Elbow Dysplasia (Also Fragmented Coronoid Process, Ununited Anconeal Process, Osteochondritis Dessicans, Joint Incongruity)

Elbow dysplasia is considered the leading cause of canine forelimb lameness. Elbow dysplasia is a general term meaning arthritis of the elbow and encompasses several elbow joint conditions, including fragmented coronoid process (FCP), ununited anconeal process (UAP), osteochondritis dessicans and joint incongruity. Each of the conditions cause elbow dysplasia but are different conditions with their own distinct pathophysiologies.

Fragmented coronoid process has a small piece of bone off the inner side of the joint breaks off the ulna. This fragment irritates the joint and wears away the cartilage of the humerus. Ununited anconeal process has a fragment break off on the back side of the joint that failed to unite with the ulna during the dog’s growth. Osteochondritis dessicans has a piece of cartilage that fully or partially detaches from the surface of the elbow joint. This causes inflammation in the lining of the joint and causes pain. Joint incongruity is when the joint doesn’t have the correct conformation and the joint cartilage wears out rapidly. This causes progressive arthritis.

Elbow dysplasia usually affects medium and large-size breeds and the disease first manifests in puppies, between 5 to 8 months of age. Dogs of any age can suffer the secondary condition of osteoarthritis from elbow dysplasia. High incidences of elbow dysplasia occur in Bernese Mountain Dogs, German Shepherds, Rottweilers, Golden Retrievers, Labrador Retrievers. The condition occurs less in Newfoundlands, Saint Bernards, Mastiffs, Springer Spaniels, Australian Shepherds, Chow Chows, Shar-Peis, Shetland Sheepdogs, and some terrier breeds. Typically both elbows are affected, but it can occur in only one elbow (unilateral).

All dogs affected by elbow dysplasia will experience forelimb lameness, though the degree of the lameness will vary. It usually gets worse after exercise. Your dog may seem stiff after he gets up from resting and he may tire easily. He will typically stand with both his elbows close to his body with his paws rotated outward. The elbow joint may appear thickened or swollen and he will probably resist having you touch or manipulate his elbow. He will have a decreased range of motion and arthritis will usually develop in the abnormal elbow joint over time.

Your veterinarian will diagnose your dog based on his history, clinical signs and after a complete physical exam, as well as using radiographs of the elbow(s). A CT scan and/or arthroscopy could be performed as they are more accurate than a traditional x-ray.

All forms of elbow dysplasia are genetically inherited and are not caused by an injury or trauma. There is some evidence that nutrition can play a role in the development of elbow dysplasia. Diets that promote rapid growth can lead to osteochondritis dessicans (OCD) which can then cause elbow dysplasia.

Elbow dysplasia is a progressive condition, meaning it will get worse over time. Surgery is the best option for affected dogs in addition to medical management. Your dog will benefit from physical therapy and anti-inflammatory medication. When the dysplasia is due to ununited anconeal process or fragmented coronoid process, surgery is performed to remove the damaging bone fragments. OCD and FCP can be treated with arthroscopic surgery. In joint incongruity cases, surgery will alter the length or curvature of the radius and ulna.

Since elbow dysplasia is an inherited disorder, if you’re going for a purebred, research your breeder carefully. If your breed is prone to elbow dysplasia, feed them a diet that promotes slow and steady growth. Make sure your dog falls within a healthy weight range as this will help decrease the stress on his joints and slow the development of arthritis. If the worst happens and your dog develops elbow dysplasia, regular veterinary exams are essential to monitor the progression of the disease.

If your dog is able to undergo surgery, treatment will be most successful when treated early. Many dogs that develop elbow dysplasia still make great pets, but will not be able to work or participate in agility programs. After arthroscopic surgery, most dogs are using the limb the same day of the surgery and has lameness significantly reduced. Recovery varies between whether arthritis is present. 60% of dogs with ununited anconeal process return to normal function after surgery with only 10% not improving at all. 75% of dogs with a fragmented coronoid process benefit from surgery. Surgery cannot improve arthritis, so your dog will continue to suffer stiffness or lameness after exercise or during cool, damp weather. Unfortunately, if your dog is experiencing very swollen elbows prior to surgery, these surgeries have a low rate of success.

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