Ultrasound-Guided Radiofrequency Ablation and Pulsed Radiofrequency Treatment for Chronic Lameness Due to Distal Forelimb Disease in Horses: A Pilot Study

Radiofrequency ablation (RFA) and pulsed radiofrequency (PRF) are non-pharmacological techniques employed in humans for chronic pain, but their veterinary application is unexplored. This pilot study evaluated clinical effects of RFA and PRF in twenty-four horses with chronic distal forelimb lameness. Ultrasound-guided RFA (N = 8; 60-90 °C, 2-8 min) or PRF (N = 16; 42 °C; 12 min) was applied to palmar digital nerves. Lameness was scored (American Association of Equine Practitioners scale) at baseline and monthly for six months (T1-T6). At T2, partial- and non-responders in both groups received PRF. Complications and return to previous work were recorded. At T2, the PRF group had significantly lower lameness scores (1, 0-3) than the RFA group (3, 2-4; <i>p</i> < 0.001) and significantly improved from baseline (3, 2-4; <i>p</i> < 0.01). RFA caused more complications (N = 6) than PRF (N = 1; <i>p</i> < 0.001), including increased lameness and allodynia. Sixteen horses (RFA: N = 7; PRF: N = 9) were retreated at T2. Overall, lameness significantly improved from T2 (2, 0-4) to T6 (0, 0-3; <i>p</i> < 0.001). At T6, 83% (19/23) of horses resumed previous work. RFA was ineffective and caused complications, whereas PRF appeared safer and more effective. Two PRF treatments yielded better outcomes with fewer side effects and may help manage lameness and associated pain for up to six months.