Tenoscopic examination and proximal annular ligament desmotomy for treatment of equine “complex” digital sheath tenosynovitis.

The research paper studies the effectiveness of tenoscopic surgery in treating equine “complex” digital sheath tenosynovitis, a condition involving tendon inflammation and related complications in horses. The results showed a 72% success rate of horses returning to athletic soundness after surgery, with the presence of pre-existing clinical conditions and synovial masses adversely affecting both cosmetic and functional outcomes.

Research Methodology

• The study involved a retrospective review of 25 horses diagnosed with palmar or plantar proximal annular ligament (PAL) constriction and synovial masses or adhesions within the digital tendon sheath.
• The horses underwent tenoscopic surgery involving annular ligament desmotomy along with adhesiolysis (breaking down of adhesions) and/or synovial mass resection.
• The researchers used Spearman’s rank correlation to gauge the relationship between preoperative variables such as duration of clinical signs, digital sheath synovial fluid total protein concentration and nucleated cell count, PAL thickness, severity of adhesions and synovial masses, degree of synovial distention, and the limb affected, and the horses’ postoperative functional and cosmetic outcomes.

Results and Findings

• Out of 25 horses, 18 (72%) returned to their previous athletic condition, 4 showed improvements but not complete recovery, and 3 did not show any improvements.
• In terms of cosmetic outcome, 10 horses appeared normal, 12 showed improvements but not complete return to normal, and 3 horses did not show any improvements.
• Listed among the adverse factors significantly impacting functional and cosmetic outcomes were the duration of clinical signs and the severity of synovial masses – an important point to consider in preoperative evaluation and planning.

Conclusion

• The study suggested that tenoscopic surgery could be successfully used in treating complex tenosynovitis syndrome characterized by synovial masses, adhesions, or both, coupled with PAL constriction, with good prognoses for the affected horses’ return to athletic soundness.
• However, the research also pointed out that horses with PAL constriction along with additional digital tendon sheath pathology such as adhesions and synovial masses have a 60% chance of retaining some cosmetic blemish in the affected limb post-surgery.
• As the duration of clinical signs was found to be inversely related to postoperative outcome, the study recommended prompt surgical attention for affected horses.