Navicular disease is associated with intraosseous hypertension and venous stasis.
Although core decompression by drilling is an accepted treatment regimen for similar
conditions in humans, no experimental results exist concerning its application in the
equine navicular bone and its physiological effects.
During an in vitro study, the effects of decompression drilling of various drill bit sizes and
drill channel numbers on the intraosseous pressure and the 3-point bending breaking
strength of isolated navicular bones were studied and correlated to the bone mineral
density (BMD).
Core decompression significantly reduced the intraosseous pressure response to stresstest-
injections. A significant correlation existed between response to stress tests and
BMD. The drill channels did not significantly reduce the 3-point bending breaking
strength, regardless of their size and number.
In the course of the second part of the investigation, core decompression was carried
out arthroscopically in navicular bones of 6 healthy horses. The procedure was
performed in both front limbs staged by 3 weeks. The venous, arterial, articular and
intraosseous pressures were recorded before and after drilling, after intraosseous stress
– test- injections as well as 3 resp. 6 weeks after core decompression. Postoperative
lameness was assessed subjectively and using force plate gait analysis before inclusion
of the animals into the study as well as 1, 3 and 6 weeks post operatively. Navicular
radiographs were taken prior to acceptance of the horses into the program, immediately
after surgery and at week 1,3,6,9 and 12. Fluorochrome bone – labeling was performed
by alternating intravenous administration of oxytetracycline and calcein green every 3
weeks starting at day 0 (first surgery). The animals were sacrificed following a 12 week
observation period. The navicular bones were isolated, the bone mineral density was
measured and bone histology was performed on undecalcified sections using Toluidinblue
and von Kossa/McNeill stains in addition to the unstained fluorochrome slides.
Core decompression significantly reduced the intraosseous pressure response to stresstest-
injections. The effect decreased over the course of the observation period. A
significant correlation existed between response to stress tests and BMD.
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No significant lameness was observed after the first 5 days following surgery. The drill
defects were clearly visible on tangential radiographs for the entire study period.
Histology revealed an almost complete seal of the drill channels with fibrous tissue and
woven bone at the time of sacrifice, 12 weeks after surgery. Significant remodeling and
neovascularization was demonstrated in the vicinity of the surgery sites.
In conclusion core decompression of the equine navicular bone appears to be a safe
procedure in regard to breaking strength and postoperative lameness score. It
significantly decreased intraosseous pressures following stress tests in healthy horses.
As the direct decompression effects of the procedure are short – lived due to the rapid
healing of the drill channels, its possible long – term effects, which might be extended by
the neovascularization, as well as its efficacy in the treatment of horses with navicular
disease remain to be assessed.