Early Intervention for Elbow Dysplasia if Changes Are Detected Upon Screening

Elbow dysplasia is a major cause of front limb lameness in medium to large dog breeds. Underlying causes of elbow dysplasia include ununited anconeal process (UAP), medial coronoid process disease (MCPD) and osteochondritis dissecans (OCD) of the medial humeral condyle. Elbow dysplasia is most often diagnosed when forelimb lameness is persistent and not controlled by anti-inflammatory drugs. Unfortunately, by this time, degenerative joint disease has already been established and surgical treatment will not prevent its progression entirely. Both the owner and the veterinarian may overlook initial signs of joint pain in puppies because of their hyperactive nature. Furthermore, elbow dysplasia typically affects both elbows and therefore, clinical signs may be very subtle. The first radiographic signs of elbow dysplasia are often missed by the general practitioner, which delays the diagnosis. When a definitive diagnosis of elbow dysplasia is finally made, the surgeon can improve elbow function, but cannot entirely prevent the progression of osteoarthrosis. According to A. Wind (1986) and to our experience too, joint incongruity commonly co-exists with ED, even when not easily detectable; removal of loose osteo-cartilaginous bodies and regional debridement is often not rewarding if joint incongruity persists. In such instances, overloading and subchondral bone exposure with erosion of the cartilage of the medial humeral condyle and medial coronoid process often lead to medial compartment disease (MCD) and progression of OA. Later in life the degenerative joint disease may become severe and debilitating and result in a very poor quality of life.

In view of a preventive medicine approach for all developmental skeletal diseases – other examples include hip dysplasia, OCD in different locations and patellar luxation - early diagnosis upon systematic screening is critical for successful treatment. Early diagnosis when the dysplastic process is just starting, could intercept the disease process at its early stage. Thereafter early diagnosis of elbow dysplasia allows prompt surgical treatment, which is aimed at restoring joint congruity. As well, the progression of the disease and osteoarthrosis may be prevented or reduced.  [...]