Outcome of tenoscopically guided palmar/plantar annular ligament desmotomy for the treatment of palmar/plantar annular ligament constriction without concurrent intrathecal soft-tissue injury in a UK horse population.
Abstract: To determine the outcome of tenoscopically guided palmar/plantar annular ligament (PAL) desmotomy to treat PAL constriction without concurrent intrathecal soft-tissue injury, notably of the digital flexor tendons and manica flexoria. Methods: Retrospective multicenter cohort study. Methods: Sixty-five horses. Methods: Horses from four UK equine hospitals, with digital flexor tendon sheath (DFTS) tenosynovitis, which underwent tenoscopically guided PAL desmotomy for treatment of PAL constriction between 2017 and 2022 were included. All horses had lameness isolated to the DFTS/PAL, and PAL constriction was diagnosed tenoscopically when there was difficulty maneuvering the endoscope into or through the fetlock canal. Horses with tearing of the digital flexor tendons and/or manica flexoria, or any other intrathecal pathology, were excluded. Follow up was via structured telephone questionnaire. Results: Follow up (median 25 months) was available for 61 horses with cobs and ponies predominating. Forty-two returned to their previous level of work, or a higher level, postoperatively and 50 owners were satisfied with the outcome of surgery. Eleven horses returned to lower level exercise, and six were retired/euthanized as they did not regain soundness. Fifty-two horses achieved soundness (median 3 months postoperatively). Conclusions: Tenoscopically guided PAL desmotomy for the treatment of PAL constriction in the absence of intrathecal soft tissue injury had a good prognosis for return to previous levels of exercise in a UK horse population. Conclusions: The prognosis for horses undergoing tenoscopically guided PAL desmotomy to treat PAL constriction in the absence of intrathecal injury is better than previously described. Cobs and ponies seem to be predisposed to PAL constriction in agreement with the previous literature.
© 2024 The Author(s). Veterinary Surgery published by Wiley Periodicals LLC on behalf of American College of Veterinary Surgeons.
Publication Date: 2024-05-29 PubMed ID: 38808526DOI: 10.1111/vsu.14120Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Journal Article
Summary
This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.
This research study evaluates the outcome of a surgical procedure called the tenoscopically guided palmar/plantar annular ligament (PAL) desmotomy in treating PAL constriction in horses. The successful study results showed a good prognosis for horses to return to previous levels of exercise after the procedure, especially when there are no other injuries in the soft tissue.
Research Methodology
- The study is a retrospective multicenter cohort type, involving sixty-five horses from four UK equine hospitals.
- The horses had digital flexor tendon sheath (DFTS) tenosynovitis and had undergone PAL desmotomy, a surgical procedure, to treat PAL constriction between 2017 and 2022.
- The condition was diagnosed when there was difficulty maneuvering the endoscope into or through the fetlock canal during a tenoscopic examination.
- Horses with additional injuries, like tearing of the digital flexor tendons and/or manica flexoria or any other intrathecal pathology, were excluded from the study.
- Follow ups were performed using a structured telephone questionnaire.
Results of the Study
- Follow-ups were available for 61 horses, targeting cobs and ponies predominantly.
- Forty-two horses returned to their previous level of work or even a higher level after the surgery. Also, 50 owners expressed satisfaction with the outcome of the surgery.
- Eleven horses only returned to a lower level of exercise, whereas six horses were either retired or euthanized as they didn’t regain soundness.
- Typically, the horses achieved soundness about three months after the surgery.
Conclusions from the Study
- The study asserts that tenoscopically guided PAL desmotomy for treating PAL constriction, where there’s no soft tissue injury, has a good prognosis for return to previous exercise levels in a UK horse population.
- The prognosis for this surgical procedure is even better than described previously in the literature.
- Cobs and ponies are identified as predisposed to PAL constriction, according to the study and accompanying literature.
Cite This Article
APA
Wood AD, Parker RA, Marcatili M, Anderson J, Robinson N, Stack JD.
(2024).
Outcome of tenoscopically guided palmar/plantar annular ligament desmotomy for the treatment of palmar/plantar annular ligament constriction without concurrent intrathecal soft-tissue injury in a UK horse population.
Vet Surg.
https://doi.org/10.1111/vsu.14120 Publication
Researcher Affiliations
- Liphook Equine Hospital, Forest Mere, Hampshire, UK.
- Liphook Equine Hospital, Forest Mere, Hampshire, UK.
- Pool House Equine Clinic, Crown Inn Farm, Fradley, UK.
- Rainbow Equine Hospital, Rainbow Farm, Malton, UK.
- VetPartners Ltd, York, UK.
- University of Liverpool, Department of Equine Clinical Studies, Neston, UK.
