Endoscopic evaluation of the navicular bursa: observations, treatment and outcome in 92 cases with identified pathology.
Authors: Smith, Wright
Journal: Equine veterinary journal
Summary
# Editorial Summary: Endoscopic evaluation of the navicular bursa Smith and Wright's 2012 analysis of 92 horses with navicular bursa pathology represents a significant body of evidence for bursoscopy as both a diagnostic and therapeutic tool in cases of navicular region lameness. Deep digital flexor tendon (DDFT) injuries were identified in 98% of affected bursae, with 56% of MRI-examined cases showing concurrent DDFT and navicular bone damage—findings that substantially support the hypothesis that navicular bursa lameness commonly involves dorsal border DDFT pathology. Surgical debridement via endoscopy achieved return to work in 61% of horses, though only 42% regained previous performance level, with outcome strongly correlating to injury severity; notably, horses with extensive DDFT tearing and combination injuries had significantly poorer prognoses. For practitioners, this work demonstrates that bursoscopy is both diagnostically informative and therapeutically valuable, allowing precise assessment of lesion extent and enabling targeted treatment—however, the moderate return-to-work rates and lower return-to-performance figures underscore the importance of careful case selection, appropriate client communication regarding realistic expectations, and consideration of injury severity (ideally determined via MRI preoperatively) when discussing intervention with owners.
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Practical Takeaways
- •Navicular bursa lameness should raise suspicion for DDFT involvement—endoscopic evaluation can identify and characterize these injuries for targeted treatment
- •Bursoscopy with debridement offers better outcomes than conservative management alone, though prognosis depends heavily on injury severity
- •Pre-operative MRI showing extensive tearing or bone involvement should guide client expectations, as these cases have significantly poorer return-to-performance rates
Key Findings
- •98% of horses with navicular bursa lameness had DDFT injuries identified at endoscopy
- •56% of MRI-examined cases had combination injuries involving both DDFT and navicular bone
- •61% of horses returned to work sound and 42% returned to previous performance after bursoscopy and debridement
- •Extensive DDFT tearing and combination injuries were associated with worse outcomes