Endoscopy of the navicular bursa: a new technique for the treatment of contaminated and septic bursae.

Abstract

A technique for evaluation of the navicular bursa using a 4 mm 25 degrees inclined view arthroscope is described. This allows examination of the palmar/plantar surface of the navicular bone, the insertions of the navicular suspensory, T and impar ligaments, the bursal synovium and the dorsal surface of the deep digital flexor tendon. The technique was used in 16 horses with punctures of the navicular bursa. Procedures facilitated by the technique were bursal lavage, removal of pannus, synovial resection and debridement of lesions on the palmar/plantar surface of the bone and in the deep digital flexor tendon. Following treatment, 10 animals were sound and returned to their pre-injury use and 6 animals had persistent lameness; 2 of these were salvaged after neurectomy, 1 was retired for use as a broodmare and 2 were destroyed. In contrast to the 'streetnail' procedure, the reported technique is less invasive and post operative care is simpler. The success rate is also better. Endoscopically guided treatment therefore appears to offer an advantage in the treatment of contaminated or septic navicular bursae.