A Comparison of Surgical and Medical Treatment of Fragmented Coronoid Process and Osteochondritis Dissecans of the Canine Elbow

Summary

A randomized prospective clinical study was performed to compare the effect of surgery for fragmented coronoid process (FCP) and osteochondritis dissecans (OCD) of the canine elbow, with medical treatment using pentosan polysulphate (PPS). Nineteen dogs with FCP and/or OCD of the elbow were randomly assigned to either the surgical or medical group. Lameness examination, radiographic evaluation and force plate analysis were performed at the time of admission, and were repeated at two, four, six and nine months after treatment. In dogs with asymmetrical lameness, in both the medical and surgical groups, the peak vertical forces and mean vertical forces for the more affected limbs were significantly lower than the control means at time zero. In both the medical and surgical group, the peak and mean vertical forces improved during the course of the study. Weightbearing in medically treated dogs approached that in controls at a faster rate than in those treated surgically. After nine months of follow-up, differences could not be detected between the dogs treated surgically, and those treated with PPS.

Surgical and medical treatment for fragmented coronoid process and osteochondritis dissecans of the canine elbow were compared. Medical treatment resulted in a more rapid return to normal weight-bearing than did surgical treatment. After nine months of follow-up, differences were not detected between the medically and surgically treated dogs.

Keywords

Fragmented coronoid process - osteochondritis dissecans - pentosan polysulphate - force plate analysis

