Joint Solutions: Elbow

The elbow is a complex joint that involves three bones – humerus, ulna and radius. If one of these bones develops abnormally (elbow dysplasia), their articulation is not physiological anymore, which leads to an unfavorable concentration of forces and consequent damage of cartilage and other tissue in the joint. We diagnose elbow dysplasia most commonly in large and giant dogs, often bilaterally in up to 80% of the dogs of a particular breed (Bernese Mountain Dogs, German Shepherds, and Golden Retrievers).

Elbow dysplasia is an umbrella term for the following conditions: 

  1. Fragmented Processus Coronoideus – FCP/MCD
  2. Ununited anconeal process – UAP
  3. Osteochondrosis
  4. Joint incongruity

The treatment depends on the age of the animal. 

On dogs that are approximately four months old, surgeons often perform Distal Ulna Osteotomy (DUO), Proximal Ulna Oblique Osteotomy (PUO) and Proximal Radius Oblique/Lengthening Osteotomy. The decision concerning which method to use will depend on the severity and combinations of conditions.

Once a patient is skeletally mature at one year or older, a fragment removal will provide a temporary benefit, but lameness will return, and progression of the disease will persist.

Proximal Abducting Ulnar Osteotomy (PAUL) procedure has been most effective in patients who receive treatment before the advanced progression of the disease. Still, older patients also see a benefit, typically an improvement of one to two grades of lameness. 

The end-stage of the disease requires elbow joint replacement.


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