A study of 118 cases of navicular disease: treatment by navicular suspensory desmotomy.

This study explores the treatment of navicular disease in 118 horses using a surgical procedure known as navicular suspensory desmotomy, and examines the factors that affect the success of the treatment. After the surgery, horses were monitored for up to 36 months with check-ups every 6 months. The findings show that while a substantial percentage of horses were found to be free of the disease after treatment, several factors including age, severity of lameness and certain clinical features adversely affected the outcome.

Treatment by Navicular Suspensory Desmotomy

• The main focus of this research was on treating navicular disease, a painful condition in horses, through a surgical procedure called navicular suspensory desmotomy, where the ligamenta sesamoidea collateralia is severed. This is one of the ligaments that stabilize the distal sesamoid bone, often implicated in navicular disease.
• Out of the 118 horses that were diagnosed and then treated, three different surgical techniques were employed, though the research does not specify what these were. Post-surgery, the horses went through a standardized recovery program to facilitate healing and restoration of normal function.

Clinical and Radiological Evaluations

• These evaluations were carried out at intervals of 6 months to track the progress of the patients, with the longest follow-up period being 36 months. This allowed the researchers to determine the efficacy and longevity of the treatment.
• About 76% of the horses were sound or cured 6 months post-surgery, but this fell to roughly 43% after 36 months.

Factors Impacting the Outcome of Surgery

• The study identified several factors that adversely affected the success of the surgical treatment, including the age of the horse, the duration and severity of lameness and angular limb deformities.
• Additionally, certain pre-exiting clinical features appeared to reduce the effectiveness of surgery, including defects of the flexor cortex, enthesophytes on the proximal border, mineralisation of the deep digital flexor tendon and medullary sclerosis.

Radiological Changes and Clinical Outcome

• Post-surgery, only about 1.7% of horses showed changes in the radiological appearance of distal border synovial invaginations.
• However, around 67.3% had changes in flexor cortex defects, a condition often associated with navicular disease. Other radiological features showed changes at lower frequency.
• Relevantly, despite these changes, there seemed to be no clear relationship between the occurrence of radiological changes and the clinical outcome, i.e., whether the horse healed or not.