Nonseptic tenosynovitis of the digital flexor tendon sheath caused by longitudinal tears in the digital flexor tendons: a retrospective study of 135 tenoscopic procedures.
Abstract: Longitudinal tears (LTs) of the digital flexor tendons are an important cause of chronic tenosynovitis of the digital flexor tendon sheath (DFTS). The origin of those marginal tears is not yet fully understood. The long-term outcome after medical and surgical treatment is guarded. Objective: To determine the prevalence of LTs of the digital flexor tendons in a large population of horses undergoing diagnostic tenoscopy of the DFTS and to assess the outcome of surgical treatment and the factors influencing the outcome. Methods: Medical records of 130 horses with chronic tenosynovitis of the DFTS that had tenoscopic surgery between 1999 and 2009 were evaluated. One hundred and thirty-five DFTSs were examined. LTs were diagnosed in 104 DFTSs in 101 horses and long-term follow-up was obtained. Results: Seventy-eight percent of the horses with a nonseptic tenosynovitis of the DFTS had a LT. Preoperative ultrasonographic examination diagnosed tears in 76% of the cases. In showjumpers forelimbs were more frequently affected than hindlimbs (88 vs. 12%), with the right front having a higher incidence of injury than the left front (76 vs. 24%). Seventy-nine percent of the tears involved the deep digital flexor tendon (DDFT) and 87% were located on the lateral tendon border. Thirty-seven horses (38%) returned to an equal or higher level of work. The use of a radiofrequency probe (coblation) was associated with a lower level of performance and decreased the cosmetic end result. Persistence of marked post operative distension of the DFTS carried a poor prognosis for return to previous level of work. Conclusions: A guarded prognosis for future soundness should be given to horses presented for treatment of LTs of the digital flexor tendons. The use of coblation wands had a negative effect on the final outcome.
© 2010 EVJ Ltd.
Publication Date: 2011-06-08 PubMed ID: 21649711DOI: 10.1111/j.2042-3306.2010.00341.xGoogle Scholar: Lookup
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- Journal Article
- Research Support
- Non-U.S. Gov't
Summary
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The research investigates the impact of longitudinal tears (LTs) in the digital flexor tendons on nonseptic tenosynovitis of digital flexor tendon sheath (DFTS) in horses. The records of horses treated via tenoscopic surgery between 1999 and 2009 were evaluated, finding that LTs were diagnosed in the majority, and the long-term outcome tended to be guarded, particularly when using a radiofrequency probe (coblation).
Study Overview
- The study is a retrospective investigation into nonseptic tenosynovitis caused by longitudinal tears (LTs) in the digital flexor tendons of horses. Tenosynovitis is the inflammation of a fluid-filled sheath that surrounds a tendon, and in this case, the inflammation occurring in the DFTS.
- The research sample included 130 horses that underwent tenoscopic surgery between 1999 and 2009 for chronic tenosynovitis of the DFTS. A total of 135 DFTS cases were examined.
- The goal was to determine the prevalence of LTs in this population, assess the outcome of surgical treatment, and identify factors influencing the outcomes.
Key Findings
- Of the cases examined, LTs were diagnosed in 104 DFTSs in 101 horses. This amounts to 78% of horses with nonseptic tenosynovitis of the DFTS having an LT.
- Preoperative ultrasonographic examinations were able to diagnose tears in 76% of the cases.
- Among showjumper horses, the forelimbs were more frequently affected than the hindlimbs (88 vs. 12%), with the right front having a higher incidence of injury than the left front (76 vs. 24%).
- Most of the tears involved the deep digital flexor tendon (DDFT) (79%), and 87% were located on the lateral tendon border.
- Only 37 horses (38%) were able to return to an equal or higher level of work post-surgery.
Impact of Coblation
- The use of a radiofrequency probe, also known as coblation, was found to be associated with a lower level of performance and decreased the cosmetic result after surgery.
- Noticeable post-operative distension of the DFTS was associated with a poor prognosis for the horse to return to its previous level of work.
Conclusions
- The study concluded with a guarded prognosis for future soundness for horses undergoing treatment of LTs in the digital flexor tendons. This basically means the long-term outcome for these horses is uncertain and typically not promising.
- The use of coblation wands during surgery had a negative effect on the final outcome, suggesting alternatives need to be explored for improved treatment outcomes.
Cite This Article
APA
Arensburg L, Wilderjans H, Simon O, Dewulf J, Boussauw B.
(2011).
Nonseptic tenosynovitis of the digital flexor tendon sheath caused by longitudinal tears in the digital flexor tendons: a retrospective study of 135 tenoscopic procedures.
Equine Vet J, 43(6), 660-668.
https://doi.org/10.1111/j.2042-3306.2010.00341.x Publication
Researcher Affiliations
- Dierenkliniek de Bosdreef, Spelonckvaart 46, Moerbeke-Waas, Belgium and Dierenkliniek De Morette, Edingsesteenweg 237, Asse, Belgium.
MeSH Terms
- Animals
- Female
- Forelimb
- Horse Diseases / surgery
- Horses
- Male
- Retrospective Studies
- Tendons / pathology
- Tenosynovitis / diagnosis
- Tenosynovitis / surgery
- Tenosynovitis / veterinary
Citations
This article has been cited 4 times.- van Veggel ECS, Selberg KT, van der Velde-Hoogelander B, Vanderperren K, Cokelaere SM, Bergman HJ. Deep Digital Flexor Tendon Injury at the Level of the Proximal Phalanx in Frontlimbs With Tendon Sheath Distension Characterized by Standing Low-Field Magnetic Resonance Imaging in Horses: 13 Cases (2015-2021).. Front Vet Sci 2021;8:734729.
- Chanda M, Klinphayom C, Sungsuwan T, Senarat W, Thongkham E, Kamlangdee A, Senarat N. Diagnostic imaging features, cytological examination, and treatment of lymphocytic tenosynovitis of the common digital extensor tendon sheath in an eventing horse.. Vet Anim Sci 2021 Dec;14:100209.
- Khan MR, Dudhia J, David FH, De Godoy R, Mehra V, Hughes G, Dakin SG, Carr AJ, Goodship AE, Smith RKW. Bone marrow mesenchymal stem cells do not enhance intra-synovial tendon healing despite engraftment and homing to niches within the synovium.. Stem Cell Res Ther 2018 Jun 19;9(1):169.
- Bertuglia A, Mollo G, Bullone M, Riccio B. Identification of surgically-induced longitudinal lesions of the equine deep digital flexor tendon in the digital flexor tendon sheath using contrast-enhanced ultrasonography: an ex-vivo pilot study.. Acta Vet Scand 2014 Nov 25;56(1):78.
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