Elbow dysplasia is a common developmental disorder affecting growing dogs. It is a painful condition that can cause significant lameness in our canine companions. It is often seen in larger breeds. Sadly it can have a big effect on the quality of life of your dog, and there is no quick fix or cure for the condition. The good news is that there are many different options for managing the disease and making your dog more comfortable. These techniques and management strategies can mean a significant improvement for lots of dogs. It is certainly worth knowing your options and being well informed about the best ways to help your furry friend if they are affected by this condition.

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Understanding Elbow Dysplasia

The elbow joint is a hinge joint that is fairly complicated due to it being a point where three bones meet up. It comprises the humerus, which is the upper leg bone, and the radius and ulna, which are the lower leg bones. 

In a healthy dog, these three bones slot together nicely, which allows for smooth and controlled extension and flexion of the leg. When elbow dysplasia occurs, the harmony is disrupted. 

Elbow dysplasia is a complex disease and there are several underlying causes. It is thought that genetics and rapid growth of larger breed puppies are major contributing factors. 

The term Elbow dysplasia means ‘abnormal development of the elbow’

It covers a variety of abnormalities that occur in different locations in the joint. Problems arise as the cartilage that forms the surface of the joint and the structures around it are disturbed meaning it doesn’t grow properly. This causes primary lesions within the joint. Primary lesions start early on in puppies and are often seen in both front legs. The presence of primary lesions causes secondary osteoarthritis. The usual primary lesions your vet will pick up on include: 

  • Ununited anconeal process (UAP) 
  • Fragmented or ununited medial coronoid process (FCP)
  • Osteochondritis dissecans (OCD or OD)

The typical way elbow dysplasia develops usually goes something like this: 

1. Incongruity 

This basically just means the bones don’t slot together properly. When this happens, it causes uneven distribution of pressure and unnecessary friction. 

2. Osteochondrosis Dissecans (OCD)

Fragments of bone and cartilage become detached from the surface of the joint. This means there are loose fragments that irritate the lining of the joint.

3. Joint Instability 

Laxity or excessive looseness of the joint can lead to abnormal movement and more damage causing inflammation, pain, and further degeneration of the cartilage of the joint. 

Diagnosing Elbow Dysplasia

If you notice your dog limping or if you become suspicious of any issues with your dog’s elbow, the first port of call should always be your vet. The earlier a diagnosis is made and treatment starts, the better the outcome for your furry friend. 

Vets typically can’t diagnose elbow dysplasia until a dog is at least 4-6 months old. A definitive diagnosis often takes a few more months after that. If the disease is only very mild, dogs may not be diagnosed until they are much older when they start to have arthritis in their joints. 

To diagnose elbow dysplasia, your vet will usually carry out the following: 

Clinical exam 

Your vet will need to assess if there are any signs of pain, they will need to assess your dog’s gait (the way they walk) and the range of motion in the elbow joint. They will feel for any obvious lumps and bumps and injuries. 

X-rays 

Radiographs (X-rays) are really useful when it comes to diagnosing elbow dysplasia. They can be used to assess bone malformations, narrowing of the joint spaces, and the presence of OCD fragments. 

Advanced imaging 

If your vet requires a more detailed look at the joint, they may recommend a CT scan or arthroscopy. Elbow arthroscopy is often used to diagnose elbow dysplasia in our furry friends. It is a minimally invasive procedure that is considered a really good way to identify issues within the elbow joint. It involves inserting a small camera into the joint, which gives your vet a magnified view of the bits inside. If there are any small fragments of cartilage present these can be removed from the space and recovery is normally very speedy after this sort of procedure. 

Surgical Options for Elbow Dysplasia 

It is important to note that there is no quick fix for elbow dysplasia. Surgical techniques massively improve joint function and offer significant pain relief for dogs but unfortunately, there is no ‘cure-all’ procedure.

The surgical approach chosen largely depends on the type of dysplasia and how severe it is. 

Arthroscopy 

This is a minimally invasive technique and is often the first line of treatment for dogs suffering in the early stages of elbow dysplasia. 

A tiny camera and specialised instruments are inserted through small incisions made to visualise the joint. Your vet can remove any loose fragments of cartilage causing trouble in the joint. They can also smooth out damaged cartilage surfaces and address some minor instability issues. 

The benefits of arthroscopy include that it is minimally invasive, meaning that there is usually a shorter recovery time. It is useful for early-stage lesions where mild damage is present. It is also a helpful tool for deciding if further treatment is required. Limitations include that it cannot be used to treat severe malformations or significant instability. 

Osteochondral fragment removal

Small fragments of cartilage or bone will irritate the joint. A surgery called an arthrotomy can be carried out to remove larger fragments (sometimes called “joint mice”!), promoting healing and reducing pain. As mentioned above, arthroscopy can be used to remove these small fragments too. 

