Elbow Dysplasia
What is Elbow Dysplasia?
Elbow dysplasia is a syndrome encompassing various pathological lesions, resulting in arthritis, pain, and limited range of motion in the elbow joint. The pathology emerges due to anatomical anomalies leading to abnormal bone contact within the joint. The abnormal relation between the three bones (joint incongruity) results in overloading specific areas of the joint during normal limb movement, causing cartilage damage, micro-fractures, and arthritis.
The most common primary lesions include:
- Micro-fracture of the ulna
- Fragmented or ununited medial coronoid process (FCP)**Elbow Dysplasia Overview**
Elbow dysplasia, a syndrome causing arthritis, pain, and limited joint movement, primarily affects young, large- to giant-breed dogs. Breeds such as German Shepherds, Golden Retrievers, Labrador Retrievers, and others, including smaller breeds like French Bulldogs, can be affected.
Diagnosis and Age of Treatment
Early intervention is crucial to minimize arthritis formation. Diagnosis involves radiographs, and in inconclusive cases, a CT scan or arthroscopic exploration may be necessary. Early signs can be detected between 4 and 6 months of age. Early treatment, especially before visible soreness, through corrective osteotomy can enhance joint congruency, resulting in a milder progression of osteoarthritis and a better long-term outcome.
Treatment Types
Treatment options vary based on the clinical case and can be medical or surgical.
Surgical Treatment
Surgical procedures include:
1. Arthroscopy
A minimally invasive procedure using a small camera to inspect and treat cartilage damage, and remove small bony fragments.
2. PAUL-2 (Proximal Abduction Ulna Osteotomy)
Used in severe cases, it involves cutting the ulna bone and shifting body weight to alleviate lameness. Significant improvement is observed, but some residual lameness may persist.
3. Total Elbow Replacement
Reserved for end-stage cases with severe osteoarthritis, it replaces the entire elbow joint with a metal prosthesis. Post-operative infection is a notable complication, sometimes leading to implant removal, elbow arthrodesis, or limb amputation.
Medical (Conservative) Treatment
Medical treatment includes pain management, physiotherapy, weight control, and joint supplements. While some cases can be well-managed with medical treatment alone, surgery generally provides better outcomes, preventing rapid arthritis progression and pain.
Long-Term Management
All patients with elbow dysplasia, whether surgically treated or not, require long-term management of secondary arthritis. Early surgical intervention helps minimize arthritis progression and reduces long-term pain.