Fragmented Medial Coronoid Process Research Articles

Computed tomography-guided cannulated lag screw placement for treatment of ununited anconeal process: surgical technique, clinical outcome, and radiographic healing in 7 dogs.

A novel technique and outcomes for correction of ununited anconeal process (UAP) via CT-guided cannulated lag screw placement in 7 canine patients is described. Cases of canine patients (7 patients/8 elbows) diagnosed with UAP that subsequently underwent CT-guided cannulated lag screw placement were retrospectively evaluated. Pre- and postoperative exam findings (lameness and pain on range of motion) are presented. Preoperative radiographs and postoperative radiographs at 2 time points (approximately 8 weeks postoperatively and at the time of the most recent imaging; mean, 221 days; range, 85 to 828 days) were scored for degree of arthrosis and postoperative radiographs were evaluated for radiographic union. Complications were reported and stratified by severity and time postoperatively. Minor perioperative (0 to 3 months postoperatively) complications included seroma formation (n = 1) and major perioperative complications involved development of surgical site infections (2), with 2 patients requiring implant removal in the perioperative period (44 and 82 days postoperatively). All patients achieved radiographic union, defined as partial or complete bridging of the anconeal process to the ulna within the study period (mean radiographic follow-up time 221 days postoperatively; range, 85 to 828 days; 5/8 joints partial bridging, 3/8 joints complete bridging) and pre- versus postoperative elbow arthrosis scores remained static in all patients. The case outcomes described support the use of CT-guided cannulated lag screw placement as a feasible option for treatment of UAP.

Canine elbow realignment osteotomy for treatment of axial humeroradial or humeroulnar incongruency in four dogs

AbstractCanine elbow incongruity is a condition that may be associated with the development of dysplastic lesions of the elbow; namely, medial coronoid process disease, osteochondrosis of the humeral condyle and ununited anconeal process. Axial elbow incongruity (either short radius or short ulna syndrome) may predispose to the development of elbow osteoarthritis. Surgical correction of incongruity has previously been described in an effort to improve lameness and mitigate progression of osteoarthritis, although a system by which to achieve measured and precise adjustment of congruity of both the radius and ulna has been lacking. This case series describes use of a novel acute correction surgery, canine elbow realignment osteotomy for correction of axial elbow incongruency in four dogs.

Fragmented medial coronoid process in a cat

AbstractFragmented medial coronoid process is common in dogs, but has only been described in the cat once historically. This case describes a case of presumed traumatic fragmented medial coronoid process in a cat, which presented for right thoracic limb lameness of 3‐month duration, which did not respond to medical management. A computed tomography study demonstrated the fragmented medial coronoid process, and surgical removal of the fragment was performed via arthrotomy without complication. Histological examination of the fragment did not show microdamage of the bone or osteocyte loss, which is evident in developmental cases of fragmented medial coronoid process, and was suggestive of a historical fracture that resulted in non‐union. The patient improved postoperatively, but still experiences intermittent lameness after periods of exertion.

The use of subchondral bone topography to approximate the center of rotation of the elbow joint in dogs.

The aim of this study was to compare the approximate center of rotation in normal and diseased elbows in dogs. Cross-sectional study SAMPLE POPULATION: Computer tomography scans of nine dogs with unilateral fragmented medial coronoid process (FMCP). A board certified radiologist confirmed that each dog had unilateral FMCP, and a normal contralateral elbow. Digital 3D models of all elbow joints were uploaded into a surgical planning software package. Four axes approximating the center of rotation (COR) of elbow joints were generated using five geometric shapes based on subchondral topography of the humeral condyle radius and ulna. Images showing the locations where axes exited the medial and lateral cortex of the humeral condyle were captured and imported into a second software package, for measurement of distances between exit points and the origin of a system of axes. In normal joints 20/27 (74%) axes exited the medial cortex, and 25/27 (93%) axes exited the lateral cortex cranial and distal to the medial and lateral epicondyles, respectively. In diseased joints 22/27 (81%) axes exited medial cortex and 19/27 (70%) axes exited the lateral cortex, caudal and distal to the medial and lateral epicondyles, respectively. Based on CT- derived geometry, the COR of elbow affected with FMCP was generally more caudal than normal. External landmarks approximating the location of the elbow COR are provided, and while not validated, may assist in planning, creation, and assessment of procedures for FMCP.

