Langetermijnresultaten van tenoscopische behandeling van letsels in de sesamschede: een retrospectieve studie van vijftig paarden

Thünker, Franziska; Oosterlinck, Maarten; Vanderperren, Katrien; Martens, Ann

doi:10.21825/vdt.v88i1.16039

Cited by 3 publications

(2 citation statements)

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“…Whilst several reports promote the advantages of surgical PAL desmotomy resulting in local decompression of the fetlock canal, a clear association with improved outcomes following PAL transection is lacking 3,6,23 . In the current study, PAL desmotomy was performed where the fetlock canal appeared narrowed during tenoscopy and potentially also in preparation for complex surgical procedures like the minimally invasive resection of the MF, which required maximal space within the DFTS.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and outcome following tenoscopic surgery of the digital flexor tendon sheath in German sports and pleasure horses

Cender

Mählmann

Ehrle

et al. 2022

Equine Veterinary Journal

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Background: Digital flexor tendon sheath (DFTS) pathology is an important cause of lameness in horses. The outcome after surgical treatment is variable and depends on the exact diagnosis.Objectives: To (1) describe the prevalence of lesions associated with lameness caused by nonseptic DFTS tenosynovitis in a large population of German sports and pleasure horses; (2) determine the sensitivity and specificity of diagnostic imaging techniques for identifying lesions within the DFTS with tenoscopic diagnosis being the gold standard; (3) explore associations between tenoscopically diagnosed lesions and signalment, purpose, and limb affected; and (4) describe the outcome following DFTS tenoscopy with nonseptic DFTS tenosynovitis in this population.Study design: Retrospective case series.Methods: Medical records of horses admitted for tenoscopic surgery of nonseptic DFTS tenosynovitis between 2011 and 2020 were reviewed. Follow-up information was obtained via telephone contact. Sensitivity and specificity of ultrasonography and contrast tenography were determined using tenoscopic diagnosis as gold standard and univariable analysis was used to explore associations between signalment, case history, and tenoscopic diagnosis.Results: Medical records from 131 horses were retrieved, of which 8 horses had bilateral disease and 6 horses were presented for tenoscopy on two separate occasions (3 for tenoscopy in the same limb, 3 in a different limb), thus, making a total of 145 limbs. Lesions were most commonly diagnosed in the deep (DDFT; n = 55 limbs) and superficial (SDFT; n = 55 limbs) digital flexor tendons. Manica flexoria (MF) lesions were detected in 44 limbs and palmar/plantar annular ligament (PAL) constriction in 99 limbs. In 36 limbs, only one structure within the DFTS was injured, whereas in 109 limbs a combination of lesions was noted, the most common being the combination of a SDFT lesion with PAL constriction. All affected limbs were

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Section: Discussionmentioning

confidence: 99%

Diagnosis and outcome following tenoscopic surgery of the digital flexor tendon sheath in German sports and pleasure horses

Cender

Mählmann

Ehrle

et al. 2022

Equine Veterinary Journal

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“…Nonseptic tenosynovitis of the digital flexor tendon sheath (DFTS) is a common cause of distal limb lameness in the horse. [1][2][3][4][5][6] The DFTS contains, and is closely associated with, several important anatomic structures that are commonly injured, including the superficial digital flexor tendon (SDFT), [1][2][3] manica flexoria (MF), [2][3][4] deep digital flexor tendon (DDFT), [1][2][3] and palmar/plantar annular ligament (PAL). 5,6 Adventitious fluid-filled structures have also been associated with the DFTS.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound‐guided tenoscopic decompression of digital sheath synoviocoeles in 10 horses

Hawkins

Chapman²,

Meter³

et al. 2021

Veterinary Surgery

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Objective To report the diagnostic features and clinical outcome of horses with digital flexor tendon sheath (DFTS) synoviocoeles treated tenoscopically under ultrasonographic guidance. Study design Retrospective case series. Animals Client‐owned horses (n = 10). Methods Medical records were searched for horses with lameness localized to the region of the DFTS and clinical evidence of a fluid‐filled mass (synoviocoele) associated with the DFTS. Diagnostic imaging and surgical findings, together with long‐term outcome, were reported. Results Lameness and synoviocoeles were unilateral (5 forelimbs, 5 hindlimbs; 3 lateral and 2 medial in both) and located proximal to the palmar/plantar annular ligament. Synoviocoeles had a firm consistency and focal pain with inability to deflate on non–weight‐bearing examination. Intrathecal DFTS anesthesia was positive in 7/8 horses in which it was performed, with the remainder localized to the region of the synoviocoele using perineural and/or intralesional anesthesia. Communication between the DFTS and synoviocoele was suspected ultrasonographically in all cases and confirmed on contrast tenography (6/6). Tenoscopic fenestration of the communication between the DFTS and synoviocoele under ultrasonographic guidance, with treatment of concurrent intrathecal injury (4/10), resolved the lameness in all horses re‐evaluated by a veterinarian (9/9) and allowed return to full athletic function in all cases at long‐term follow up (median 5 years; range 1.25‐9 years). Conclusion Tenoscopic decompression was an effective treatment for DFTS synoviocoeles, which, along with treatment of concurrent intrathecal injury, carried an excellent prognosis and avoided the need for resection via an extrasynovial approach.

