Histological tissue healing following high-power laser treatment in a model of suspensory ligament branch injury. Equine Veterinary Journal. 54(6), 1114–1122. DOI:

Preacher, K. (2001). Calculation for the chi-square test: An interactive calculation tool for chi-square tests of goodness of fit and independence. [online]. Available at: [Accessed December 2021].

Quiney, L., Murray, R. & Dyson, S. (2020). Management of Primary Injuries of the Medial Collateral Ligament of the Carpus in Two Horses. Journal of Equine Veterinary Science. 86, 102878. DOI:

R Core Team. (2021). R: A language and environment for statistical computing. R foundation for statistical computing, Vienna, Austria. [online]. Available at: [Accessed December 2021].

Ribitsch, I., Baptista, P., Lange-Consiglio, A., Melotti, L., Patruno, M., Jenner, F., Schnabl-Feichter, E., Dutton, L., Connolly, D., van Steenbeek, F., Dudhia, J. & Penning, L. (2020). Large Animal Models in Regenerative Medicine and Tissue Engineering: To Do or Not to Do. Frontiers in Bioengineering and Biotechnology. 8, 972. DOI:

Schramme, M., Hunter, S., Campbell, N., Blikslager, A. & Smith, R. (2010). A surgical tendonitis model in horses: Technique, clinical, ultrasonographic and histological characterisation. Veterinary and Comparative Orthopaedics and Traumatology. 23(4), 231–239. DOI:

Zielińska, P., Kiełbowicz, Z. & Paczuska, J. (2015). High Intensity Laser Therapy (HILT) in the treatment of orthopedic diseases in horses. Medycyna weterynaryjna. [online]. 71(6), 373–376. Available at: (in Polish, English abstract). [Accessed December 2021].

Zielińska, P., Nicpoń, J., Kiełbowicz, Z., Soroko, M., Dudek, K. & Zaborski, D. (2020). Effects of High Intensity Laser Therapy in the Treatment of Tendon and Ligament Injuries in Performance Horses. Animals. 10(8), 1327. DOI:

Zielińska, P., Soroko, M., Howell, K., Godlewska, M., Hildebrand, W. & Dudek, K. (2021). Comparison of the Effect of High-Intensity Laser Therapy (HILT) on Skin Surface Temperature and Vein Diameter in Pigmented and Non-Pigmented Skin in Healthy Racehorses. Animals. 11(7), 1965. DOI:

Vol. 8 No. 1 (2023): The first issue of 2023

Section: Knowledge Summaries

Categories :  Small Animal  /  Dogs  /  Cats  /  Rabbits  /  Production Animal  /  Cattle  /  Sheep  /  Pig  /  Equine  /  Exotics  /