Owner assessed outcomes following elbow arthroscopy with or without platelet rich plasma for fragmented medial coronoid process.

ObjectiveDocument the outcomes of bilateral arthroscopic subtotal coronoidectomy for the fragmented medial coronoid process, quantify persistent lameness that required additional treatment (PRP), and document the outcomes of dogs that followed up with PRP injections.Study designRetrospective study.Sample populationOverall, 115 dogs underwent arthroscopy alone and 31 received PRP at least 6 weeks after arthroscopy. The owner's response rate was ~50% (73 dogs).MethodsCollected data included signalment, unilateral or bilateral clinical signs, intra-articular chondroprotective injection during the procedure, if PRP intra-articular injection was received postoperatively, and if it was received, the time from the initial surgery to administration was recorded. Outcomes were assessed via standardized owner questionnaires using the Liverpool Osteoarthritis in Dogs (LOAD) score, the Canine Brief Pain Inventory (CBPI) score, and the overall quality of life (QOL) assessment.ResultsApproximately 20% of the patients received PRP post-operatively due to persistent lameness following surgery. Similar pain scores were found between the two groups with an average of 11–13 LOAD score, 13–15 CBPI score, and good quality of life. Older animals at the time of surgery and those that received pain-relieving medications after the procedure were more painful and affected their functional outcome. PRP as an adjunctive therapy achieved a perceived good to excellent quality of life in ~90% of pets in this population.ConclusionArthroscopy and subtotal coronoidectomy followed by PRP, if needed, seemed to decrease pain, and improve lameness in the long term.Clinical significancePRP should be considered as adjunctive therapy in dogs with the limited response to arthroscopy alone.

Autologous Bone Marrow Mononuclear Cells (BMMCs) for the Treatment of Uncomplicated Grade 2 Ununited Anconeal Process (UAP) in Six Dogs: Preliminary Results.

The aim of this study was to report the results of autologous bone marrow mononuclear cell (BMMC) transplantation as a minimally invasive treatment for grade 2 UAP in dogs. This was an observational case series on six German shepherd dogs affected by grade 2 UAP as defined according to their clinical condition as well as radiographic and CT findings. Bone marrow was collected from the iliac crest and the mononuclear fraction was separated with density gradient centrifugation. Cells were suspended in fibrin glue before BMMC administration and implanted via transcutaneous injection under IB or CT guidance, using a spinal needle directly inserted into the ossification centre between the anconeal process and the olecranon. Clinical and radiographic follow-up was performed for up to 6 months. Microradiographic assessment was performed on one dog that died of other causes. A progressive reduction of pain within 3 weeks after BMMC administration was observed in all dogs, with gradually increased weight bearing on the affected limb. Radiographic and CT follow-up revealed the progressive fusion of the ossification centre at 90 days without any signs of secondary OA. The examination of microradiographs showed newly formed bone tissue in which a residue of calcified cartilage was present at the site of BMMC implantation. On the basis of these results, BMMC therapy for grade 2 UAP may be considered to be an effective and minimally invasive treatment option for dogs.

Computed tomography findings in a cohort of 169 dogs with elbow dysplasia - a retrospective study

