Radiofrequency Probe and Sharp Transection for Tenoscopic-Guided Desmotomy of the Accessory Ligament of the Superficial Digital Flexor Tendon

OBJECTIVE: To compare intra and postoperative clinical features of desmotomy of the accessory ligament of the superficial digital flexor tendon (ALSDFT) using the Saber radiofrequency (SaberRF) electrosurgical probe versus sharp transection with a tenotomy knife.

STUDY DESIGN: Randomized, controlled, blocked (horse) design.

ANIMALS: Adult horses (n = 6).

METHODS: Each horse received bilateral, tenoscopic-guided ALSDFT desmotomy with a SaberRF and tenotomy knife, randomly assigned to left, or right limb. The desmotomy duration and intraoperative hemorrhage grades were recorded. Postoperatively, the grades for surgical incision, carpal sheath effusion, carpal range of motion, flexion pain, and lameness were recorded. Light microscopy using hematoxylin and eosin, and viability staining were performed on the ALSDFT, flexor carpi radialis tendon, radial head of the deep digital flexor tendon, and the deep digital flexor tendon. Variables were compared between desmotomy methods with a paired t-test, Wilcoxon signed rank test, or a repeated measures mixed model. Statistical significance was set at P < .05.

RESULTS: Desmotomy of the ALSDFT was completed in all horses. Only mild hemorrhage was observed and not different between methods (SaberRF 2/5 limbs; tenotomy knife 5/6 limbs, P = .078). Carpal sheath effusion was greater for SaberRF at Day 1 (P = .019) but not different from tenotomy knife at any later time. There was no significant difference between methods for viability staining or other measured outcomes.

CONCLUSIONS: Tenoscopic-guided ALSDFT desmotomy with the SaberRF probe showed no difference in measured outcomes to sharp transection with a tenotomy knife and minimal collateral tissue damage was observed.