Outcome following surgical treatment of 23 cases of primary plantar/palmar annular ligament desmopathy: a retrospective study

Reasons for performing study:

Little exists in the literature regarding the outcome of endoscopically-guided desmotomy of the palmar/plantar annular ligament (PAL) where injury to the PAL was the only diagnosis.

Objectives:

To report the return to previous level of exercise in horses treated with endoscopically guided PAL resection in which PAL injury was considered to be the primary condition.

Study design:

Retrospective case series.

Methods:

Medical records of surgical cases at Donnington Grove Veterinary Surgery between 2005 and 2013 were reviewed. The inclusion criteria were cases that had undergone surgical transection of the palmar/plantar annular ligament under general anaesthesia and endoscopic guidance using a No. 12 scalpel blade where annular ligament injury was the only notable finding at surgery. Follow-up was obtained by a telephone questionnaire.

Results:

Twenty-three horses were included in the study. Twenty horses were noted to have restriction to passage of the arthroscope within the digital flexor tendon sheath at the time of surgery. Following the initial 3-month post operative rest period 21 horses were sound. Three horses did not return to their previous level of activity due to unrelated lameness issues and 2 returned to a lower level of competition due to owner preference. Of the remaining 18 horses, 16 returned to their previous level of athletic performance. Two horses had recurrent or persistent lameness associated with the residual PAL desmopathy.

Conclusions:

In this case series surgical treatment of primary PAL injury carries a good prognosis (89% return to previous level of exercise) in contrast to a previously reported study (<50% of horses were able to return to athletic function) [1].