References
This article includes 20 references
- Cender AN, Mählmann K, Ehrle A, Merle R, Pieper L, Lischer CJ. Diagnosis and outcome following tenoscopic surgery of the digital flexor tendon sheath in German sports and pleasure horses.. Equine Vet J 2023;55(1):48‐58.
- Kent AV, Chesworth MJ, Wells G. Improved diagnostic criteria for digital flexor tendon sheath pathology using contrast tenography.. Equine Vet J 2020;52(2):205‐212.
- Arensburg L, Wilderjans H, Simon O, Dewulf J, Boussauw B. 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 2011;43(6):660‐668.
- Smith MRW, Wright IM. Noninfected tenosynovitis of the digital flexor tendon sheath: a retrospective analysis of 76 cases.. Equine Vet J 2010;38(2):134‐141.
- Findley JA, De Oliveira F, Bladon B. Tenoscopic surgical treatment of tears of the Manica Flexoria in 53 horses.. Vet Surg 2012;41(8):924‐930.
- Owen KR, Dyson SJ, Parkin TDH, Singer ER, Kristoffersen M, Mair TS. Retrospective study of palmar/plantar annular ligament injury in 71 horses: 2001‐2006.. Equine Vet J 2008;40(3):237‐244.
- Hawkins A, O'Leary L, Bolt D, Fiske‐Jackson A, Berner D, Smith R. Retrospective analysis of oblique and straight distal sesamoidean ligament desmitis in 52 horses.. Equine Vet J 2022;54(2):312‐322.
- Schramme MC, Smith RKW. Diseases of the digital synovial sheath, palmar annular ligament, and digital annular ligaments.. Diagnosis and Management of Lameness in the Horse Elsevier Inc; 2003:674‐684.
- Fortier LA, Nixon AJ, Ducharme NG, Mohammed HO, Yeager A. Tenoscopic examination and proximal annular ligament desmotomy for treatment of equine “complex” digital sheath tenosynovitis.. Vet Surg 1999;28(6):429‐435.
- McGhee JD, White NA, Goodrich LR. Primary desmitis of the palmar and plantar annular ligaments in horses: 25 cases (1990–2003).. J Am Vet Med Assoc 2005;226(1):83‐86.
- Auer J, Stick J. Equine Surgery.. 2012.
- McIlwraith CW, Nixon AJ, Wright IM. Tenoscopy.. Diagnostic and Surgical Arthroscopy in the Horse Elsevier; 2015:344‐386.
- Fiske‐Jackson AR, Barker WHJ, Eliashar E, Foy K, Smith RKW. The use of intrathecal analgesia and contrast radiography as preoperative diagnostic methods for digital flexor tendon sheath pathology.. Equine Vet J 2013;45(1):36‐40.
- AAEP Horse Show Committee. Guide to Veterinary Services for Horses Shows.. 7th ed. American Association of Equine Practitioners; 1999.
- Wyn‐Jones G. Equine Lameness.. Blackwell Scientific; 1988.
- Kümmerle JM, Theiss F, Smith RKW. Diagnosis and Management of Tendon and Ligament Disorders.. Equine Surgery Elsevier; 2019:1411‐1445.
- Aßmann AD, Ohlerth S, Torgerson PR, Bischofberger AS. Sensitivity and specificity of 3 tesla magnetic resonance imaging and multidetector computed tomographic tenography to identify artificially induced soft tissue lesions in the equine cadaveric digital flexor tendon sheath.. Equine Vet Educ 2022;35(7): e507‐e516.
- Shanklin AJ, Baldwin CM, Ellesmere L, Stack JD. Computed tomographic contrast tenography aids pre‐operative diagnosis in clinical conditions of the digital flexor tendon sheath.. Equine Vet Educ 2023;36(4):197‐205.
- Fortier LA. Indications and techniques for tenoscopic surgery of the digital flexor tendon sheath.. Equine Vet Educ 2005;17(4):218‐224.
- Seignour M, Coudry V, Norris R, Denoix JM. Ultrasonographic examination of the palmar/plantar aspect of the fetlock in the horse: technique and normal images.. Equine Vet Educ 2012;24(1):19‐29.
Citations
This article has been cited 0 times.Use Nutrition Calculator
Check if your horse's diet meets their nutrition requirements with our easy-to-use tool Check your horse's diet with our easy-to-use tool
Talk to a Nutritionist
Discuss your horse's feeding plan with our experts over a free phone consultation Discuss your horse's diet over a phone consultation
Submit Diet Evaluation
Get a customized feeding plan for your horse formulated by our equine nutritionists Get a custom feeding plan formulated by our nutritionists
