Total Elbow Replacement (TER) Procedure for Dogs
ACCESS Bone and Joint Center was at the forefront of the advances in the total elbow joint replacement. In fact, Dr. Guiot was involved in the development of the latest generation total elbow replacement system (TATE) by BioMedtrix and has successfully used it to treat elbow dysplasia since 2008.
Elbow dysplasia in dogs is an abnormal condition involving multiple developmental abnormalities of the elbow joint. Elbow is a complex joint that consists of 3 bones. When they don’t fit perfectly together, it leads to pain, lameness, and the development of osteoarthritis. The exact cause of elbow dysplasia is unknown. It usually occurs in larger breed dogs, and in most cases, it affects both elbows. Unfortunately, once the elbow joint is affected, arthritis will progress and can lead to a loss of elbow function.
Signs of elbow dysplasia can manifest themselves at various times in your pet’s life – from a 5-month-old pup to a 5-year-old dog. You might notice that your pet developed front limb lameness, became less active and playful, choosing to lie down, refusing to exercise or complete a walk.
Total Elbow Replacement procedure
Total Elbow Replacement is a surgical procedure in which the damaged elbow joint is removed and replaced by a prosthetic.
Advantages of a Total Elbow Replacement
- It closely mimics the mechanics of a normal elbow joint
- It offers the best chance to restore full elbow functionality and return to normal activity
- It provides the best option for a pain-free elbow
- It eliminates or reduces the need for pain medication
Elbow Joint Before and After Surgery
Total Elbow Replacement FAQs
A total elbow replacement is recommended when the elbow joint is damaged beyond repair. Usually, it occurs at the end stages of elbow dysplasia when conservative management becomes ineffective.
Total Elbow Replacement is not recommended when infection is part of the primary disease. It is also shouldn’t be performed when the supporting ligament is weak or damaged and can’t support an implant. Your pet needs to be in overall good physical and neurological health.
The commercial elbow implants are currently available for large breed dogs. However, custom implants might be an option for smaller pets. This is on case-by-case basis.
After a total elbow replacement, your pet will be able to bear weight on the operated limb in the first 2 weeks, but the activity level will need to be restricted for approximately 12 weeks. During those 12 weeks need to be stringent. There can be no running, jumping, playing, or access to stairs, and a sling should be used when walking. At-home physical therapy exercises, such as passive range of motion and weight shifting, are highly encouraged. At the 12-week mark, most pets are cleared for a progressive return to normal activity and professional physical rehabilitation can begin if indicated.
Yes, patients will be hospitalized overnight following a total elbow replacement procedure. In some instances, two-three nights might be necessary. Our 24×7 hospital is the best place for your pet to recover after surgery under the monitoring of our staff.
The current expectation for return to normal function after a total elbow replacement is very good. While long-term data on this newer procedure isn’t available, it is expected to continue to provide comfort and mobility as the patient ages.
Risks associated with a total elbow replacement involve fracture of the humerus or ulna, loosening of the prostheses and infection. Enforced rest and physical rehabilitation play a major role in a positive outcome. In the event of catastrophic total elbow replacement failure, arthrodesis or amputation would be the fallback procedures. Lameness can take 3-6 months to resolve.
Medical management of elbow dysplasia can include the use of non-steroidal anti-inflammatory drugs (NSAIDs). It can be successful when combined with nutritional supplementation, weight and exercise modulation, and a rehabilitation program.
Surgical fusion of the joint (arthrodesis) or amputation of the limb may be the last resort options. Fusion will likely remove the pain associated with the joint but will lead to an abnormal gait because the elbow joint will no longer bend as the bones will be fused at a pre-defined angle. An amputation is an option if the disease is occurring in only one of the elbows and the limb is not used.