One of the most common causes of fore limb lameness in the dog is Elbow Dysplasia. Elbow Dysplasia is a generic term meaning arthritis in the elbow joint. As in people, arthritis in the dog is painful, resulting in intermittent and persistent lameness, especially following physical activity.
Elbow Dysplasia has 4 developmental causes:
- Osteochondritis Dessicans (OCD)
- Ununited Anconeal Process (UAP)
- Fragmented Coronoid Process (FCP)
- Elbow In-congruency
Elbow Dysplasia that develops as a result of one or a combination of OCD, FCP, and Elbow incongruency is referred to as Medial Compartment Syndrome. Put simply, elbow dysplasia is early onset arthritis resulting from the abnormal development of the elbow joint. It is believed to be due to a combination of genetic factors, diet, rapid growth, and/or trauma.
Signs of Medial Compartment Disease:
- sudden and/or gradual lameness on one or both fore limbs
- stiffness and/or decreased range of motion after long periods of rest
- fore limb lameness following exercise
- initial signs may appear between 5-12 months of age
Consequences of Elbow Dysplasia
- Cartilage deterioration releases a combination of inflammatory factors from the ligament.
- Increasing instability of the joint from the damaged cartilage causes arthritis to develop quickly within the joint.
- Every time the pet bears weight on the affected leg, abnormal or overloading of the medial compartment occurs. This abnormal loading often leads to concurrent cartilage erosions (often full thickness) and possible fragmentation of the medial coronoid. Once the cartilage is damaged arthritic change accelerates and perceived pain worsens.
- a vicious cycle of compensation related damage leads, in many instances, to debilitating lameness.
Elbow dysplasia and medial compartment disease is a condition in need of a better treatment. At the moment relatively few options are available for these patients. Treatment options to minimize lameness range from conservative treatment, prescribing pain management drugs and special diets, to aggressive surgical treatment, cutting bone to alter joint biomechanics and even total elbow replacement. Although pain management drugs may help the dog feel better and cope with a bad elbow, they do not alter the progression of disease.
The PAUL is a novel new paliative technique for the treatment of this lameness, showing particular benefit in younger patients, treated prior to the advanced stages of osteoarthritis.