Elbow Arthrodesis in Dogs

When an elbow joint has deteriorated beyond repair, few options are left to treat the affected dog. To save partial use of the leg, elbow arthrodesis may be performed. This is a surgical procedure in which metal implants are used to fuse the bones of the elbow together. This is a last resort option to maintain some limb function. 

Issues that lead to deteriorated elbows may stem from injuries or may be inherited genetically. Dogs who suffer from damaged elbows may be unstable when moving or may not use the affected limb at all. This is due to the pain associated with the damaged joint. An arthrodesis should only be performed by an ACVS board-certified veterinary surgeon.

The veterinarian will likely examine the affected leg to assess limited movement or dislocation. X-rays will be used to identify the cause of lameness and to plan the best way of addressing it. On the day of the operation, the leg will be shaved and cleaned to prepare for surgery. The dog will be sedated and an IV will be placed. General anesthesia can be administered at this time.

An incision will be made up the leg to expose the surface of the bone. The surrounding muscles will need to be dissected so that the joint may be seen. All of the cartilage inside the joint will need to be removed. The elbow then can be placed into its permanent position. A wire will be used to secure the joint until the metal implants are in. Plates, screws and pins can be used to fix the elbow in place. A bone graft from either the patient or a donor will be packed over the surface of the joint. The tricep attachment can then be secured back into place using a screw. The incision may then be closed using sutures. 

Arthrodesis is generally successful at reducing pain and degeneration in damaged elbow joints. While the combination of plates and screws is more effective than the use of screws alone, in small dogs, arthrodesis using only screws may be attempted. The amount of movement the dog has after the operation will be less than before, but the limb will be less painful.

The dog will be monitored closely as the anesthesia wears off to ensure that all vital functions resume. A dressing will be placed around the surgical wound to keep it clean through the healing process. The limb will then be placed in a cast or a splint will be attached to immobilized it. This will need to remain for up to 12 weeks. 

Follow-up appointments will be needed throughout this time to assess how the elbow is healing. X-rays will be used to determine when the bones have fused together. At this point, the cast or splint may be removed. Physiotherapy or hydrotherapy can be started to help the dog increase its mobility.

The price of an elbow arthrodesis generally costs between $2,000 to $6,000. Physiotherapy through the healing process can cost up to $75 a day. Once an elbow has deteriorated to the point where arthrodesis is recommended, the only other options are amputation or euthanization. Arthrodesis is the only procedure that saves the limb. Elbow replacements, while not yet commonplace, may be suitable, though expensive, alternative treatments in the future. 

All surgery involving general anesthesia brings with it certain risks. Dogs with other health issues may react badly to the sedative. Once the elbow is fused, more strain is put on both the shoulder and the wrist joints. This can lead to sprains, arthritis or even fractures. While not common, the metal implants may also break or come loose which would necessitate a second surgery. Infection can develop in the surgical site if not kept clean. 

Damage that results from traumatic injuries may be prevented by the use of a leash on walks. Vigorous play should also be discouraged. Some joint conditions are hereditary. To avoid these, always inquire about the family health history of a dog before buying it. If arthritis is identified in its early stages, its progression may be slowed with the use of supplements such as glucosamine and chondroitin. Issues involving growth will be noticeable by a veterinarian as your puppy ages. Bringing your dog in for regular check-ups can help find problems before they become untreatable.