A study of 118 cases of navicular disease: treatment by navicular suspensory desmotomy

The 118 horses diagnosed as suffering from navicular disease by prospective criteria were treated by desmotomy of the ligamenta sesamoidea collateralia (navicular suspensory desmotomy). Three techniques were used and a standard post-operative programme was followed with clinical and radiological evaluations at 6-monthly intervals for periods of 6-36 months after surgery. At 6 and 36 months after treatment, 76% and 42.9% of horses were sound respectively. The clinical features of age, period of lameness, severity of lameness and angular limb deformities adversely affected response to surgery. The presence of flexor cortex defects, proximal border enthesophytes, mineralisation of the flexor digitorum profundus tendon and medullary sclerosis were also associated with a diminished response. There were few (1.7%) changes in the radiological appearance of distal border synovial invaginations during the follow-up period. By contrast, the majority (67.3%) of flexor cortex defects changed. Other radiological features changed at a low frequency but there was no association between radiological change and clinical outcome.