BackgroundCanine elbow dysplasia (CED) is a complex developmental skeletal disorder associated with a number of pathological conditions within the cubital joint. Because CED is a heritable disease, it is important to identify and remove the affected animals from breeding. The first objective of this study was to describe the prevalence of medial coronoid process disease (MCPD) without (MCD) or with (FMCP) fragmented medial coronoid process, osteochondrosis (OC) and/or osteochondritis dissecans (OCD), ununited anconeal process (UAP), radio-ulnar incongruence (INC R-U) and humero-ulnar incongruence (INC H-U) in dogs with the use of CT imaging. The second aim was to determine the influence of demographics on the prevalence of investigated pathologies in dogs with clinical evidence of elbow dysplasia.ResultsIn this retrospective study, CT data records of 169 dogs of different breeds presented to the small animal veterinary clinic from 2012 to 2018 were included. 69.23% of dogs diagnosed with CED were young (≤ 2 years old). The mean age of dogs presented with INC R-U was 1.68 ± 1.82 years, while in dogs without INC R-U the mean age was 2.64 ± 2.59 years. The mean age of dogs with INC H-U was 1.94 ± 2.06 years, while without INC H-U 3.29 ± 2.09 years. Labrador Retrievers, German Shepherd and Bernese Mountain dogs were most frequently presented with CED-associated lameness. In 122 dogs OA of varying severity was found.ConclusionINC H-U, FMCP and MCD were among the most frequently found components of CED found in the present study. OCD and UAP were the least frequently diagnosed. Dogs presented with INC R-U and INC H-U were significantly younger than dogs without these CED components. Boxers, Dog de Bordeaux, American Staffordshire terriers and mixed-breed dogs were diagnosed later in life than the other breeds. OA of varying severity was found in 72.18% of dogs. Males accounted for more than 75% of the study population.

Digital Analysis of Subtrochlear Sclerosis in Elbows Submitted for Dysplasia Screening.

Ulnar trochlear notch (UTN) subchondral bone sclerosis is observed in elbow dysplasia (ED) associated with the medial coronoid disease. However, its evaluation is based on a simple visual examiner assessment of bone radio-opacity level and is considered subjective. The purpose of this study was to objectively characterize the radiographic opacity of the ulnar trochlear notch (UTN) subchondral bone in mediolateral elbow projections classified, using the International Elbow Working Group guidelines. Records and mediolateral flexed elbow images from the Danish Kennel Club database for the ED screening scheme between 2012 and 2018 were available. Of the dogs in the database, those with an ED-negative status in the left limb were identified. From these, 20 dogs each having a status free from ED, or with Grade 1, 2, or 3 in the right limb, were randomly chosen. Joints with primary ununited anconeal process were excluded from the sample. A template was developed using the ImageJ software, for computer UTN sclerosis analysis. It was overlaid onto each image to define five regions of interest (ROIs): ROI-1, distal UTN; ROI-2, middle UTN; ROI-3, caudal UTN; ROI-4, cortical bone; and ROI-5, bone marrow. Mean pixel intensity for each UTN ROI was divided by the mean pixel intensity of ROI-4 to normalize the data. The mean ± standard deviation (SD) of the normalized pixel intensity in the disease joints (ED Grades 1, 2, and 3) was 1.18 ± 0.17, 1.03 ± 0.12, and 0.92 ± 0.09 for ROIs 1, 2, and 3, respectively. The corresponding values for the contralateral normal left joints were 1.16 ± 0.17, 1.01 ± 0.1, and 0.91 ± 0.08. There was a significant difference (P < 0.05) in the normalized mean pixel intensity in dysplastic vs. non-dysplastic elbow joints for ROIs 1 and 2. The raw mean pixel intensity from right and left cortical and marrow bone ROIs sometimes showed relatively large differences. Digital radiography is associated with exposure and post-processing variabilities. Differences in apparent radio-opacity (as indicated by pixel intensity) though statistically significant in dysplastic joints compared with contralateral normal joints are slight and are thus problematic for computer-aided assessments of UTN sclerosis.

Canine developmental elbow disease part 2: surgical and non-surgical management

Developmental elbow disease is the term encompassing several abnormalities of the elbow joint, including fragmented medial coronoid process (FCP), osteochondrosis of the humerus (OC), ununited anconeal process (UAP), cartilage injuries and incongruity of the elbow joint. These disorders are associated with varying degrees of joint instability, inflammation, and loose fragments within the joint, which result in lameness and osteoarthrosis. Treatment should ideally involve correcting the underlying causes of the disease before significant joint damage has occurred. There are many surgical options for the treatment of developmental elbow disease which aim to unload the medial compartment, replace joint surfaces and manage pain. These include the sliding humeral osteotomy, proximal abducting ulna osteotomy, joint resurfacing and joint replacement. Studies evaluating the different treatments have low case numbers, variable outcome parameters, inconsistent diagnostic criteria and short follow-up times. Non-surgical manangement should always be part of the treatment plan to manage pain and symptoms as virtually all dogs with elbow disease will go on to develop osteoathritis.

