Effect of humeral osteotomy on joint surface contact in canine elbow joints

Fujita, Yukihiro; Schulz, Kurt S.; Mason, David R.; Kass, Philip H.; Stover, Susan M.

doi:10.2460/ajvr.2003.64.506

Cited by 32 publications

(83 citation statements)

References 24 publications

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“…Associations between degree of cartilage generation and clinical outcome associated with high tibial osteotomy in humans have not been reliably documented. 31,34 The secondary changes recognized in medial gonioarthrosis of the human knee joint resemble in nature and extent the cartilage changes seen in MCD of the canine elbow and have been demonstrated to occur because of chronic overloading of the medial compartment [23][24][25] . Radioulnar step defects, humeroulnar incongruence, mechanical radioulnar-humeral varus deformity, or imbalances between skeletal and muscular mechanics may all contribute to medial compartment overload of the canine elbow.…”

Section: Discussionmentioning

confidence: 98%

“…Fujita et al 25 noted that individual variation between limbs was substantial, so biomechanical predictors may be difficult to fully elucidate. Mason et al 24 suggested that abduction or adduction of the limb during weight bearing could also be associated with significant variations in biomechanical load distribution.…”

Section: Discussionmentioning

confidence: 99%

“…Medial opening wedge osteotomy or lateral sliding osteotomy (lateral translocation of the proximal humeral diaphysis with respect to the elbow) had been proposed to elicit lateral shifting of the load axis. 25 The lateral sliding humeral osteotomy (SHO) and 101 medial opening wedge osteotomy were found to significantly alter joint surface contact regions of the canine elbow joint. 25 Osteotomies resulted in a reduction in the size of the radial, ulnar, and combined radioulnar contact areas.…”

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confidence: 99%

“…25 The lateral sliding humeral osteotomy (SHO) and 101 medial opening wedge osteotomy were found to significantly alter joint surface contact regions of the canine elbow joint. 25 Osteotomies resulted in a reduction in the size of the radial, ulnar, and combined radioulnar contact areas. Both osteotomies also resulted in craniolateral migration of the radial contact area and craniomedial recession of the ulnar contact area.…”

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confidence: 99%

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Techniques of Application and Initial Clinical Experience with Sliding Humeral Osteotomy for Treatment of Medial Compartment Disease of the Canine Elbow

Fitzpatrick¹,

Yeadon²,

Smith³

et al. 2009

Veterinary Surgery

109

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Objective-To determine medium-term clinical efficacy of sliding humeral osteotomy (SHO) for treatment of lameness and elbow pain associated with clinically diagnosed elbow disease featuring cartilage eburnation of the medial elbow compartment (medial compartment disease-MCD). Study Design-Case series. Animals-Dogs (n ¼ 49) with severe or persistent lameness attributable to MCD. Methods-Signalment, lameness history, and preoperative imaging findings were recorded. A custom, locking, stepped SHO plate was applied to the medial aspect of the humerus, stabilizing a middiaphyseal transverse osteotomy, medially translating the distal segment relative to the proximal segment. Three variants of technique of application were used and outcomes compared between respective patient groups. Outcome measures included lameness scoring, anatomic measures, VAS scoring of elbow pain, and owner assessment of function. Measures recorded preoperatively, 12, and 26 weeks postoperatively were compared. Results-Of 59 limbs that had SHO, 39 had preoperative focal treatment of the diseased medial aspect of the coronoid process. Mean AE SD dog age was 45.5 AE 37.48 months and body weight ranged from 13.6 to 46.7 kg. Mean preoperative duration of lameness was 14.7 AE 18.50 months. Lameness improved for all limbs by 26 weeks, and resolved in 21/32 limbs. Significant improvements in postoperative elbow pain scores and most owner assessments of function were observed. Incidence of major complications requiring surgical intervention was 17.2%, 22.2%, and 4.8% for each of the 3 technique variants described. Histologic examination of 2 elbows at 412 months revealed fibrocartilage cover of medial aspect of humeral condyle. Conclusions-Canine SHO with or without focal treatment of the diseased medial aspect of the coronoid process ameliorates lameness and pain associated with MCD at medium-term follow-up. Application technique is critical to minimizing morbidity. Clinical Relevance-SHO is appropriate for clinical management of pain and lameness in select cases of canine MCD. r

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Techniques of Application and Initial Clinical Experience with Sliding Humeral Osteotomy for Treatment of Medial Compartment Disease of the Canine Elbow

Fitzpatrick¹,

Yeadon²,

Smith³

et al. 2009

Veterinary Surgery

109

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“…In vitro studies have demonstrated the efficacy of humeral osteotomies in transferring load bearing forces toward the relatively healthy lateral joint compartment, 63,64 with force at the proximal articular surface of the ulna being decreased after SHO of 4 and 8 mm by 25% and 28% respectively. 64 Outcomes of clinical application in 59 elbows have been positive, and arthroscopic (Fig 11) and histologic documentation of novel fibrocartilaginous cover of previously eburnated regions has been achieved.…”

Section: And Extensive Medial Humeral Condylar Kissing Lesionmentioning

confidence: 99%