Elbow dysplasia and the secondary arthritis are the most common causes of foreleg lameness in dogs. Fragmented coronoid process (FCP) is the most common form of elbow dysplasia in dogs. In this disease, a fragment of bone and cartilage of one of the bones of the elbow joint (ulna) is broken off. More important, the rest of the joint may be normal or there may be additional cartilage damage, including severe full-thickness cartilage loss. Damage to the cartilage in dogs with elbow dysplasia is called Medial Compartment Disease because it commonly results in severe erosion of the cartilage of the medial aspect of the joint.
Diagnosis of FCP and Medial Compartment disease (MCD)
Diagnosis of FCP and MCP can be challenging. The diagnosis is initially based on a careful orthopedic examination. X-rays (radiology) are of limited use in the diagnosis of FCP. The FCP fragment and damage to the cartilage cannot be seen on x-rays. We recommend arthroscopy for the diagnosis of FCP and MCD because it allows early and accurate diagnosis and treatment
Dogs with Medial Compartment Disease usually require more continuous medical treatment of osteoarthritis and owners should consider additional surgical treatment options.
Advanced surgical treatments of Medial Compartment Disease include Sliding Humeral Osteotomy (SHO) and total elbow replacement.
Total elbow replacement may be indicated when the cartilage is severely damaged throughout the elbow joint. Numerous total elbow replacements have been designed over that last 15 years and to date none has been proven to be safe and effective enough for routine use.
Sliding Humeral Osteotomy
Sliding Humeral Osteotomy (SHO) was developed in the Orthopedic Research Laboratory of the University of Californita by Dr Schulz. This procedure is based on similar procedures that are performed on people for arthritis of the knee. The procedure realigns the limb to shift the forces off of the area of cartilage damage and back on to healthy cartilage. This relieves the pain of grinding of bone on bone and gives the damaged joint an opportunity to heal.
The sliding humeral osteotomy procedure is the result of almost 10 years of laboratory research. These studies have demonstrated that the sliding humeral osteotomy significantly decreases joint pressure in the medial side of the elbow joint.
Over the last 3 years the SHO procedure has been performed in over 70 dogs. Careful clinical studies have been performed to evaluate the efficacy of this procedure. The majority of dogs undergoing SHO have decreased lameness by 12 weeks postoperatively with many dogs having no visible lameness at a 26 week evaluation. The owner satisfaction rate following SHO has been nearly unanimous.
Surgeons performing the SHO procedure are all highly experienced orthopedic veterinary surgeons. They have completed a course covering the theory, indications, and application of the SHO technique.