Canine developmental elbow disease part 1: aetiopathogenesis and diagnosis

Elbow dysplasia or ‘developmental elbow disease’ as it is now known, is an umbrella term encompassing multiple abnormalities of the elbow joint. These include elbow incongruity, fragmented medial coronoid process, osteochondritis dissecans and ununited anconeal process. These problems may occur individually or in combination with each other and all may cause lameness, pain, reluctance to exercise and restricted movement as the disease progresses. The advanced stage of osteoarthritis associated with medial coronoid disease involving extensive damage to or loss of cartilage is known as medial compartment disease. There are multiple modalities available for imaging the elbow joint: radiography which is widely available in general practice can detect some changes but may miss others; computed tomography in conjunction with arthroscopic examination is considered the ‘gold standard’ in elbow imaging. Part 1 of this two part series of articles introduces the aetiopathogenesis of canine developmental elbow disease, and part 2 will cover the surgical and nonsurgical management.

Computed Tomography Enhances Diagnostic Accuracy in Challenging Medial Coronoid Disease Cases: An Imaging Study in Dog Breeding Appeal Cases.

The aim of this study was to determine the radiographic sensitivity in detecting medial coronoid disease (MCD), using computed tomography (CT) as reference in dogs presented for an official second opinion, and to compare the medial coronoid process (MCP) in fragmented and fissured MCP as well as those unaffected by MCD. The data of dogs, presented for official second opinion radiographs and CT, were reviewed by three board-certified observers and in accordance with the International Elbow Working Group guidelines regarding MCD. Radiographic delineation, radiopacity and Hounsfield Units (HU) of the MCP were recorded additionally and the correlation between radiography and CT was investigated. Sensitivity and specificity of radiography compared with CT yielded values of 83.6% for the former and 83.5% for the latter. False-negative grading in radiography correlated significantly (p = 0.0001) with a present fissure line in CT. The mean delineation (p = 0.03) and mean HU of fragmented MCP (p = 0.0045) were significantly reduced compared with fissured MCP and no significant differences in measured HU for fissured MCP were detected in comparison to elbows unaffected by MCD. The results of the present study show substantial agreement between radiography and CT in second opinion cases. However, sensitivity is reduced compared with not preselected cases. A present fissure line in CT was significantly associated with a false-negative grading in radiography. Therefore, CT imaging of the elbows is strongly recommended in cases of appeal.

Avaliação morfológica e morfométrica da articulação umerorradioulnar em cães através de exames radiográficos e por tomografia computadorizada

RESUMO: Este estudo teve como objetivo apresentar de forma detalhada dados morfológicos e morfométricos da articulação umerorradioulnar de cães de raça definida avaliados por meio de exames físicos, radiográficos e tomográficos. A amostra dessa pesquisa constituiu-se de 44 cotovelos de cães com idades variadas. Para análise de informações obtidas, o coeficiente kappa e de correlação interclasse e associação foram realizados. Constatou-se que o desempenho individual de cada projeção radiográfica teve pobre concordância com o exame tomográfico; não houve concordância entre os observadores para as mensurações do ângulo da incisura ulnar ao exame radiográfico e tomográfico. Porém houve boa/moderada concordância para mensuração da incongruência radioulnar no plano sagital entre os observadores. Concluiu-se que nenhuma das cinco incidências radiográficas foi superior para análise radiográfica, uma vez que cada projeção apresentou melhor identificação de um compartimento do cotovelo. Medidas ao exame tomográfico para incongruência radioulnar não apresentaram reprodutibilidade no plano de reconstrução frontal, entretanto no corte sagital apresentaram boa e moderada concordância entre os observadores e que a mensuração do ângulo da incisura ulnar não apresentou repetibilidade ao exame radiográfico e nem reprodutibilidade ao exame tomográfico. Esses resultados contribuem para melhor utilização de cada exame de acordo com a região a ser avaliada bem como ressaltam a necessidade da somatória de múltiplos exames de imagem para a correta avaliação desta afecção.

