Endoscopy of the Calcaneal Bursa in Horses

Objective —To describe endoscopic approaches to the calcaneal bursa and clinical findings in 2 horses with calcaneal bursitis.
Study Design —Cadaver evaluations and retrospective case reports.
Animals —12 cadavers and 2 adult horses.
Methods —Cadaver specimens of the calcaneal bursa were evaluated with a rigid arthroscope and gross dissection to determine the endoscopic appearance of anatomic structures located within the bursa. The site(s) for placement of the arthroscope and instrument(s) was determined based on cadaver dissection and endoscopic examination.
Results —Placement of the arthroscope 1 cm dorsal to the superficial digital flexor tendon (SDFT) and 1 cm distal to the medial or lateral aspect of the SDFT retinaculum allowed consistent examination of the tuber calcis, proximal aspect of the long plantar ligament, calcaneal tendon of the gastrocnemius muscle inserting on the tuber calcis, SDFT and the proximal and distal extent of the bursa. Lesions observed and treated with use of endoscopy included local bone necrosis of the proximoplantar aspect of the tuber calcis and damage of the origin of the long plantar ligament in one horse. Mild disruption of the superficial digital flexor tendon and long plantar ligament were observed and debrided in another horse.
Conclusions —Endoscopic exploration of the calcaneal bursa is clinically feasible to treat infectious and noninfectious bursitis and to help identify the cause(s) of undiagnosed bursitis or lameness associated with the calcaneus, superficial digital flexor tendon, tendon of the gastrocnemius muscle, and the long plantar ligament.
Clinical Relevance —An endoscopic approach to the calcaneal bursa is recommended whenever possible to decrease complications associated with surgery in this region and improve the diagnosis of infectious and non-infectious calcaneal bursitis.