• REFERENCES

• 1 Olsson SE. General and aetiologic factors in canine osteochondrosis. Vet Quart 1987; 9: 268-78.
• 2 Wind AP. Elbow incongruity and developmental elbow diseases in the dog: part I, II. J Am Anim Hosp Assoc 1986; 22: 711-30.
• 3 Olsson SE. Osteochondritis dissecans in the dog. Proceedings from 42nd annual meeting of the American Animal Hospital Association. 1975: 362-8.
• 4 Berzon JL. Diagnosis and surgical management of osteochondritis dissecans of the elbow joint. Comp Cont Ed 1983; 5: 285-8.
• 5 Boudrieau RJ, Hohn RB, Bardet JF. Osteochondritis dissecans of the elbow in the dog. J Am Anim Hosp Assoc 1983; 19: 627-35.
• 6 Goring RL, Bloomberg MS. Selected developmental abnormalities of the canine elbow: radiographic evaluation and surgical management. Comp Cont Ed 1983; 5: 178-88.
• 7 Grondalen J. Arthrosis in the elbow joint of young rapidly growing dogs. III. Nord Vet Med 1979; 31: 520-7.
• 8 Mason TA, Lavelle RB, Skipper SC, Wrigley WR. Osteochondrosis of the elbow joint in dogs. J Small Anim Pract 1980; 21: 641-56.
• 9 Bennett D, Duff SRI, Kene RO, Lee R. Osteochondritis dissecans and fragmentation of the coronoid process in the elbow joint of the dog. Vet Rec 1981; 109: 329-36.
• 10 Houlton JEF. Osteochondrosis of the shoulder and elbow joints in dogs. J Small Anim Pract 1984; 25: 399-413.
• 11 Read RA, Armstrong SJ, O’Keefe JD, Eger CE. Fragmentation of the medial coronoid process of the ulna in dogs: A study of 109 cases. J Small Anim Pract 1990; 31: 330-4.
• 12 Huibregtse BA, Johnson AL, Muhlbauer MC, Pijanowski GJ. The effect of treatment of fragmented coronoid process on the development of osteoarthritis of the elbow. J Am Anim Hosp Assoc 1994; 30: 190-5.
• 13 Burkhardt D, Ghosh P. Laboratory evaluation of antiarthritic drugs as potential chondroprotective agents. Sem Arthrit Rheum 1987; 17 suppll 3-34.
• 14 Hannan N, Ghosh P, Bellenger C, Taylor T. Systemic administration of glycosaminoglycan polysulfate (Arteperon) provides partial protection of articular cartilage from damage produced by meniscectomy in the canine. J Orthop Res 1987; 5: 47-59.
• 15 Altman RD, Dean DD, Muniz OE, Howell DS. Therapeutic treatment of canine osteoarthritis with glycosaminoglycan polysulfuric acid ester. Arthrit Rheum 1989; 32: 1300-7.
• 16 Altman RD, Dean DD, Muniz OE, Howell DS. Prophylactic treatment of canine osteoarthritis with glycosaminoglycan polysulfate acid ester. Arthrit Rheum 1989; 32: 759-766.
• 17 Todhunter RJ, Lust G. Polysulfated glycosaminoglycan in the treatment of osteoarthritis. J Am Vet Med Assoc 1994; 204: 1245-51.
• 18 Read RA, Cullis-Hill D. The systemic use of the chondroprotective agent pentosan polysulfate in the treatment of osteoarthritis - results of a double blind clinical trial in dogs. Proceedings from 20th annual Veterinary Orthopedic Society meeting. 1993
• 19 Budsberg SC, Verstraete MC, Soutas-Little RW. Force plate analysis of the walking gait in healthy dogs. Am J Vet Res 1987; 48: 915-8.
• 20 Budsberg SC, Jevens DJ, Brown J, Foutz TL, DeCamp CE, Reece L. Evaluation of limb symmetry indices, using ground reaction forces in healthy dogs. Am J Vet Res 1993; 54: 1569-74.
• 22 Rumph PF, Kincaid SA, Baird DK, Kammermann JR, Visco DM, Goetze LF. Vertical ground reaction force distribution during experimentally induced acute synovitis in dogs. Am J Vet Res 1993; 54: 365-9.
• 23 Jevens DJ, Hauptman JG, DeCamp CE, Budsberg SC, Soutas-Little RW. Contributions to variance in force-plate analysis of gait in dogs. Am J Vet Res 1993; 54: 612-5.
• 24 Riggs CM, DeCamp CE, Soutas-Little RW, Braden TD, Richter MA. Effects of subject velocity on force plate - measured ground reaction forces in healthy Greyhounds at the trot. Am J Vet Res 1993; 54: 1523-6.
• 25 Anderson MA, Mann FA. Force plate analysis: a noninvasive tool for gait evaluation. Comp Contin Ed 1994; 16: 857-67.
• 26 McLaughlin RM, Roush JK. Effect of limb stance time and subject velocity on ground reaction forces in normal greyhounds at the trot and walk(abstract). Proceedings ACVS meeting, Washington D.C., October. 1994
• 27 Griffon DJ, McLaughlin RM, Roush JK. Vertical ground reaction force redistribution during experimentally induced shoulder lameness in dogs. V.C.O.T 1994; 7: 154-7.
• 28 Dueland R, Bartel DL, Antonson E. Force plate technique for canine gait analysis of total hip and excision arthroplasty. J Am Anim Hosp Assoc 1977; 13: 547-52.
• 29 Budsberg SC, Verstraete MC, Soutas-Little RW, Flo GL, Probst CW. Force plate analyses before and after stabilization of canine stifles for cruciate injury. Am J Vet Res 1988; 49: 1522-4.
• 30 O’Connor BL, Visco DM, Heck DA, Myers SL, Brandt KD. Gait alterations in dogs after transection of the anterior cruciate ligament. Arthrit Rheum 1989; 32: 1142-7.
• 31 Person MW. Arthroscopic treatment of osteochondritis dissecans in the canine shoulder. J Vet Surg 1989; 18: 175-89.
• 32 McLaughlin RM, Miller CW, Taves CL, Hearn TC, Palmer NC, Anderson GI. Force plate analysis of triple pelvic osteotomy for the treatment of canine hip dysplasia. J Vet Surg 1991; 20: 291-7.
• 33 Dogan S, Manley PA, Vanderby R, Kohles SS, Hartman LM, McBeath AA. Canine intersegmental hip joint forces and moments before and after cemented total hip replacement. J Biomech 1991; 24: 397-407.
• 34 McLaughlin R, Roush JK. A comparison of two surgical approaches to the scapulohumeral joint in dogs. J Vet Surg 1995; 24: 207-14.