Does Adipose-derived Stromal Cell Adjuvant Therapy for Fragmented Medial Coronoid Process in Dogs Influence Outcome? A Pilot Project

&lt;p&gt;&lt;strong&gt;Objective:&lt;/strong&gt; The primary objective of this study was to identify adverse events associated with multiple intra-articular injections of adipose stromal cell (ASC) therapy and secondarily to objectively assess the therapeutic effect of ASC therapy for treatment of fragmented medial coronoid process (FMCP) in dogs when used as an adjuvant to standard of care (SOC) treatment. &lt;/p&gt;&lt;p&gt;&lt;strong&gt;Background:&lt;/strong&gt; Preliminary trials assessing autologous ASC therapy to treat osteoarthritis indicate a positive impact on clinical signs, but assessment of donated, allogeneic ASC therapy is lacking.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Evidentiary value:&lt;/strong&gt; This prospective, randomised, controlled trial in dogs (n=30) provides objective evidence for clinical practitioners regarding ASC therapy in a naturally occurring osteoarthritic disease model.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Dogs diagnosed with FMCP and osteoarthritis were enrolled. All dogs had arthroscopic fragment removal and proximal ulnar osteotomy (PUO) and were assigned into three groups (n=10/group): 1) control group with no further treatment beyond the PUO and fragment removal (SOC), 2) PUO + autologous ASCs and 3) PUO+ allogeneic ASCs. Each dog had force platform gait analysis, Canine Brief Pain Inventory (CBPI) questionnaires, and delayed gadolinium enhanced magnetic resonance imaging scores prior to and six months after therapeutic intervention.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results:&lt;/strong&gt; No serious adverse events were reported in any participant. 3/10 dogs in the control group, 3/10 autologous ASC group and 7/10 allogeneic ASC group participants were assessed as successful outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study provides preliminary safety data for the use of intra-articular allogeneic ASC therapy to treat osteoarthritis, and justification for larger clinical studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Application:&lt;/strong&gt; Clinical practitioners considering ASC therapy within their practice are provided with additional evidence of autologous ASC therapy for osteoarthritis. Researchers committed to developing and generating effective ASC therapies are provided with safety information for allogeneic ASC, as well as identified biases important for study design.&lt;/p&gt;&lt;br /&gt; &lt;img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access" /&gt; &lt;img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed" /&gt;

Analysis of risk factors for elbow dysplasia in giant breed dogs.

Identify radiographic risk factors for development of elbow dysplasia in giant breed dogs less than one year of age. Twenty-five giant breed puppies (Bernese Mountain dogs, English Mastiff, and Newfoundland) were studied. Both elbows of each dog were radiographed monthly from two to six months of age, then every other month until radial and ulnar physeal closure, followed two months later by bilateral elbow computed tomography. Radiographic parameters measured included the presence or absence of a separate centre of ossification of the anconeal process (SCOAP), medial coronoid disease (MCD), ununited anconeal process, humeral osteochondrosis, elbow incongruity, as well as the length of the radius and ulna, radius-to-ulna ratio, and date of closure of the radial and ulnar physes. Fifteen dogs completed the study. Two Bernese Mountain dogs were diagnosed with MCD. Risk factors significantly associated with medial coronoid disease included dyssynchronous physeal closure and a decreased radius-to-ulna ratio, both detected between eight to 11 months of age. A separate centre of ossification of the anconeal process was present in 60% of the dogs, and was not a risk factor for development of elbow dysplasia. Transient, dyssynchronous growth of the radius and ulna may be a risk factor for development of MCD in Bernese Mountain dogs. Dyssynchronous physeal closure or decreased radius-to-ulna ratio prior to radiographic closure of the distal ulnar and radial physes warrants further study in Bernese Mountain dogs and other breeds subject to MCD development.

