Annular Ligament surgery!

[Rosa_Velluto]

Hi all,
I’m after some help and experience with this.Getting nowhere after 2 years of trying to find my girls lameness and I’m so tired and stressed

Has anyone had the surgery done on a standing sedated horse?

Did your horse have any thickening of the ligament?my girl has hefty windgall that does block but shows nothing on scan and no thickening of annular ligament of either front legs. (She’s lame on both)

My vet feels so bad for me that’s he’s stopped charging but wants to damn well give me a diagnosis.

Many xrays and scans and blocks won’t pinpoint anything.

Fabulous feet with great foot balance although we have her in bars and equipak to rule that out.

She went lame at 4 and is now only 6 dream dressage horse…love her to bits please help

[AZ_TD]

Did you do a nuclear scan? My horse was lame, no thickening on legs, went thru everything, nuc scan found carpel tunnel, did surgery, laid him down, to cut annualar ligament. During rehab, the other leg developed same problem. Not good retire. He was 18.

[kittykeno]

I had an Arabian that had this surgery on a front leg. The procedure was performed at an equine surgical facility with him lying down. The original problem was a tear in the superficial digital flexor tendon. As the tendon repaired with time-off the leg thickened. The annualar ligament needed to be cut to accommodate the thickening of the SDF. The annular ligament itself was not thickened. There was no further issue with this leg once recovery was complete.

[flyracing]

It sounds like you said it doesn’t block, but also that it blocks to the tendon sheath. Can you clarify which one is correct?

Has your vet tried corticosteroids in the tendon sheath? Shockwave?

Here is a client information page that is pretty good: http://www.atlantaequine.com/pages/client_lib_ALCS.html

[Rosa_Velluto]

Hi…yes she blocked partially to the sheath.We tried steroid which worked for a few weeks but then the other front legs came up lame so we put a steroid in that sheath which didn’t work at all.She blocks out with the abaxial nerve block and the low four point.Only so it’s something around the fetlock but not the joint itself.Latest scans of both legs from knees down showed nothing…thank you for your replies

[Rosa_Velluto]

Hi kittykeno,
Could you please tell me how the lameness presented eg lame leg outside of circle, was the sheath swelling?did they see tear on a scan?squirrels lame on both fronts so it’s tricky when you say laid down do mean heavily sedated or under general anesthetic?

[flight]

Yes, my horse had a desmotomy of her annular ligament. It was done under a general anaesthetic though, not standing sedation.
The vet wanted the horse anaethetised completely for the surgery (no chance of them moving).
She had a definite thickening of the ligament and a very mild lameness. It took a good few months post surgery for her to be completely sound.

[Rosa_Velluto]

Thankyou flight

Would you say your horse got worse before she got better after the surgery?

It’s all very scary but pleased to hear you have a happy sound horse.

[Sandy_M]

My previous horse had annular ligament surgery (hind leg) when he was about 13. Never had any issues with it thereafter. Recovery was relatively quick and uneventful (4 weeks hand walking/3 months walking under saddle/gradual return to full work thereafter).

[kittykeno]

My horse was completely unconscious and down on his side in the recovery room. This is where they did the desmotomy, not in a surgical suite. It took maybe 10 minutes to perform the procedure including the two stitches at the surgical site.

The Superficial Digital Flexor had a small tear with slight tendon sheath swelling. As the tendon healed it thickened down the back of the front leg. Since the annular ligament is not elastic it could not accommodate the increase thickening of the superficial. A small knot just above the annular ligament edge could be felt along the superficial.

I’m sorry but I really can’t remember how the original lameness presented. This was at least 20 years ago. I waited months for the superficial to heal but the lameness never actually went away completely until after the annular ligament desmotomy. That leg never bothered him again.

[flight]

No, not really, she stayed with a slight headbob in trot after the (can’t remember how long - 4 to 6 weeks??) confinement, and I was sick of it all so just turned her out. About a month after that I noticed her looking sound in the paddock so I started her gradually back in work, and she’s been ok since.

[Rosa_Velluto]

Thankyou all,very positive info and I hope after all we have been through that this is the problem found

[JLR1]

I had this surgery done on both hind legs of my mare standing and under sedation. The first surgery was somewhat of an emergency as the ligament was constricting blood flow to the surrounding tendons. As such, recovery time was a bit longer, but she recovered to 100% within 12 weeks. The second surgery the ligament was less damaged and she returned to doing lower level dressage in 6 weeks. When she was older and semiretired she developed a thickening of the annular ligament on a foreleg. Due to her age I opted to do 3 treatments of shockwave. This was hugely successful! If this is an option for you I would highly recommend trying the less invasive procedure first before resorting to surgery. With shockwave there was no down time or stall rest. I have known several dressage horses over the years who have had the surgery and all of them returned to full work.

[Rosa_Velluto]

JLR1 that’s amazing news!I will ask vet about shockwave…it worked on the mineralization in suspensory so I know it works,although Squirrel doesnt have thickened annular bands so it may not work?Did your horse have nasty windgalls though?

[JLR1]

[QUOTE=Rosa Velluto;8807016]
JLR1 that’s amazing news!I will ask vet about shockwave…it worked on the mineralization in suspensory so I know it works,although Squirrel doesnt have thickened annular bands so it may not work?Did your horse have nasty windgalls though?[/QUOTE]

She had noticeable windgalls and thickening of the ligament on the hind legs that had surgery. The foreleg was not as noticeable but given her history with the hind legs the vet was confident it was the same issue. The shockwave was somewhat of a calculated gamble given that if it didn’t work surgery would have been the next step.

[Rosa_Velluto]

JLR1 I’m about to put the shockwave idea to my vet.Do you remember where your vet applied the shockwave?was it moved around the whole annular ligament or focused in one place like they do for proximal suspensory…

Thankyou for you advice

[JLR1]

[QUOTE=Rosa Velluto;8810722]
JLR1 I’m about to put the shockwave idea to my vet.Do you remember where your vet applied the shockwave?was it moved around the whole annular ligament or focused in one place like they do for proximal suspensory…

Thankyou for you advice :)[/QUOTE]

It has been so long now I honestly don’t recall. I wish I could help you.

[Rosa_Velluto]

No worries you have been so helpful!

[Rosa_Velluto]

Looks like the surgery will be all go,surgeons happy to do it standing sedation…I’m feeling like it’s the right decision.Did suggest shockwave and they have gone away thinking about it.
JLR1 sorry another few questions Did your mare windgalls disappear after surgery? and was she on bute or similar for awhile after?

Also did the windgalls on her back legs stick out the back of leg or just bulge at the sides?wish I could post a video or photo.

Many thanks x

[Rosa_Velluto]

My vet wants to try steroids again into the sheaths and possibly shockwave the annular band.He said there’s a good chance of it not working ; ( I’m still thinking about your mare JLR1 and it’s keeping me hopeful…he also said it was a one off treatment not 3 over 3weeks like suspensory?

Any info would be amazing,thanks everyone xx