Endoscopic assessment and treatment of lesions of the deep digital flexor tendon in the navicular bursae of 20 lame horses.
Authors: Smith, Wright, Smith
Journal: Equine veterinary journal
Summary
# Editorial Summary: Endoscopic Assessment of Deep Digital Flexor Tendon Lesions in the Navicular Bursa Deep digital flexor tendon (DDFT) injuries within the navicular bursa represent an increasingly recognised source of foot lameness, yet their diagnosis has traditionally relied on indirect imaging methods that may miss critical pathology. Smith and colleagues examined 23 navicular bursae in 20 lame horses using endoscopy, identifying DDFT tears in all but one bursa and concurrent cartilage lesions in eight cases—damage that computed tomography and low-field MRI failed to detect in most instances. Beyond its diagnostic value, navicular bursoscopy enabled direct treatment of lesions through minimally invasive access; of the 15 horses with follow-up data beyond six months, 11 returned to soundness and 9 regained their preoperative performance level. This work demonstrates that endoscopic visualisation provides morphological detail unavailable through conventional imaging and permits therapeutic intervention that radiographic examination alone cannot offer. For practitioners managing chronic foot lameness unresponsive to standard diagnostics, navicular bursoscopy warrants consideration as a definitive investigative and treatment modality, particularly where cartilage pathology is suspected alongside or instead of bone involvement.
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Practical Takeaways
- •Navicular bursoscopy should be considered in lame horses with foot pain localised to the navicular region, as it identifies lesions missed by standard imaging (CT/MRI)
- •Expect to find DDFT tears in nearly all cases of clinical navicular bursa disease, and cartilage damage in approximately one-third of cases
- •Bursoscopy enables minimally invasive treatment, with good prognosis: ~73% of followed horses returned to soundness and pre-injury performance
Key Findings
- •Navicular bursoscopy identified DDFT tears in all 20 horses examined (22 of 23 bursae)
- •Cartilage lesions were present in 8 bursae but were not detected by CT or low-field MRI
- •Of 15 horses with >6 month follow-up, 11 were sound and 9 returned to preoperative performance levels
- •Bursoscopy provided superior diagnostic capability compared to non-invasive imaging modalities for identifying cartilage damage