Ulnaire osteotomie als behandeling van een losse processus anconeus bij een jonge mastino napoletano

Een losse processus anconeus, onderdeel van het elleboogdysplasiecomplex, is een frequent voorkomende orthopedische ontwikkelingsstoornis bij snelgroeiende jonge honden behorend tot grote en chondrodystrofe rassen. Proximale ulnaire osteotomie is een van de mogelijke behandelingsmethoden, op voorwaarde dat het dier nog niet volwassen is. Deze ingreep is gericht op het herstellen van de lengteverhouding tussen radius en ulna, waardoor de opwaartse kracht, die de losse processus anconeus veroorzaakt, opgeheven wordt. Door de osteotomie is tevens een kanteling van het olecranon mogelijk, waardoor de losse processus anconeus alsnog kan fusioneren en het manken verdwijnt. Wanneer een proximale ulnaire osteotomie succesvol uitgevoerd wordt, zonder bijkomende articulaire chirurgie, wordt er minder osteoartrose gevormd en is het resultaat op lange termijn gunstiger. In dit artikel wordt de behandeling door middel van ulnotomie bij een jonge mastino napoletano besproken en worden de resultaten van de behandeling toegelicht.

Relationship between axial radioulnar incongruence with cartilage damage in dogs with medial coronoid disease.

To quantify axial radioulnar incongruence (aRUI) in dogs with simple fragmented medial coronoid process (FCP) and those with advanced medial coronoid disease (MCD). Retrospective clinical study. Group 1: 54 elbow joints (54 dogs) with FCP, but no other visible cartilage damage. Group 2: 32 elbows (32 dogs) with Outerbridge grade 3-4 cartilage pathology of the medial coronoid ± FCP. aRUI was quantified using CT based 3D models of the radioulnar joint cup. A sphere was fitted to the trochlear notch of each of the 3D models and aRUI estimated in millimeters based on the relation of the sphere and the radial joint surface. Coronoid disease was diagnosed, classified, and graded using arthroscopy. Mean (±SD) aRUI for group 1 (0.2 ± 0.8 mm) was significantly less than in group 2 (0.8 ± 0.9 mm; P = .001). Overall, 14% had negative aRUI whereas 40% were congruent. Stepwise logistic regression analysis identified age and aRUI, but not body weight as significant covariates. The corresponding odds ratios for advanced MCD were 1.6 for age and 6.4 for RUI, respectively. Axial RUI is greater and more prevalent in elbows with severe cartilage disease, and consists most commonly of a short radius.

Evaluation of biomarkers for osteoarthritis caused by fragmented medial coronoid process in dogs

The aim of the present work was to evaluate whether concentrations of the carboxy-terminal cross-linked fragment of type II collagen (CTX-II), the activities of matrix metalloproteinase-2 and -9 (MMP-2/-9) and Myeloperoxidase (MPO) in canine synovial fluids (SF) can reflect structural alterations of articular cartilage in dogs with fragmented medial coronoid process (FMCP). Elbow joints with FMCP underwent radiographic and arthroscopic examination. Commercially available assays were used to analyze SF for CTX-II concentration and MMP-2/-9 activity. MPO activity was measured by o-dianisidine-assay. The MMPs were further evaluated by zymography. CTX-II concentration and MMP-2 activity showed age-dependent trends in controls. Increased enzyme activities of MPO and MMP-2/-9 were found in diseased dogs. MMP-9activity seems suitable to underline the subjective assessment of the degree of cartilage damage. These initial data of the study suggest that MPO and MMP-2/9 may be used as objective biomarkers in the diagnosis of canine osteoarthritis due to FMCP.

