Elbow dysplasia or ED is a general term that encompasses several anatomical problems; resulting in malformation of the elbow joint leading to early-onset osteoarthritis.
The word dysplasia means abnormality of development, and different developmental elbow diseases, have multiple causes and treatments.
The elbow is a complex joint because it involves three bones articulating together – the humerus of the dog’s upper foreleg and the radius and ulnar of the lower foreleg. Its function is not weight-bearing, but it helps with stability, particularly when the dog’s front leg extends.
If these three bones do not fit together perfectly, an abnormal load or force exerts on a specific region of the elbow joint. Mechanical stresses; as the joint is unable to move normally and wear and tear of the joint starts to occur, leading to secondary osteoarthritis.
Elbow dysplasia is the most common cause of forelimb lameness in young large and giant breed dog’s involving abnormal bone growth or cartilage development.
Several specific developmental abnormalities lead to elbow dysplasia
Ununited anconeal process or UAP
A condition most commonly seen in large dog breeds. The anconeal process lies at the back of the elbow joint and attaches to the ulna; in some dogs, the anconeal process does not fuse with the main body of the ulna and instead forms a separate bone referred to as an ununited anconeal process.
As a result of the anconeal process failing to form fully, elbow function is impaired, osteoarthritis develops and causes lifelong pain, discomfort and disability.
Fragmented medial coronoid process or FCP
The medial coronoid process is a piece of bone that should form part of the top of the ulna and the elbow joint. In FCP this breaks away during development and fails to connect to the ulna.
This small piece of bone irritates the cartilage that lines and cushions the bone and can begin to grind away at the cartilage of the humerus, ultimately leading to the development of osteoarthritis.
Osteochondritis dissecans or OCD
Refers to joint cartilage that develops abnormally or becomes damaged, leading to thickening, cracking and fragmentation of the cartilage away from the bone.
These pieces of cartilage do not die off but continue to grow and cause pain as the lining of the joint becomes inflamed.
Due to natural conformation issues, the malformed articular surfaces of the three bones that make up the elbow do not fit together as they should.
It can affect the weight-bearing surfaces between the humerus, the radius and the ulna and how the upper part of the ulna fits inside the lower end of the humerus. As the joint does not fit well together, progressive osteoarthritis develops as the joint comes under more wear and tear.
Ununited medial epicondyle or UME
A less common condition seen in early development, where the medial epicondyle, a rounded articular extremity of the humerus, fails to unite with the humerus.
Most dogs diagnosed with elbow dysplasia present a limp on one or both front legs, and this can be seen as a downward nod of the head when the good leg touches the ground and a lifting of the head when the affected leg touches the ground.
The joint may appear stiff or unable to move freely, and advanced cases develop osteoarthritis, fluid build-up within the joint, and a grating or crackling sound.
The disease is often present by 5-9 months of age but can present later in life; affected dogs may be treated with rest and painkillers, although treatment may need to be life-long. Various surgical procedures are likely to be recommended before the degenerative changes of osteoarthritis occur.
THE USE OF MYOTHERAPY TO SUPPORT ELBOW DYSPLASIA
Surgical treatments for elbow dysplasia aim to treat the current source of pain and minimize the likelihood of osteoarthritis progression.
Non-surgical treatments for elbow dysplasia aim to treat elbow pain and maintain mobility but cannot minimize osteoarthritis progression.
Myotherapy treatment can support pre-surgical conditioning as well as post-operative rehabilitation.
It can help reduce loading issues on the joint and reduce the soreness and tension throughout the body, particularly in areas of overcompensation.
Myotherapy can be beneficial in releasing the compensatory tension and muscle spasms in the lower neck and behind the shoulder associated with elbow dysplasia.