Elbow Dysplasia


Elbow Dysplasia is an abnormal development of the elbow joint. This causes damage to the cartilage surface of the joint - a process called Osteochondrosis or OCD. Elbow Dysplasia and Osteochondrosis collectively lead to the development of arthritis (Osteoarthritis). Any of these three conditions may cause elbow pain.

It is a genetic disorder caused by the genes from the parents. An uneven fit is suspected and this results in abnormal distribution of weight within the joint. Points of increased pressure cause damage to the cartilage covering the bones, and fragmentation of cartilage and the underlying bone may develop (Osteochondrosis).

Elbow Dysplasia is a common condition, especially in large breed dogs like:- Labradors, Golden Retrievers, Rottweillers, Burmese Mountain Dogs, German Shepherds, Irish Wolf Hound and Bassetts. But is not uncommon in smaller breeds as well.

Symptoms and Diagnosis

These conditions cause gradual lameness between 5-8 months of age or in adult dogs a few years old. Lameness can be intermittent and is usually worse after exercise with stiffness on getting up after resting. On examination there may be muscle wastage (atrophy). Manipulation of the elbow joints may cause increased pain. Swelling and restriction in movement may be obvious.

X-rays (radiographs) are the most common method of diagnosing elbow dysplasia. They enable the presence and severity of secondary osteoarthritis to be assessed.

A CT scan is a form of X-ray that produces thin slices through the joint in any plane. These images can be reformatted to give a 3-D model of the joint. CT gives excellent detail of the shape (congruency) of the joint and enables detection of small bony fragments. Damage to the surface of the joint can be assessed by placing a small camera in the joint – this is called arthroscopic examination. It provides more detail of the joint surfaces than radiographs or a CT scan.

Treatment

There is no complete cure but Elbow Dysplasia can be treated by non-surgical means i.e. Weight Control, Restricted Exercise and Medication, Hydrotherapy and Physiotherapy will help to strengthen muscles and reduce laxity in the joint.

Dogs with elbow dysplasia that fail to respond to non-surgical means may need surgery. There are three key types of surgery :-

Fragment Removal Surgery

- This is the most common type of surgery for elbow dysplasia. It involves removing any loose fragments of cartilage and bone from the inside of the elbow joint. This can be done under guidance from a camera through a very small hole (arthroscopically) or via a direct surgical approach.

Recovery, especially from arthroscopic surgery, tends to be reasonably rapid. Unfortunately, lameness fails to improve in a number of cases. This may be due to the underlying abnormal development of the joint (poor fit or incongruency) or the secondary osteoarthritis.

Incongruency Surgery

- Attempts may be made to improve the shape of the elbow joint and make it a better fit (or more congruent). This can be done by either removing the key pressure point within the joint or cutting the bone at the back of the joint (the ulna) to change the shape of the joint. Recovery from the latter procedure is slow and this surgery is only for a few selected cases.

Salvage Surgery

- Salvage surgery for elbow dysplasia is rarely necessary. However, occasionally the combination of elbow dysplasia, osteochondrosis and osteoarthritis cause persistent elbow pain that cannot be controlled by other more conservative means.