Pathology of Articular Cartilage and Synovial Membrane From Elbow Joints With and Without Degenerative Joint Disease in Domestic Cats

The elbow joint is one of the feline appendicular joints most commonly and severely affected by degenerative joint disease. The macroscopic and histopathological lesions of the elbow joints of 30 adult cats were evaluated immediately after euthanasia. Macroscopic evidence of degenerative joint disease was found in 22 of 30 cats (39 elbow joints) (73.33% cats; 65% elbow joints), and macroscopic cartilage erosion ranged from mild fibrillation to complete ulceration of the hyaline cartilage with exposure of the subchondral bone. Distribution of the lesions in the cartilage indicated the presence of medial compartment joint disease (most severe lesions located in the medial coronoid process of the ulna and medial humeral epicondyle). Synovitis scores were mild overall and correlated only weakly with macroscopic cartilage damage. Intra-articular osteochondral fragments either free or attached to the synovium were found in 10 joints. Macroscopic or histologic evidence of a fragmented coronoid process was not found even in those cases with intra-articular osteochondral fragments. Lesions observed in these animals are most consistent with synovial osteochondromatosis secondary to degenerative joint disease. The pathogenesis for the medial compartmentalization of these lesions has not been established, but a fragmented medial coronoid process or osteochondritis dissecans does not appear to play a role.

Cubital Subchondral Joint Space Width and CT Osteoabsorptiometry in Dogs With and Without Fragmented Medial Coronoid Process

To evaluate subchondral joint space width measurements (SJSW) and CT-osteoabsorptiometry (CTOAM) measurements in the elbow of dogs with naturally occurring fragmented medial coronoid process (FMCP) preoperatively and 6 months postoperatively, and to compare these to normal dogs. Prospective randomized clinical trial. Large breed dogs <1 year of age (n = 15). Arthroscopic FMCP debridement was performed, followed by randomization to a proximal ulnar ostectomy with IM pin (PUO). CTs were performed pre-operatively and 6 months post-operatively. CTOAM and SJSW measurements were acquired in 7 locations within the joint and compared to an age-matched normal control group. Pearson correlation was performed on SJSW and CTOAM measurements. A linear mixed model determined the effect of disease and treatment on SJSW and CTOAM measurements. Fifteen dogs (28 elbows) with FMCP participated (11 arthroscopic FMCP removal, 17 with additional PUO). Data were normally distributed. Pearson correlation between CTOAM and SJSW measurements showed moderate to strong negative correlation in the control dogs. Preoperatively, affected elbows had lower medial compartment and higher lateral coronoid process CTOAM values than normal elbows. After treatment, CTOAM values of the medial compartment increased to normal. Treatment with PUO did not affect SJSW or CTOAM. Our data agree with these previous studies suggesting lower subchondral plate mineralization in dogs affected by FMCP. Arthroscopy may result in higher CTOAM values secondary to increased loading.

Does Radiographic Arthrosis Correlate With Cartilage Pathology in Labrador Retrievers Affected by Medial Coronoid Process Disease?

To compare radiographic elbow arthrosis with arthroscopic cartilage pathology in Labrador retrievers with elbow osteoarthritis secondary to medial coronoid process (MCP) disease. Retrospective epidemiological study. Labrador retrievers (n = 317; 592 elbow joints). Data were collected retrospectively (June 2007-June 2011) to identify Labrador retrievers with thoracic limb lameness and elbow pain, a complete set of elbow radiographs, and a comprehensive arthroscopic surgery report. Each radiograph was scored for osteophytosis on the anconeal process and ulnar subtrochlear sclerosis using a modification of the International Elbow Working Group (IEWG) scoring system. Elbows affected by traumatic MCP fracture, humeral condylar osteochondrosis, or ununited anconeal process were excluded. The arthroscopic report was used to generate a composite cartilage score (CCS; 0 = normal, 1 = mild, 2 = moderate, 3 = severe) for each elbow joint. Ordinal regression analysis was performed to test the relationship between radiographic arthrosis score and CCS. There was a significant relationship between radiographic elbow arthrosis and CCS (P < .001). Elbows with a higher radiographic score were significantly more likely to have a higher CCS than elbows with a lower radiographic score. For every month increase in age, the odds of having a higher CCS increased by 0.016 (1.6%). Radiographic arthrosis can be used to predict the severity of arthroscopic cartilage pathology in Labrador retrievers affected by MCP disease.