Radiofrequency Probe and Sharp Transection for Tenoscopic-Guided Desmotomy of the Accessory Ligament of the Superficial Digital Flexor Tendon.
Authors: Nelson Brad B, Kawcak Chris E, Ehrhart E J, Goodrich Laurie R
Journal: Veterinary surgery : VS
Summary
# Editorial Summary Surgical division of the accessory ligament of the superficial digital flexor tendon (ALSDFT) is a recognised treatment for certain cases of flexural deformity and carpal pain in horses, yet the optimal surgical technique remains unclear. Nelson and colleagues compared two approaches to tenoscopic-guided desmotomy in a randomised controlled trial using six adult horses, with each animal receiving bilateral procedures—one limb treated with radiofrequency electrosurgery (SaberRF) and the contralateral limb with traditional sharp transection using a tenotomy knife—allowing direct paired comparison whilst controlling for individual variation. Both techniques successfully completed the desmotomy; radiofrequency showed a trend towards less intraoperative haemorrhage (2/5 limbs versus 5/6 limbs, P = 0.078), and whilst greater carpal sheath effusion appeared at Day 1 post-operatively with the SaberRF probe, this difference resolved within days and no significant distinction emerged between methods for subsequent clinical outcomes, histological viability staining, or collateral tissue damage. The findings suggest that radiofrequency and sharp transection are functionally equivalent for tenoscopic ALSDFT desmotomy, offering practitioners flexibility in technique selection based on equipment availability and personal preference, though the small sample size warrants cautious interpretation and further investigation in clinical populations with naturally occurring disease.
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Practical Takeaways
- •Both radiofrequency and sharp transection are equally effective surgical options for tenoscopic ALSDFT desmotomy, so choice can be based on equipment availability and surgeon preference
- •Expect slightly more carpal sheath fluid accumulation in the first post-operative day with radiofrequency but monitor as it resolves quickly
- •Recovery outcomes including lameness and function are equivalent between techniques, supporting either approach as viable
Key Findings
- •Both radiofrequency probe (SaberRF) and sharp transection (tenotomy knife) successfully completed ALSDFT desmotomy in all 6 horses with minimal hemorrhage
- •SaberRF caused greater carpal sheath effusion at Day 1 post-operatively (P=0.019) but this difference resolved by later time points
- •No significant differences between methods for tissue viability, collateral tissue damage, lameness, flexion pain, or range of motion outcomes
- •SaberRF and tenotomy knife methods showed equivalent clinical efficacy with minimal collateral tissue damage in both approaches