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

• Published in: Veterinary surgery 2024-07, Vol.53 (5), p.893-903
• Main Authors: Wood, Andrew Douglas, Parker, Russell Alexander, Marcatili, Marco, Anderson, Jonathan, Robinson, Natalie, Stack, John David
• Format: Article
• Language: English
• Subjects: Animal populations; Animals; Cohort Studies; Constrictions; Endoscopes; Endoscopy - methods; Endoscopy - veterinary; Female; Health services; Horse Diseases - surgery; Horses; Injuries; Ligaments; Ligaments - injuries; Ligaments - surgery; Male; Prognosis; Retrospective Studies; Sheaths; Soft Tissue Injuries - surgery; Soft Tissue Injuries - veterinary; Soft tissues; Tendons; Tenosynovitis; Tenosynovitis - surgery; Tenosynovitis - veterinary; Treatment Outcome; United Kingdom
• ISSN: 0161-3499; 1532-950X; 1532-950X
• DOI: 10.1111/vsu.14120

Objective 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. Study design Retrospective multicenter cohort study. Animals 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). Conclusion 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. Clinical significance 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.