Elbow Osteochondritis Dissecans Surgery
What is elbow osteochondrosis/osteochondritis dissecans (OCD)?
Osteochondrosis is a developmental condition in which a disturbance in the normal development of joint cartilage into underlying bone (called endochondral ossification) results in an abnormally thick area of cartilage. This is a problem because cartilage relies entirely on diffusion of nutrients from joint fluid for nutrition, and if the cartilage layer is too thick, the deepest portion becomes devitalized and breaks down. This, in turn, often results in the overlying cartilage, no longer anchored to the underlying bone, forming a protruding flap that in some cases completely detaches into the joint. This disruption of the normally smooth joint surface causes an inflammatory condition called osteochondritis, which results in significant pain, inflammation, and lameness.
Osteochondrosis dissecans is a disease most commonly seen in immature male large and giant breed dogs. It’s suspected to be a genetic condition, although excessive or unbalanced nutrition may also play a role. The most common areas to see OCD in a dog include the shoulder, elbow, knee, and hock.
Is there a particular dog breed that’s predisposed to OCD?
Genetic factors are the most common cause of OCD with strong breed predispositions, particularly in large and giant breed dogs. Labradors, Golden Retrievers, German Shepherds, Bernese Mountain Dogs, St. Bernards, Rottweilers, and Great Danes are all at increased risk of developing OCD. Different dog breeds appear to be predisposed to developing OCD in different joints. Various other factors can include dietary or nutritional problems, hormonal imbalances and joint trauma.
How do I know if my dog suffers from OCD?
Most dogs with OCD will show clinical signs before the age of one, although occasionally signs may develop when your dog is slightly older. The clinical signs of OCD depend on the affected joint and the size of the cartilage defect. The most common signs of OCD in dogs include lameness, stiffness, joint pain or swelling, reluctance to exercise or play, or general depression.
How is elbow OCD diagnosed?
The diagnosis of OCD is based on a thorough orthopedic exam and sedated x-rays of the affected joint. Because OCD can occur simultaneously with other developmental orthopedic diseases (such as other components of elbow dysplasia), many dogs with OCD may require additional diagnostic imaging such as a CT or MRI. Following diagnostic imaging, your dog may require arthroscopic surgery on the affected joint to allow a close-up examination inside the joint. If an OCD lesion is identified during an arthroscopic procedure, it can often be treated at the same time.
Will my dog develop osteoarthritis from OCD?
Immediately after OCD develops, osteoarthritis (inflammation of the joint and associated bones) starts to develop as well. The arthritic changes that have already developed cannot be reversed, but further progression can be slowed down significantly with treatment of the OCD lesion.
How is elbow OCD treated in dogs?
Treatment of elbow OCD in dogs depends on the size and location of the cartilage defect. In most cases, the cartilage flap is removed and the resulting defect is debrided to encourage the growth of fibrocartilage to replace the missing diseased cartilage. While this fibrocartilage will never turn into normal joint cartilage, it functions adequately to maintain joint health long-term. In some cases where a large lesion is present, osteochondral grafting or synthetic osteochondral resurfacing may be recommended.
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