Veterinary Medicine: Research and Reports (Mar 2023)
A Randomized, Self-Controlled Case Series Evaluating Core Osteostixis of Osseous Cyst-Like Lesions of the Navicular Bone to Improve Lameness in Horses with Podotrochlear Syndrome
Abstract
Bo A Brock,1 Hunter R Greer,1 Clifford M Honnas,2 Brad E Gilleland,3 Myra F Barrett,4 James N Moore,3 Noah D Cohen5 1Brock Veterinary Clinic, Lamesa, TX, USA; 2Texas Equine Hospital, Bryan, TX, USA; 3Department of Large Animal Medicine, College of Veterinary Medicine, Athens, GA, USA; 4Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA; 5Department of Large Animal Clinical Sciences, School of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX, USACorrespondence: Noah D Cohen, Department of Large Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX, 77843-4475, USA, Tel +1 979 845 0741, Fax +1 979-847-8863, Email [email protected] Bo A Brock, Brock Veterinary Clinic, 1204 S Dallas Avenue, Lamesa, TX, 79331, USA, Tel +1 806 872 3183, Email [email protected]: Podotrochlear syndrome is a common cause of lameness in Quarter Horses involving both soft tissue and bony structures within the heel region. Current surgical treatment of podotrochlear syndrome addresses pathological changes affecting the soft tissue structures of the navicular region but does not address either edema or cyst-like lesions of the navicular bone.Objective: The objective of this randomized, self-controlled case series was to determine whether core osteostixis improved lameness in Quarter Horses with podotrochlear syndrome characterized by bilateral magnetic resonance imaging (MRI) findings of osseous cyst-like lesions of the navicular bone.Methods: Seven Quarter Horses that had not responded to standard medical management were included. Each horse had an affected forefoot randomly assigned to surgical treatment with navicular bursoscopy and core osteostixis; the contralateral limb was assigned to navicular bursoscopy only. Video recordings were used to assign lameness scores and make comparisons of each limb at baseline and 24 weeks post-operatively by an observer blinded to the surgical treatment. A second MRI was performed 24 weeks after surgery to reevaluate navicular bone edema, osseous cyst-like lesions of the navicular bone, and tears of the deep digital flexor tendon (DDFT).Results: Reduction of lameness score from baseline was significantly (P = 0.0254) greater for the limbs treated with core osteostixis than limbs treated with bursoscopy. New DDFT tears were noted in 3 of 7 limbs treated with core osteostixis and in 1 of 7 bursoscopy limbs.Conclusion: Results of this study suggest that core osteostixis of the navicular bone combined with navicular bursoscopy can improve lameness in horses with osseous cyst-like lesions. Further evaluation of this technique is warranted.Keywords: navicular disease, lameness, osteostixis, horse, surgery
