Navicular bursoscopy in the horse: a comparative study.
Authors: Haupt Jennifer L, Caron John P
Journal: Veterinary surgery : VS
Summary
# Navicular Bursoscopy: Comparing Surgical Approaches Diagnostic examination of the navicular bursa presents a technical challenge for equine surgeons, particularly regarding instrument manoeuvrability and inadvertent tissue trauma during endoscopic assessment. Haupt and Caron compared two arthroscopic approaches using 16 equine cadaver forelimbs: a conventional technique versus a modified transthecal approach involving sharp dissection through the digital flexor sheath immediately palmar to the T ligament, measuring access time, visualisation capability, and iatrogenic damage to the navicular bone and deep digital flexor tendon (DDFT). Whilst the conventional approach achieved faster bursal access (1.21 minutes versus 2.09 minutes), the modified technique enabled visualisation of approximately 80% of the bursa compared to 60% with conventional access, and critically, produced significantly lower damage scores to both the navicular bone (P=0.003) and DDFT (P=0.012). The modified transthecal approach therefore warrants consideration in clinical practice despite requiring slightly longer operative time, as it reduces structural damage whilst providing substantially superior visualisation of intrabursal pathology through a single portal. For practitioners managing cases of suspected navicular disease, awareness of this evidence—particularly the marked reduction in iatrogenic lesions—should influence discussion with referring veterinarians regarding diagnostic options and their anatomical consequences.
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Practical Takeaways
- •Consider adopting the modified transthecal bursoscopy technique when navicular bursa exploration is indicated, as it provides superior visualization (80% vs 60%) with substantially less damage to the navicular bone and deep digital flexor tendon despite slightly longer access time
- •The modified approach is most suitable for practitioners with arthroscopic experience; the additional dissection technique requires skill but becomes straightforward with practice
- •This technique may improve diagnostic accuracy and reduce secondary damage during navicular bursa investigations, potentially affecting prognosis and post-operative outcomes
Key Findings
- •Modified transthecal approach visualized 80% of navicular bursa compared to 60% with conventional approach
- •Modified approach required longer access time (2.09 vs 1.21 minutes) but caused significantly less iatrogenic damage to navicular bone (P=0.003) and DDFT (P=0.012)
- •Modified technique allows near-complete examination of navicular bursa through single endoscopic portal with minimal structural damage