Elbow surgery & arthroscopy

A four-week-old puppy, that was intended to grow up as a “ratter” on a farm, presented with a dislocated left elbow. In fact, strictly speaking, this elbow wasn’t “dislocated” as it had never in fact been “located” in the first place! The owners were counselled that there was little chance that this elbow could ever be returned to a functional joint.

The anconeal process is found in the elbow. It is a “keel” of bone on the ulna (one of the bones of the forearm) which slots into the back of the humerus (the bone of the upper arm) and which gives stability to the elbow when that joint is in extension.

Incomplete ossification of the humeral condyle (IOHC) is most frequently see in Spaniels.

Harvey, a gentle, elderly crossbred male, who had serious elbow degenerative joint disease (DJD) – “osteoarthritis” was bought to us at West Midlands Referrals in Burton-Upon-Trent.

Bailey is an 8-year-old Labrador. He has had chronic right elbow degenerative joint disease and lameness, but a left elbow lameness was recently evident. A mobile blob of cartilage and bone was visible on x-ray and palpable in the joint when he was under GA.

We’ve done arthroscopy for some time at West Midlands Referrals in Burton-Upon-Trent, but in early 2016 we revamped and upgraded our kit. We now have 2.4mm and 1.9mm Storz arthroscopes and are seeing many elbows and shoulders for arthroscopic diagnosis and treatment. Maciej leads these procedures. Cases to be considered for arthroscopy are first seen by him in as an outpatient consultation.

Placement of a “camera” into joints – most commonly the elbow or the shoulder – allows for inspection with magnification and for some procedures to be minimally invasive without a fully open surgical procedure.

Arthroscopy is an alternative to CT scan for diagnosing humeral intercondylar fissure (incomplete ossification of the humeral condyle), typically seen in Spaniels. This is a line of weakness in the lower end of the humeral condyle that can propagate into a fracture (see separate articles on condylar fracture and Y fracture, in the case study section on fractures).

Floki, an 11-month-old Cane Corso, presented to us at West Midlands Referrals with right forelimb lameness and an un-united anconeal process. The left elbow anconeal process was united as normal. This large free mass of bone, loose in the elbow joint, was removed through a modest incision.