Endoscopic evaluation of the navicular bursa: observations, treatment and outcome in 92 cases with identified pathology.

This research evaluates the usefulness of diagnostic navicular bursoscopy in horses, by analyzing clinical, diagnostic and endoscopic findings of 92 cases, surgical techniques used, and the outcome of these cases. The study also evaluates the prognostic values of this method in identifying and treating navicular injuries and diseases in horses.

Research Objective and Hypothesis

• The objective of this study was threefold: to report on the clinical, diagnostic and endoscopic findings in a series of cases, to assess surgical techniques and case outcomes, and to explore the prognostic values of the procedure.
• The authors had four hypotheses: that lameness localizing to the navicular bursa is commonly associated with injuries to the deep digital flexor tendon (DDFT); that endoscopy allows for the assessment and treatment of these injuries; that case outcome is related to the severity of DDFT injury; and that the technique itself is safe and carries little risk of morbidity.

Methods

• The study was conducted by reviewing case files of all horses that underwent endoscopy of a forelimb navicular bursa for the investigation of lameness.
• Cases with injuries within the bursa were selected for further analysis.

Results

• Out of the one-hundred-and-fourteen horses identified, ninety-two had injuries within the bursa and DDFT injuries were identified in 98% of these.
• When these horses were examined using Magnetic Resonance Imaging (MRI), it was discovered that 56% had combination injuries involving both the DDFT and the navicular bone.
• Regarding the efficacy of the treatment, it was found that 61% of the horses returned to their work sound with 42% returning to their previous performance level. However, horses with extensive tearing and combination injuries of the DDFT and navicular bone identified with MRI had worse outcomes.

Conclusions

• The authors concluded that lameness localising to the navicular bursa is commonly associated with injuries to the dorsal border of the DDFT.
• Bursoscopy was seen to be effective in identifying and characterising injuries within the navicular bursa and enables lesion management.
• The outcome following debridement was related to the severity of the injury but overall was deemed reasonable.
• Finally, it was posited that horses with lameness localising to the navicular bursa may have tears of the DDFT and that bursoscopy can provide beneficial diagnostic and prognostic information, with debridement of lesions improving the outcome compared to conservative management.