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.

Summary

# Tenoscopically Guided Palmar/Plantar Annular Ligament Desmotomy: UK Outcomes Palmar/plantar annular ligament (PAL) constriction causing digital flexor tendon sheath tenosynovitis represents a treatable source of lameness, yet evidence supporting intervention remains limited. This UK-based retrospective study evaluated 65 horses from four equine hospitals that underwent tenoscopically guided PAL desmotomy between 2017 and 2022, with strict inclusion criteria excluding concurrent intrathecal soft-tissue injury to the digital flexor tendons or manica flexoria. Of the 61 horses with available follow-up data (median 25 months), 52 (85%) achieved soundness within a median timeframe of three months, with 42 (69%) returning to their previous exercise level or higher and 50 (82%) owners reporting satisfaction with surgical outcomes; only six horses were retired or euthanased due to lack of soundness recovery. The finding that PAL desmotomy yields substantially better prognoses than previously reported suggests careful patient selection—particularly in cobs and ponies who show predisposition to this condition—combined with meticulous tenoscopically guided technique and exclusion of concurrent pathology, represents a valuable option for practitioners managing horses with isolated PAL constriction and DFTS inflammation.

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Key Findings

• •64.6% of horses (42/65) returned to previous or higher level of work postoperatively
• •80% of horses (52/65) achieved soundness with median recovery of 3 months
• •81.9% of owners (50/61 with follow-up) were satisfied with surgical outcome
• •Cobs and ponies showed predisposition to PAL constriction

Conditions Studied