Long-term effect of sesamoiditis?

[Kitei]

I have a possible gelding on my mind that looks very much what I'm after, but his history mentions a case of sesamoiditis. What long term effects could this have on a horse, or is it something that could potentially not cause any further issues?

 

[Archiepoo]

A lot depends on whether there is damage to the suspensory and sesamoidean ligaments. The proximal sesamoids are a part of the suspensory apparatus that supports the whole distal limb. The suspensory ligaments begin at the knee in a fore limb, or at the hock in a hind limb and run down the backs of the cannons to attach to the tops of the proximal sesamoid bones at the fetlock joints. The distal sesamoidean ligaments originate from the bottoms of the proximal sesamoid bones and attach at the backs of the long and short pastern bones.
So, the suspensory apparatus of each fetlock joint includes the suspensory ligament, proximal sesamoid bones, and distal sesamoidean ligaments which all work together to prevent overextension of the joint during full weight-bearing.

Sesamoiditis results from overextension and strain to the fetlock joint, and from inflammation at the joint of the suspensory ligament and distal sesamoidean ligaments with the sesamoid bones. Pain and lameness are typical signs, and xrays confirm the diagnosis. If the horse you are interested in has been diagnosed only by xray, is important to also have ultrasound of the suspensory and distal sesamoidean ligaments to evaluate them for damage as well. Xrays will show the damage to bone and calcification in soft tissues around the bone, but won't show tears or lesions of the ligaments, and in order to determine a reasonable prognosis, you need both the xrays and ultrasound results.

Rest and recovery can take months, and rehab is gradual. Sixty days of rest sounds minimal, and sounds overly optimistic to me. If there is no ligament damage then it might be accurate, but it could take more like 8 or 9 months before the horse is fully sound. Again, be sure there were ultrasound exams of the ligaments, and not just xrays diagnosing the sesamoids. You should have your own veterinary evaluation performed if you do decide to pursue this horse further.
If you do go with this, the horse may need combinations of therapies including antiinflammatory and other meds, hot or cold therapies, or even injections into the fetlock joint (such as intra-articular HA injections), etc. Correct and regular hoof maintenance is also a crucial part of the recovery, with the vet and farrier/trimmer consulting on what is best.
There are no guarantees as to how this may turn out for this horse, and you may want to just keep looking.

 

[Kitei]

The ad says that he's been off work for about 5 months and is 'ready to bring back into', but I figured I'd ask because I'd much rather get a matter of fact opinion here, than get the horse and find out I can't do anything with him.

Thanks very much for the advice.