Total Elbow Replacement
What is Total Elbow Replacement?
Total Elbow Replacement (TER) is reserved for animals that have painful conditions of the elbow joint that have proved unresponsive to conventional surgical techniques or conservative management using pain relief and rehabilitation. Total elbow replacement is used as a salvage procedure i.e. it is performed as a last resort where other treatments have proven to be or will be ineffective.
Dogs with advanced osteoarthritis of the elbow joint may in some cases benefit from replacement of the elbow joint. Total elbow replacement is an advanced surgical procedure and should only be performed by experienced orthopaedic surgeons.
What does Total Elbow Replacement surgery involve?
Currently we are one of the few practices in the UK able to provide total elbow replacement surgery routinely and we offer a number of different types of elbow replacement prostheses including custom made prostheses There are ‘off-the-shelf’ total elbow replacement systems available however at Fitzpatrick Referrals we have pioneered custom made total elbow implant systems in collaboration with a group of experienced human total elbow surgeons. We are currently the only referral centre in the UK offering custom made implants for elbow disease in dogs. Each implant prosthesis is made specifically for the patient using information gained from detailed CT images of the patient’s diseased and non-diseased elbow joints.
Total elbow replacement involves removal of the entire elbow joint surface. The images below illustrate the Sirius Total Elbow System developed by Osteogen in collaboration with the University of Liverpool Vet School. The Sirius total elbow replacement is comprised of three components; a stemmed humeral component, a radioulnar tray, and an ultra-high molecular weight polyethylene bearing. The Sirius elbow system uses special porus titanium surfaces and a coating called hydroxyapatite to help the implants integrate into the patient’s bone providing a pain free elbow joint.
What are the potential complications with Total Elbow Replacement?
The major complications encountered with total elbow replacement are dislocation of the elbow joint in the post-operative period, implant loosening or infection. Infection is rare but a potentially devastating complication of any surgical procedure and we take every possible precaution to try and prevent the patient developing an infection. The risk of loosening is also rare. Careful post-operative management of the patient helps prevent dislocation of the elbow joint and implant loosening.
What is the typical recovery after Total Elbow Replacement?
Careful rehabilitation after total elbow replacement is the key to success and it is vital that patients who undergo this surgery are managed diligently for the first 7-10 days after surgery to prevent damage to the operated elbow. After the initial 10 days post-op period each elbow replacement patient is placed on a carefully managed physiotherapy and exercise program uniquely designed by our team of chartered physiotherapists. The aim of the rehabilitation is to gradually progress exercise to off-lead exercise by approximately 12 weeks following surgery for most cases.
During your dogs hospitalisation period they will be cared for by a dedicated team of ward nurses and patient care auxiliaries who work alongside your dogs clinician, a team of veterinary surgeons and chartered physiotherapists ensuring all your dogs clinical and emotional needs are met. Due to the prolonged hospitalised period following surgery the patient care team make sure your dog feels at home and treat them just as if they were their own with the love and affection they desire and deserve.
What alternatives to Total Elbow Replacement are available?
Arthrodesis, or fusion, of the elbow joint may be a viable alternative in patients that are not suitable for total elbow replacement.