Dogs with Bilateral Medial Coronoid Disease Can Be Clinically Sound after Unilateral Arthroscopic Fragment Removal-Preliminary Study

Abstract

The purpose of this study was to assess the outcome of dogs with bilateral medial coronoid disease (MCD) treated with arthroscopic intervention for the clinically more severely affected side and conservative management for the contralateral side. The medical records of dogs with bilateral medial coronoid disease diagnosed using computed tomography (CT) and treated using arthroscopic intervention on one elbow and conservative management on the other elbow were retrospectively reviewed. The outcome evaluation included clinical re-examination; follow-up radiographic-visible osteophytic lesions; as well as sclerotic changes and Liverpool osteoarthritis in a dogs questionnaire. Data from 48 clinically affected elbow joints (24 dogs) with bilateral MCD diagnosed using CT were included. Every dog underwent arthroscopic intervention on the elbow joint, which was clinically more severely affected, and the other side was treated with conservative management. A fragment of the medial coronoid was diagnosed using CT in all elbows, whereas 19 elbows (39.4%) showed a dislocation of the fragment and the other 29 elbows (60.4%) did not. There are no findings regarding the radioulnar Incongruence. Initially, 86% of all radiographs had the same degree of osteophytes. At the time of follow-up, the arthroscopic-treated limbs had more severe radiological changes in comparison to the conservatively treated limbs. Lameness improved after arthroscopic therapy in walking. The conservative group showed a largely unchanged gait pattern. Radiological changes do not necessarily reflect the severity of clinical signs. Arthroscopic intervention showed an improvement of the clinical gait pattern, even though the radiographic changes worsened.

Keywords: arthroscopic intervention; arthroscopy; clinical outcome; conservative management; dogs; fragmented coronoid process; medial coronoid process disease; radiographs.

Figure 1

Measurement of the Trochlear Notch Sclerosis (TNS). Line AB: extent of sclerosis; line AC: ulnar depth 90° to caudal ulnar shaft → AB/AC = TNS [13].