In horses with osteoarthritis is treatment with intra-articular polyacrylamide gel more likely to reduce the severity of clinical signs associated with lameness when compared to treatment with intra-articular corticosteroid?

PICO question In horses with naturally occurring osteoarthritis, is treatment with intra-articular polyacrylamide gel more likely to reduce the severity of clinical signs associated with lameness when compared to treatment with intra-articular corticosteroid?   Clinical bottom line Category of research question Treatment The number and type of study designs reviewed Twelve studies; four case series, three uncontrolled prospective studies, one non-blinded, non-randomised control trial, one non-blinded randomised control trial, two systematic reviews and one systematic review and meta-analysis Strength of evidence Weak Outcomes reported Studies examined: Clinical signs relating to lameness after use of corticosteroid or polyacrylamide gel to treat osteoarthritis; improvement in lameness and treatment success (including return to work in some papers) Conclusion It is not possible to recommend one treatment over the other given the absence of studies which provide direct comparison. This highlights the need for further controlled and comparative 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.