What is Shoulder Osteochondrosis?

Shoulder osteochondrosis (OCD) is a developmental disorder where a segment of bone underneath the cartilage in the shoulder doesn't convert into bone, leading to cartilage thickening. Over time, this thickened cartilage can separate from the surrounding bone, causing pain and inflammation.

It's believed to be a mix of genetics, rapid growth, nutrition, and trauma. It's more common in large and fast-growing breeds.

How Do We Diagnose Shoulder Osteochondrosis?

1. Physical examination: Shoulder OCD is a common cause of lameness. The vet assesses for pain, swelling, or lameness in the affected limb.
2. X-Rays: They provide insights into the shoulder's bone structures, but early stages might not always show up.
3. CT Scan: For more subtle lesions, or where more planning is required, a CT scan gives a three-dimensional assessment of the joint.
4. Arthroscopy: A minimally invasive method, it gives a direct glimpse inside the joint to see the cartilage. Arthroscopy is also the method of choice for treating shoulder OCD.

Arthroscopy & Treatment: A Closer Look

What is Arthroscopy?

It involves using a tiny camera (arthroscope) to get a clear inside view of the shoulder's structures. This is a minimally-invasive surgical technique that uses small incisions rather than a large incision into the joint.

How Does Arthroscopy Help?

• Direct diagnosis: It provides an accurate assessment of the cartilage's condition and any related damage.
• Immediate treatment: If defects are identified, specialized tools can remove the diseased cartilage, facilitating healing. After removal of the abnormal cartilage, new fibrocartilage will fill the gap. This isn’t as functional as regular joint cartilage, but still provides an excellent weight-bearing surface in the shoulder.

Synthetic Cartilage Replacement: Introducing SynACART

SynACART is an innovative solution, acting as a synthetic cartilage to replace damaged areas, especially for large osteochondrosis lesions. This is recommended for those dogs with very large OCD lesions, or those dogs that don’t do as well as expected after traditional arthroscopic treatment.

SynACART requires a slightly larger incision to access the joint surface, but this is still a small approach.

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 a SynACART was placed, we’ll take some radiographs to confirm that the implant is stable.

What is the expected prognosis?

In most dogs with shoulder OCD, the response to arthroscopic treatment is excellent. Some osteoarthritis will develop in the shoulder over time, but this is unlikely to affect your pet’s quality of life.

A small number of dogs with large lesions may not respond as well to arthroscopic treatment and may have some continued lameness. SynACART may offer a better outcome in these patients.

We would still 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.