Subtotal coronoid ostectomy for treatment of medial coronoid disease in 263 dogs.

Abstract

OBJECTIVE: To document clinical outcomes after subtotal coronoid ostectomy (SCO) for treatment of medial coronoid disease (MCD). STUDY DESIGN: Prospective clinical study. ANIMALS: Dogs (n=263) with MCD. METHODS: MCD was treated by a combination of SCO via mini-arthrotomy, cage confinement (6 weeks), leash restricted exercise (12 weeks) and pentosan polysulfate administration. Outcomes were assessed by clinical examination in the short-term (324 elbows), owner questionnaires (146 dogs), clinical examination (90 dogs), subjective assessment of gait (110 elbows) and radiographic examination (180 elbows), 4 months to 7 years 7 months after surgery. RESULTS: One intraoperative complication occurred (1 elbow with fissuring of the ulna) and 8.2% elbows had immediate postoperative complications, the most common being wound infection (7%). Improvement in subjective lameness assessment to a score of 0 was noted at 5 weeks in 74.4% of elbows (veterinary) and 45.6% (owner) and at 12 weeks in 71.5% (veterinary), and 91.2% (owner). Subjective assessments of outcomes in the medium-term revealed 81.9% dogs remained sound, with significantly (P<.05) improved daily function scores compared with preoperative values, 83.5% of dogs received no NSAID. Clinical examination revealed good limb function and subjective assessment showed 51% of limbs were free from lameness. Radiographic progression of osteophytosis occurred on average by one grade. CONCLUSION: Management of MCD using the described management regime, including SCO via mini-arthrotomy, deserves consideration and comparison with existing treatment methods. CLINICAL SIGNIFICANCE: Management of MCD by SCO can be considered when gross fissuring or fragmentation of the MCP is not evident. This technique does not require specialized instrumentation.