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ELBOW - 

OSTEOCHONDRITIS DESSICANS OCD

Osteochondritis Dessicans (OCD) of the elbow refers to poor mineralisation of the bone under the articular cartilage at the bottom of the upper arm (humerus).  This abnormality in the bone under the cartilage allows a flap of cartilage to form within the joint.  This flap of cartilage can be large and cause siginificant lameness and pain in the elbow joint when it becomes detached. 

 The condition is commonly diagnosed in young, rapidly growing, large breed dogs, with patients being diagnosed at 1-2 years of age.  The large mobile fragment and abnormal wear of cartilage within the joint lead to the progression of debilitating osteoarthritis and ongoing joint pain.  The diagnosis of elbow OCD is based on clinical examination and evidence of a bone defect on the humerus seen on xrays.

Treatment usually involves arthroscopic removal of the cartilage fragment and clearing of the underlying bone, to allow the formation of scar-cartilage in its place.  Other options include the use of portions of bone and cartilage taken from other joints, usually the knee, to resurface the area of cartilage loss.

  

The prognosis for resolution of the lameness and return to function is reasonable, despite the progression of osteoarthritis, but considerably better than those patients who are left untreated.

Complications following arthroscopy are very low, with an expected quick post-operative recovery, and improvement fo function in the weeks following the procedure.  The joint will have some swelling following the surgery but this should resolve without issue in 2-5 days.  Infection is the most common complication (usually less than 2%) which should be monitored for following surgery, and is generally easily treated with antibiotics and in serious infections, washing of the joint with sterile saline.

Long-term options for the management of elbow dysplasia are based on maintenance of lean body condition, physiotherapy, joint supplementation (fish oils, glucosamine, chondroitin, pentosan polysulphate injection), joint anti-inflammatories and exercise moderation.