Evaluation of an arthroscopic approach for transection of the equine collateral sesamoidean ligament.
Authors: Sampson Sarah N, Schneider Robert K, Gavin Patrick R, Baszler Timothy V, Mealey Robert H, Zubrod Chad J, Marsh Chad A
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Arthroscopic Collateral Sesamoidean Ligament Transection in Horses Collateral sesamoidean ligament (CSL) desmotomy is performed arthroscopically to address certain types of foot lameness, but the healing response and long-term outcome of this surgical approach had not been thoroughly characterised. Sampson and colleagues used six sound horses to develop and evaluate an arthroscopic technique for CSL transection, monitoring lameness clinically and tracking ligament healing via magnetic resonance imaging at multiple timepoints (7, 90, 180, and 360 days post-operatively), alongside radiographic surveillance and histological examination at one year. All horses experienced lameness persisting up to two months following surgery, after which they returned to soundness; radiographs remained entirely normal throughout, whilst MR imaging and microscopic analysis confirmed ligament transection and subsequent healing by 360 days. These findings validate the arthroscopic approach as technically feasible and support CSL desmotomy as a viable surgical option for appropriate cases, though practitioners should counsel owners to expect a two-month recovery period and understand that ligament healing rather than permanent structural change occurs with this procedure.
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Practical Takeaways
- •Arthroscopic CSL desmotomy is technically feasible and results in reliable ligament transection, but owners must expect 2 months of lameness before return to soundness
- •The ligament reliably heals after surgical transection; this appears to be the therapeutic goal rather than permanent rupture
- •Serial MR imaging can non-invasively monitor healing progression post-operatively if clinical response is unclear
Key Findings
- •Arthroscopic CSL desmotomy successfully transected the ligament with confirmation via MR imaging at 7 days post-surgery
- •All horses experienced lameness for up to 2 months post-operatively but returned to complete soundness by month 3
- •Gross and microscopic examination at 360 days confirmed ligament healing without radiographic abnormalities
- •MR imaging tracked healing progression at multiple timepoints (7, 90, 180, 360 days) demonstrating tissue response