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Equine non‐septic tenosynovitis: A systematic literature review of site‐specific pathological lesions, outcomes and surgical complications

Caspers,

Gier,

Reesink

2023

Equine Veterinary Journal

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BackgroundNon‐septic tenosynovitis is a clinically relevant and often performance limiting musculoskeletal injury in the horse.ObjectivesTo review the published literature to determine which tendon sheaths are commonly affected by non‐septic tenosynovitis and to describe the most frequently reported pathological lesions, outcomes, and surgical complications in equine non‐septic tenosynovitis.Study designSystematic review.MethodsLiterature searches were conducted in July 2021 from the online search engines PubMed, Scopus, Web of Science Core, VetMed Resource and ProQuest Theses & Dissertations. The inclusion criteria followed a participants, interventions, comparisons, outcome and study design (PICOS) approach. For inclusion, studies had to include live equids with non‐septic tenosynovitis of any tendon sheath. Studies were excluded if they only described non‐equine species, if they included data only on non‐tendon sheath structures, or if they included data exclusively on cases of septic or contaminated tendon sheaths. Determination of non‐sepsis relied on the diagnosis of the original authors; however, if non‐sepsis was not explicitly specified, then cases that had a history of contamination of the sheath, a wound near the sheath or a positive bacterial culture were excluded from analysis. Data analysed included the distribution of structures affected by non‐septic tenosynovitis, the most common pathological lesions identified within each sheath, and the most frequently reported surgical complications of non‐septic tenosynovitis. The quality of each study was assessed using a methodological quality analysis.ResultsA total of 85 studies describing non‐septic tenosynovitis in the horse were included. Across all 85 studies, there were a total of 2449 tendon sheaths in 2101 horses reported to be affected by non‐septic tenosynovitis. The digital flexor sheath was the most reported structure to be diagnosed with non‐septic tenosynovitis: 41/85 (48%) studies examined the digital flexor sheath exclusively, followed by the carpal flexor sheath, tarsal flexor sheath, carpal extensor sheaths, tarsal extensor sheaths, and one case of biceps brachii non‐septic tenosynovitis. For most tendon sheaths, the most common pathological lesion was an intrathecal tear of a soft tissue structure, including tears of the deep digital flexor tendon and tears of the manica flexoria. Bilateral disease was most common in the carpal flexor sheath, where distal radial physeal exostoses were the most common pathological lesions. Less common causes of non‐septic tenosynovitis included neoplasia, fracture of a bone adjacent to a tendon sheath, and mineralisation of an intrathecal tendon. The likelihood of return to previous level of athletic function following non‐septic tenosynovitis of most structures was approximately 50%, and the most common complication was persistent effusion following tenoscopy. While iatrogenic infection following surgery was uncommon, it was most likely following tenoscopy of the digital flexor sheath.ConclusionNon‐septic tenosynovitis is commonly reported in equine athletes, with intra‐thecal tears of the deep digital flexor tendon, superficial digital flexor tendon and manica flexoria frequently reported. Directions for future research include more thorough assessment of and reporting of complications following non‐septic tenosynovitis and correlation of characteristics of intrathecal pathological lesions with clinical outcomes.

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Langetermijnresultaten van tenoscopische behandeling van letsels in de sesamschede: een retrospectieve studie van vijftig paarden

Cited by 3 publications

References 26 publications

Diagnosis and outcome following tenoscopic surgery of the digital flexor tendon sheath in German sports and pleasure horses

Diagnosis and outcome following tenoscopic surgery of the digital flexor tendon sheath in German sports and pleasure horses

Ultrasound‐guided tenoscopic decompression of digital sheath synoviocoeles in 10 horses

Equine non‐septic tenosynovitis: A systematic literature review of site‐specific pathological lesions, outcomes and surgical complications

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