Clinical and Radiographic Evaluation of Short- and Long-Term Outcomes of Different Treatments Adopted for Elbow Medial Compartment Disease in Dogs

Abstract

Medial compartment disease is a common occurrence in dogs affected by elbow dysplasia. Despite many treatments suggested in the literature, only few studies reported comparative outcomes in the short and long term. The aim of this study is to report and compare short- and long-term clinical and radiographic outcomes of dogs treated for medial compartment disease (MCD) by distal dynamic ulnar ostectomy (DUO), bi-oblique dynamic proximal ulnar osteotomy (BODPUO) and conservative management (CM). From 2016 to 2018, all medium to large dogs, aged between 5 and 12 months, affected by uni/bilateral MCD and treated by DUO, BODPUO or CM, were enrolled in this study and followed up for 24 months. Orthopedic and radiographic examinations were performed at T0, T2, T12 and T24 months after treatment. Lameness score, elbow arthralgia, elbow range of motion (ROM), osteoarthritis (OA) score and percentage of ulnar subtrochlear sclerosis (%STS) were evaluated at each time point. According to the treatment performed, dogs were divided into three groups: DUO, BODPUO and CM. Forty-five elbows from twenty-six dogs, treated with DUO (n = 17), BODPUO (n = 17) or CM (n = 11), were prospectively enrolled in the study. The patients enrolled in the CM group were older and showed more severe radiographic signs of OA, compared to those enrolled in the other two groups. Lameness and arthralgia scores (p < 10−4) were significantly decreased in patients that underwent surgical treatment and increased in patients managed conservatively (lameness p < 10−4, arthralgia p = 0.3068), at T12 and T24. OA score (p < 0.0040) and ROM (DUO, CM p < 10−4; BODPUO p = 0.0740) worsened in every study group, but %STS decreased in DUO (p = 0.0108), increased in the CM group (p = 0.0025) and remained unchanged in the BODPUO group (p = 0.2740). This study supports the clinical efficacy of DUO and BODPUO in reducing lameness, arthralgia and progression of %STS. Early diagnosis and surgical attention in patients affected by MCD can improve the short- and long-term outcome and reduce the progression of secondary changes.

Long‐term outcomes in dogs with elbow dysplasia, assessed using the canine orthopaedic index

“…Data regarding the long-term impact of ED/OA in dogs are sparse and have focused on the outcome of various treatment options and predominantly regarding MCPD. 17,18,39 In our study, there was no association found between ED grade and deterioration of the COI in the multivariable models. A high correlation was seen between lameness and all treatment variables as well as between previous surgery and rehabilitation treatment.…”

“…A strength of this study is the availability of data for a large number of dogs with relatively high age that are not primarily seeking veterinary care. Data regarding the long‐term impact of ED/OA in dogs are sparse and have focused on the outcome of various treatment options and predominantly regarding MCPD 17,18,39 . In our study, there was no association found between ED grade and deterioration of the COI in the multivariable models.…”

Anatomia do esqueleto apendicular de cães e as principais malformações nos membros

“…Essas alterações resultam em incongruência articular, instabilidade e desenvolvimento de osteoartrite. Anatomicamente, pode-se observar fragmentos ósseos soltos, irregularidades nas superfícies articulares e remodelação óssea (Schultz et al, 2008;Ribeiro, 2011;Coppieters et al, 2015;Eljack & Bottcher, 2015;Vezzoni & Benjamino, 2021;Pinto et al, 2021;Serrani et al, 2022).…”

“…Além do tratamento médico, o manejo das malformações ósseas frequentemente requer uma abordagem multidisciplinar, envolvendo ortopedistas, fisioterapeutas, nutricionistas e, em alguns casos, geneticistas. A reabilitação e o suporte contínuo são essenciais para maximizar a funcionalidade e a independência dos indivíduos afetados, bem como para prevenir complicações secundárias, como a artrite precoce ou a perda de mobilidade (Williauer & Vasseur, 1987;Zhu et al, 2012;Lavrijsen et al, 2014;Coppieters et al, 2015;Eljack & Bottcher, 2015;Konig & Liebich, 2021;Vezzoni & Benjamino, 2021;Pinto et al, 2021;Serrani et al, 2022;Ettinger et al, 2023). Baseado nisso, o objetivo deste trabalho é descrever o Research, Society and Development, v. 13, n. 6, e3813646028, 2024 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v13i6.46028 desenvolvimento anatômico dos membros, além de apresentar as alterações anatômicas e clínicas das principais malformações apendiculares em cães.…”

Results of using multiplanar reconstructed CT images for assessing elbow joint osteoarthritis in dogs are consistent with results of radiographic assessment

“…1-5 Also, assessing the severity of elbow OA over time facilitates evaluation of treatments aimed at slowing the progression of OA. 6,7 Elbow OA in dogs has traditionally been assessed by means of radiography, with several available grading schemes, including the International Elbow Working Group (IEWG) grading scheme, Results of using multiplanar reconstructed CT images for assessing elbow joint osteoarthritis in dogs are consistent with results of radiographic assessment…”