Elbow Arthrodesis in Cats

Arthrodesis is the process of fusing an arthrodesis plate to an injured joint in order to repair it and restore function to the joint. Elbow arthrodesis, therefore, is a procedure which fuses the joints in the elbow. Elbow arthrodesis is not typically the treatment of choice for injury and other conditions affecting the elbow. Elbow arthrodesis is only recommended if these conditions cannot be managed in another way.

1. Prior to surgery, the cat will be evaluated for anesthetization.
2. The cat will be anesthetized and prepped for surgery. The elbow will be shaved. Analgesics will be administered intravenously throughout the operation.
3. An x-ray will be taken to visualize the injury or condition.
4. The surgeon will determine the optimal angle for the elbow before starting surgery.
5. The surgeon will first make an incision into the skin and muscle, exposing parts of the humerus and ulna.
6. An olecranon osteotomy will then be performed. This involves cutting and removing a portion of the olecranon bone in order to better visualize the joint and provide a surface on which the arthrodesis plate can be fixed.
7. The cartilage of the humeral condyles, semilunar notch, and radial head are removed using a specialized burr.
8. The elbow will be positioned into the correct angle and held in place using Kirschner wire.
9. The arthrodesis plate will be placed and fitted onto the joint surface.
10. The plate will then be attached to the humerus.
11. The Kirschner wire may or may not be removed at this stage.
12. The surgeon will apply a bone graft in the spaces between the bones.
13. The plate is then attached to the ulna.
14. The removed portion of the olecranon is then fixed to the plate with a screw.
15. The surgeon will ensure the angles are correct before suturing the site.

This procedure is considered effective in restoring a normal range of motion to the elbow joint, provided that the cat rests during the recovery period and does not engage in activity. Cats that start walking, jumping, running, or climbing too early will delay healing significantly. It takes cats about two to four months to recover from arthrodesis, on average.

Owners must follow the surgeon’s recovery instructions very carefully. Cats recovering from elbow arthrodesis should not be allowed to go outside or engage in any kind of activity for up to twelve weeks. This will exacerbate the healing process. An Elizabethan collar and/or bandage are required to prevent the cat from irritating the surgery site. Owners should monitor their cat at all times during the recovery period, and should not allow it to walk on hard surfaces such as wood, linoleum, or tile. If the owner needs to leave the cat by itself, the cat should be placed in a kennel or crate. If owners find it difficult to prevent their cat from attempting to engage in activity, the cat may be boarded with a veterinarian for up to three weeks.

A follow-up appointment will be scheduled for ten to fourteen days following surgery to remove the sutures. Another appointment will be scheduled for six to eight weeks following surgery to monitor healing. Additional appointments will be scheduled at six to eight-week intervals until fusion has completed.

The cost of elbow arthrodesis will vary based on standards of living and additional costs incurred. The cost of elbow arthrodesis ranges from $500 to $3,000. The national average cost for elbow arthrodesis is $1,000.

Complications of arthrodesis may include:

• Failure of bony fusion due to breakage of implants
• Fracture of the bones near arthrodesis plate
• Infection or swelling of the surgery site
• Anesthetic death

The first two of these complications are usually attributed to slow healing as a result of premature return to activity. Owners must follow their surgeon’s postoperative care instructions exactly in order to prevent delayed healing. Even if owners explicitly follow all recovery instructions, it is possible that their cat can heal slower than normal. Bony fusion of a joint takes time, and healing times will vary based on the overall health of the cat.

Infection and anesthetic death are rare complications of any surgery. Infection is considered extremely rare for orthopedic procedures. Anesthetic death is also a rare occurrence, as surgeons strive to ensure animals are healthy enough to undergo anesthesia before surgery.

Some conditions that require elbow arthrodesis are difficult to prevent, including tumors, primary degenerative joint disease, and congenital defects. However, owners should make sure their cats do not participate in activities that could cause elbow joint trauma. This includes falling from heights, getting hit by a car, or any other source of traumatic injury.