Canine Elbow Dysplasia ED
Elbow Dysplasia in dogs has been classified into four different types
- UAP - Ununited Anconeal Process
- FCP - Fragmented Coronoid Process - also medial fragmented coronoid process MFCP
- Elbow incongruity - short radius syndrome, short ulna, ulnar notch incongruity
- Humeral Condylar Osteochondrosis HCO
Dysplasia is a term that essentially means "doesn't fit together properly" and is usually developmental, ie it develops during growth. There is a genetic association with this disease but factors may contribute to the severity of the disease during the development of the malformation, eg obesity.
Elbow dysplasia is a complicated disease conundrum. Three bones are involved in the formation of a complicated hinge joint. The radius and ulnar which are basically attached may grow at different rates causing an incongruity which causes parts of the internal joint to crack and fissure. The reality is no two elbows are exactly the same so the types of injury and severity of disease can vary considerably. A photo of the different abnormalities of elbows is shown sequentially below. The various malformations lead to rubbing of articular cartilage, cracking and fissuring, fragmenting of bony processes and osteochondrosis and osteochondritis dissicans OCD.
Ununited Anconeal Process
Fragmented Coronoid Process
Elbow Incongruity Short Ulna
Elbow Incongruity Short Radius Syndrome
Humeral Condylar Osteochondrosis HCO
Non Surgical Options For Elbow Dysplasia
Weight control is crucial. The dogs must be kept very lean.
Non steroidal anti inflammatory drugs are the cornerstone of joint pain management.
Neutroceuticals such as 4CYTE is very good.
A new drug called Antinol is wonderful for reducing inflammation as well.
At Treendale Pet Medical, we can also organise an orthotic brace to help support the elbow.
Platelet Rich Plasma Therapy and Stem Cell Therapy have also shown to be helpful at reducing pain.
Cartrophen injections are also extremely helpful in managing osteoarthritis in joints.
Ate Treendale, we are finding laser treatment is wonderful at reducing inflammation and pain also.
The reality is a combination of all of these things may be required.
So what surgical options are available for elbow dysplasia?
Surgery and the Future For Elbow Dysplasia
No elbow surgery should be done without computed tomography CT of the elbow. Arthroscopy is very helpful due to a well tolerated less invasive approach. Magnification of the joint makes problems easy to see but only the superficial surface can be seen with a camera inside the joint. CT allows a 3D perspective of the joint to be examined and whether the presence of deeper fissures in the bone may be present that are not visible with a camera inside the joint because the overlying cartilage may appear normal. CT is necessary to decide which surgical solution may be appropriate for your pet.
- Fragment removal - can be performed in a young dog with arthroscopy that has minimal joint disease.
- Subtotal Coronoid Ostectomy SCO - the medial coronoid process can be removed arthroscopically to prevent it catching when the elbow flexes and extends (a bit like chopping a corner off)
- Biceps Ulna Release Procedure BURP - this may be helpful in young dogs with mild and low grade coronoid disease
- Proximal Ulna Osteotomy PUA - This may be helpful for short radius syndrome.
- Proximal Abducting Ulna Osteotomy PAUL - this procedure aims to unload the medial aspect of the joint, ie reduce force, pressure and pain on the inside of the elbow.
- Sliding Humeral Osteotomy SHO - this is for bad elbow dysplasia with severe degenerative joint disease and osteoarthritis
- Total Elbow Replacement TER - A new elbow may be the way of the future. Only a handful of specialists around the world are doing this currently but as the science and technique and implants are improved, this may be a more widely available solution in the future.
Fragment removal by arthrocope
Subtotal Coronoid Ostectomy