Total Elbow Replacement - CVM - Veterinary Clinical Sciences, University of Minnesota
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  Home > Department Sections > Surgery > VCS Surgical Research Laboratory > Orthopedic Topics > Total Joint Replacement > Total Elbow Replacement
 

Total Elbow Replacement

Frequently Asked Questions:

What is total elbow replacement?
Why might my dog need total elbow replacement?
Where is total elbow replacement available?
What are the risks of total elbow replacement?
What is the success rate of total elbow replacement?
What happens during surgery?
How long will my dog be in the hospital?
What follow-up care will I expect after surgery?
What are complications of total elbow replacement?
What will my dog be able to do after total elbow replacement?
How much does total elbow replacement cost?
How do I make an appointment for consultation?

What is total elbow replacement?
Total elbow replacement has been commercially available since 2000 but is still regarded as a technologically cutting-edge surgical technique where much of the elbow joint of the patient is replaced, usually by cutting the damaged part of the bones in the joint and replacing them with a metal and/or plastic implant that fits the patient.  At this point four implant sizes are available and can accommodate most dogs with body weights between 40 and 120 pounds. 

Why might my dog need total elbow replacement?
Total elbow replacement may be necessary due to advanced osteoarthritis or traumatic injury leading to loss of mobility and high levels of pain resulting in a deteriorated quality of life for the dog. 

Before total elbow replacement is advised, however, all treatment options must be considered.  Elbow replacement should not be considered until nonsurgical therapies involving lifestyle changes (primarily weight loss and daily activity) and/or medications have been tried for at least two months.  Other treatment options include amputation (in rare cases) or arthrodesis (a surgery that fuses the joint to relieve pain, but results in lack of joint motion) of the affected joint.  A board-certified veterinary surgeon can provide a thorough physical, diagnostic, and radiographic evaluation to help you make a decision that will best serve your dog’s health.  It is also reasonable to get a second opinion regardless of the opinion of the first veterinarian you met with.

Where is total elbow replacement available?
Elbow replacement is performed at several hospitals around the country and world.  BioMedtrix, the company that sells the total elbow replacement system, may be able to provide information about a surgeon in your area that performs this surgeon.  Dr. Mike Conzemius who developed this system can be contacted at the University of Minnesota and regularly sees owners and patients from around the country.  Feel free to contact Dr. Conzemius if you have questions regarding elbow replacement for your dog.

What are the risks of total elbow replacement?
As with all surgeries, this procedure is not without risk, and your expectations must be reasonable.  The risks of anesthetic complications are low, but not 0%.  Additional revision surgeries may be necessary, and there is a possibility the elbow may need arthrodesis or even amputation (in rare cases) of the leg in order to save the dog’s life.

What is the success rate of total elbow replacement?
The success rate in clinical cases is reported to be 80% (Conzemius MG, Aper RL, Corti LB. Total elbow arthroplasty in dogs with severe naturally occurring osteoarthritis. Vet Surg, 2003; 32:545-52).  In effect, what this means is that 8 out of 10 dogs that have elbow replacement performed had improved function and less elbow pain in the operated leg when compared to function prior to surgery.  Dr. Conzemius’ opinion is that the current success rate is closer to 85%.

What happens during surgery?
The total elbow replacement patient is placed under continually monitored general inhalation anesthesia for the 2-hour surgical procedure. A vertical incision about 6-inches long is made over the elbow to access the joint.  Damaged articular cartilage and joint surfaces are then removed and a prosthetic implant (made of plastic, metal, or both) is inserted into the bones.  The joint is then re-articulated and the incision closed.

How long will my dog be in the hospital?
The length of stay for your dog is variable, but discharge is typically within 48-hours after surgery.  When the dog is walking comfortably and eating well – signs that the initial post-surgical pain is under control - the dog can continue its recovery in the comfort of their own home.

What follow-up care will I expect after the surgery?
We expect follow-up visits (at the UM or with your veterinarian with the information forwarded to us) throughout the first year, including radiographs, data gathering, and video imaging likely as part of the exam.  Rehabilitation will begin while your dog is in the hospital, and post-operative physical therapy after release from the hospital may be necessary.   Typical treatments include stretches and joint mobilizations to restore flexibility, decrease swelling and promote healing.  They also serve to restore and strengthen muscle tissues.  Fees are associated with the follow-up exams and physical therapies.  Click here for TEA Post-Op Care instructions.

What are the complications of total elbow replacement?
These include infection (early or late), luxation (pops out of joint), fracture or aseptic loosening.  The majority of complications occur in the first 8-12 weeks after surgery.  Some of these complications can be managed successfully with a second revision surgery but the second surgery may require removal of the implants and arthrodesis (fusion) of the elbow joint.  Dogs that have fusion of the elbow in general have no elbow pain, but they walk with a mechanical limp because the elbow no longer moves. 

What will my dog be able to do after total elbow replacement?
Obviously, this depends upon the outcome.  Empirically, the majority of dogs that have a successful outcome can run, play and easily go up and down stairs with only occasional soreness/limping.  Although some dogs have a dramatic improvement that allows them perform about any activity without limping this is not what occurs on average and should not be expected.

How much does total elbow replacement surgery cost?
Every case is unique and requires careful evaluation before an estimate can be given.  However, elbow replacement cases typically cost in the range of $5000, but can run higher if additional surgery becomes necessary.

How do I make an appointment for consultation?
You can make an appointment by calling the Small Animal Hospital at the University of Minnesota’s Veterinary Medical Center at 1-800-626-VETS (8387).  Ask for an orthopedic surgical consultation appointment with Dr. Conzemius or Dr. Pluhar.

 



 
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