title: Tenoscopic examination and proximal annular ligament desmotomy for treatment of equine "complex" digital sheath tenosynovitis.
abstract: OBJECTIVE
  To determine the outcome of horses with "complex" digital tenosynovitis treated by tenoscopic proximal annular ligament desmotomy and resection of synovial masses or adhesions, or both, within the digital sheath.
  
  
  METHODS
  Retrospective evaluation.
  
  
  METHODS
  Twenty-five horses with a clinical and ultrasonographic diagnosis of palmar or plantar proximal annular ligament constriction and ultrasonographic evidence of synovial masses or adhesions within the digital tendon sheath.
  
  
  METHODS
  Each horse had tenoscopic surgery for annular ligament desmotomy combined with adhesiolysis and/or synovial mass resection. Mean follow-up time was 3.4 years. Spearman's rank correlation was used to assess the relationship between functional outcome or cosmetic results and preoperative variables including duration of clinical signs, digital sheath synovial fluid total protein concentration and nucleated cell count, thickness of the palmar or plantar proximal annular ligament (PAL), severity of adhesions, severity of synovial masses, degree of synovial distention, or limb affected.
  
  
  RESULTS
  A total of 18 (72%) horses returned to athletic soundness, 4 were improved but not sound, and 3 were not improved. Cosmetic outcome was normal in 10 horses, improved but not normal in 12, and not improved in 3 horses. Cosmetic and functional outcome were significantly adversely affected by the duration of clinical signs and the severity of synovial masses.
  
  
  CONCLUSIONS
  With appropriate tenoscopic surgical attention, horses with complex tenosynovitis syndrome characterized by synovial masses, adhesions, or both adhesions and masses, and PAL constriction, have a good prognosis for return to athletic soundness.
  
  
  CONCLUSIONS
  Horses with PAL constriction and additional digital tendon sheath pathology such as adhesions and synovial masses have a 72% chance of returning to sound athletic performance, however 60% of horses retain some degree of cosmetic blemish in the affected limb. There is an inverse relationship between the duration of clinical signs and outcome, and therefore, prompt surgical attention is advised.
authors.affiliation: Department of Clinical Sciences and the Veterinary Medical Teaching Hospital, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA.
authors.forename: L A
authors.initials: LA
authors.lastname: Fortier
authors.forename: A J
authors.initials: AJ
authors.lastname: Nixon
authors.forename: N G
authors.initials: NG
authors.lastname: Ducharme
authors.forename: H O
authors.initials: HO
authors.lastname: Mohammed
authors.forename: A
authors.initials: A
authors.lastname: Yeager
mesh_terms: D000818:Animals; D004724:Endoscopy / Q000662:veterinary; D005260:Female; D005500:Follow-Up Studies; D005552:Forelimb; D006614:Hindlimb; D006734:Horse Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D006736:Horses; D007794:Lameness, Animal / Q000000981:diagnostic imaging / Q000601:surgery; D008022:Ligaments / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D011996:Records / Q000662:veterinary; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013717:Tenosynovitis / Q000000981:diagnostic imaging / Q000601:surgery / Q000662:veterinary*; D016896:Treatment Outcome; D014463:Ultrasonography