Corrective Osteotomies

When the bones that make up the elbow are misaligned, your vet may make surgical cuts called osteotomies. This enables them to reposition the bones using implants to improve joint stability and function. 

Your vet can perform different types of osteotomy depending on what is going on in the elbow joint. Commonly used techniques include anconeal wedge osteotomy and radial head osteotomy. An anconeal wedge osteotomy allows for correction of the misalignment of the ulna in relation to the humerus. Radial osteotomy addresses the misalignment between the radius and ulna. 

Benefits of osteotomies include being able to treat significant bony malformations. This means joint stability can be improved which potentially slows down the development of arthritis. The downside of osteotomies is that it is a much more invasive surgery, there are longer recovery times and a higher risk of complications. 

Salvage Procedures

There are several surgical procedures which are named salvage procedures as they are only used as a last resort in a scenario where other treatments would not work. Salvage procedures for elbow dysplasia include: 

Total elbow replacement 

This procedure involves completely replacing the elbow joint with artificial components. It is a very complex surgery and not readily available in general practice. That said, there are a number of specialist centres offering this, for dogs where it is the best option.

Elbow arthrodesis (fusion)

This procedure permanently fuses the elbow joint. This means that any pain associated with the movement of the joint is eliminated, but also the mobility is sacrificed as well. This is very much a last resort.

The benefits of salvage procedures are that they provide pain relief for your dog. They allow for improved function by helping to restore some degree of movement without pain and further damage to the joint. 

Limitations include the fact that they are not a cure for elbow dysplasia. They address the existing damage and possibly slow down the development of further degeneration, but the underlying condition remains. The success of the salvage procedures is highly dependent on the severity of the disease present and which techniques are used. Recovery time can be long and hard for both dogs and owners. Some dogs will always have permanent limitations in their activity level. There is a higher risk of complications such as implant failure and infection. 

It is worth noting that usually younger, more active dogs are better candidates for salvage procedures due to their ability to tolerate the surgery itself and the rehabilitation required afterward. 

Other Procedures 

Many other procedures have been described or are being used in new cases. Depending on the specific case, other procedures might be performed instead of, or alongside those mentioned above. These may include but are certainly not limited to procedures such as joint capsule imbrication. This involves tightening the joint capsule to improve stability in cases of excessive laxity. Your vet may also perform something called a coronoidectomy. This involves removing a small portion of the coronoid process (a bony bit on the ulna) if it’s causing excessive wear and tear on the joint.

Choosing the Right Surgery for Your Dog

The type of surgery your vet will recommend depends on a few things including the severity of the elbow dysplasia, your dog’s age, how active they are, and the specific anatomical abnormalities present. Your vet will be able to advise you on which approach is the most appropriate for your dog. 

When considering surgery to treat elbow dysplasia, the primary goals are: 

Making your dog more comfortable 

The primary aim is to remove the source of pain. By removing loose fragments and smoothing out damaged cartilage, your vet will be able to reduce the inflammation and irritation in the joint. 

Improve joint stability 

Addressing joint instability and realigning bones means there is less stress on the joint surfaces and this will make the joint function more smoothly. 

Delay onset of arthritic changes 

Your vet can help to slow down the progression of arthritis. Some arthritic changes in the joint will be inevitable with the condition, however, some surgeries can delay the progression and provide comfort for your dog for a longer period of time. 

Non-Surgical Options for Management of Elbow Dysplasia 

Surgery is nearly always the best option for dogs with elbow dysplasia. There are, however, some cases where surgery is not an option. With these dogs, medical management strategies can help to a certain degree. They won’t be curing the problem, but they will help to make your dog more comfortable. Plus, even in dogs who do receive surgery, the best outcomes are usually seen in those patients who have lifestyle changes and/or rehabilitation alongside. These include: 

Weight management 

Keeping your dog at a healthy weight will keep extra stress off their joints and make them feel more comfortable when moving. 

Exercise modification 

This will help to manage weight, limit the strain on the elbow joints, and strengthen supporting muscles. 

Physiotherapy 

This is often most useful after surgery but can be used to increase mobility in the joint if surgery is not possible. 

Prescription medication

Certain drugs such as antiinflammatory painkillers can be used to manage pain and help your dog feel more comfortable. 

Regenerative Medicine 

In recent years, there have been regenerative medicine treatments used such as platelet-rich plasma and stem cell therapy. More research is required to fully understand these methods. 

Final Thoughts 

Elbow dysplasia is a common issue seen in our furry friends. It can be a challenging condition to treat. Most dogs that suffer from it require ongoing management. Some cases will respond better to surgical intervention than others. The treatment your vet will recommend depends on what your vet finds when your dog is examined. Surgery can significantly improve the quality of life for dogs suffering from elbow dysplasia.  While there is no single “cure” and some degree of underlying joint disease may persist, the various surgical techniques available can address pain, improve function, and potentially slow the progression of osteoarthritis. This will help our canine companions to remain mobile and maintain an acceptable quality of life. 

Further Reading