Elbow Replacement
There are a number of new and emerging generations of elbow replacement options for dogs. These include the BioMedtrix TATE and the Kyon BANC elbow replacement. I have had the privilege of being one of the few veterinarians trained on these systems in Australia.
In addition, the Arthrex Canine Unicompartmental Elbow (CUE) system has been around for a number of years. This innovative surgery is less invasive than standard elbow replacements, allowing dogs an easier recovery and good long-term outcomes.
I’m excited to establish these surgeries at my veterinary hospital and have trained extensively in the latest elbow replacement techniques.
My aim is to usher in a new era of elbow replacement surgeries, providing pets with the pain relief and mobility they need to live healthy and happy lives.
What is Elbow Replacement?
The elbow joint is made up of three bones: the humerus, the radius and the ulna. For the elbow to work properly, these three bones must fit together perfectly and be covered with healthy cartilage. The cartilage acts as a shock absorber and prevents the bones from grinding against each other.
During elbow replacement surgery, the damaged portion of the joint is removed. It’s replaced with an artificial implant that works like the original cartilage and allows the joint to move and function normally while minimising or eliminating osteoarthritis.
Why do animals need elbow replacement?
Elbow replacement surgery is done on dogs and cats whose elbows are causing them constant pain or making it hard for them to move around due to arthritis.
Animals that need elbow replacement usually suffer from elbow dysplasia which has caused debilitating severe osteoarthritis. Dysplasia is a condition where the bones of the elbow don’t fit together properly. It leads to pain and swelling and can eventually cause the elbow joint to wear out.
Some of the classic types of pathology associated with elbow dysplasia include:
- Medial coronoid disease (MCD) also known as a fragmented medial coronoid process (FCP/FMCP)
- Osteochondritis dissecans (OCD)
- Ununited anconeal process (UAP)
- Elbow incongruity
Symptoms of elbow dysplasia/osteoarthritis include:
- pain, limping, stiffness or swelling
- lameness or change in gait
- elbows rotating outward
- decreased range of motion of one or both elbows
- reluctance to play or walk
How do I know if elbow replacement is right for my pet?
Elbow replacement is an option for your pet if it hasn’t responded to conventional treatments such as medication, lifestyle changes or physical therapy, and is still experiencing severe pain and mobility issues. It is an ‘end-stage’ operation. Elbow replacement is an option when all other options have not worked.
To determine if elbow replacement surgery is the best option for your pet, I conduct a thorough exam. I carefully consider:
- age and medical history of your pet
- severity and duration of pain or mobility issues
- overall health and fitness level
- overall quality of life for your pet
To confirm a diagnosis, I may order imaging tests such as arthroscopy, X-rays, MRIs, or CT scans.
A new type of elbow surgery: less invasive with faster recovery - The Canine Unicompartmental Elbow (CUE)
Compared to traditional elbow implant surgery which requires the removal of healthy as well as diseased joint tissues, Canine Unicompartmental Elbow (CUE) systems only require a small portion of the diseased part of the joint to be removed.
To carry out the surgery, the damaged parts of the humerus, ulna and radius are removed and replaced with titanium-alloy implants that mimic the function of the elbow joint. The humeral component has a porous coating to promote bone growth. CUE is a cementless system that is designed to be press-fit in place.
I have undergone specialist training for three different elbow replacement systems:
- BioMedtrix TATE Elbow System
- Arthrex CUE System
- BANC Kyon Elbow Replacement System
What are the benefits of elbow replacement?
What other surgeries can happen to the elbow joint?
This surgery is performed on animals where the ulna and radius don’t fit together properly (called joint incongruity). A cut is made in the ulna bone to allow it to naturally slide into alignment. This procedure is only appropriate in certain types of cases in young dogs.
Everything you need to know about elbow replacement
As this is a fairly new surgery with no long-term studies, it’s not known if elbow replacement implants wear out, although the manufacturers state that they will last the life of the patient. I have generally performed this surgery on older, end-stage animals and would expect that the implant should last the lifetime of the animal. However, there’s no guarantee.
The success rate of elbow replacement surgery will vary depending on several factors, such as the severity of disease, health and age of the pet prior to surgery. As these are new procedures, there is limited information on true success rates.
Animals are usually discharged from the hospital within 1-3 days of the procedure. The confinement period is 8 weeks of restriction with controlled walking on a leash. This will be followed by 6 months of physiotherapy to help your pet gradually get back to a full activity level.
As with any surgery, there are potential complications, some of which are serious. Major complications include infection, implant breakage, implant loosening and fracture of the arm. All these complications might lead to the fusion of the elbow or amputation of the leg if they are not fixable. You should feel fully informed before going ahead with an elbow replacement.
