What is Canine Elbow Dysplasia?

Elbow dysplasia is a term used to describe a group of inherited conditions affecting the elbow joint in dogs. This umbrella term encompasses three specific conditions: fragmented coronoid process (FCP), humeral osteochondrosis (OC), and ununited anconeal process (UAP). While each has its distinct features, all can lead to joint incongruency and secondary osteoarthritis.

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1. Fragmented Coronoid Process (FCP)

This involves a fragmentation of a small bony part within the elbow called the coronoid process. This occurs secondary to increased or abnormal loading of that part of the ulna.

Surgical Options for FCP:

• Arthroscopic removal: This minimally invasive procedure uses a tiny camera (arthroscope) to view inside the elbow joint. We then remove the bone fragments and any other damaged tissue, reducing pain and inflammation.
• Coronoidectomy: In cases with significant fragmentation, the entire coronoid process may be removed to reduce joint grinding and pain.
• Unloading: Some cases may have loss of cartilage across the entire medial side of the joint. In these cases, we may perform a procedure to shift the weight to the better side of the joint. This involves cutting the ulna and stabilising with a bone plate. This procedure is known as the PAUL (Proximal Abducting Ulnar Osteotomy).

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2. Humeral Osteochondrosis (OCD)

This condition is marked by a defect in the smooth cartilage surface of the humeral head in the elbow joint. Osteochondrosis (OCD) is a developmental disorder where a segment of bone underneath the cartilage in the humerus doesn't convert into bone, leading to cartilage thickening. Over time, this thickened cartilage can separate from the surrounding bone, causing pain and inflammation.

Surgical Options for OCD:

• Arthroscopic debridement: Damaged or loose cartilage pieces are removed, and the exposed bone is stimulated to encourage new cartilage growth. This isn’t as functional as regular joint cartilage, but still provides a durable weight-bearing surface.
• SynACART: For larger OCD lesions, a synthetic cartilage replacement can be placed into the defect.

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3. Ununited Anconeal Process (UAP)

This happens when a small bone piece at the back of the ulna, the anconeal process, doesn't fuse during growth. This occurs due to abnormal forces pushing on that part of the bone.

Surgical Options for UAP:

• Fragment fixation: If seen early enough, the fragment can be fixed in place using screws. A cut in the ulna is also performed to release the pressure on that part of the joint, promoting union and improving joint function.
• Fragment removal: If the ununited fragment has caused significant osteoarthritis, it can be surgically removed to provide some pain relief.
• Ulnar osteotomy: in very young animals, simply performing a bone cut in the ulna can allow the process to fuse.

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Post-Treatment Care

• Week 1-2: Limited movement. Brief, supervised outdoor breaks. Watch for any signs of infection or unusual changes at the incision site. We’ll see your pet at the 2-week mark to check on their progress and make sure the incisions are healing as expected.
• Week 3-4: Slow reintroduction to walks, avoiding any jumps or intense play.
• Week 5 onwards: Gradually returning to regular activities based on your vet's guidance. If any bone has been cut or implants have been placed, we’ll take some radiographs to confirm that the bone is healing.

What is the expected prognosis?

Elbow dysplasia will unfortunately result in some osteoarthritis developing in the joint. The goal of surgery is to minimise the development of osteoarthritis. This journey, though potentially challenging, is a joint effort. We're dedicated to ensuring your dog bounces back to its playful self.

We would recommend being proactive with keeping your dog to a lean bodyweight to help reduce the development of osteoarthritis. Some nutritional supplements may also be beneficial, such as omega-3 fatty acids, pentosan, and glucosamine-chondroitin. Your primary care veterinarian is in the best position to help guide this throughout your pet’s life.