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Surgical options for your pet will be discussed once the orthopedic and radiologic exam has been completed. Most cases involve arthroscopy where we explore and treat the joint with an endoscope. In this process we can remove fragmented bone (FCP) and damaged cartilage (OCD and OA) and topically treat the joint to encourage healing of the cartilage. In many cases this form of treatment is all that will be recommended.

In more severe cases with advanced arthritis, we will discuss with you the option of additional surgery to treat the arthritis. These procedures are referred to as osteotomies. In an osteotomy the bones above or below the joint are cut and realigned to improve the function of the joint. By realigning the bones and joint the patient feels better and the joint is given the opportunity to heal. The use of osteotomies for treatment of arthritis has been popular for over 20 years in human and veterinary surgery, and while there is some increased cost and risk, the outcome can be very beneficial. At this time, UC Davis is performing a unique osteotomy for elbow dysplasia that was developed in our laboratory and has so far shown very promising results.

The decision to perform arthroscopy alone or arthroscopy with osteotomy is made by both the owner and the surgeon.

• Earlier appointments can be scheduled based upon the emergent, life-threatening needs of the patient. Elbow dysplasia is a relatively high priority due to the arthritis; however, fractures and other urgent cases must take priority. Most patients are effectively managed with rest and pain medications such as Rimadyl until the appointment time.
• You may leave a message on our voice mail waiting list if you wish to be contacted if an earlier appointment becomes available.
• You may also choose to consult with a private surgery referral practice. To locate a board-certified veterinary surgeon in your area log on to www.acvs.org.

• A senior student will evaluate your pet followed by a consultation with the resident or faculty surgeon. The objective of the consultation is to review pertinent history, conduct a thorough general and orthopedic examination, review previous radiographs, obtain or repeat additional radiographs if needed, confirm the diagnosis, and discuss treatment options based on your pet’s specific condition.
• The length of the appointment ranges from 1-6 hours depending on the need for sedation, additional diagnostics, and recovery from sedatives. Anticipate spending most of the day in Davis before your pet’s evaluation is complete. We advise you arrange your schedule accordingly and bring books or materials to entertain yourself. Many clients will be seen in the morning and may be asked to return later following completion of the evaluation. Drop-off appointments are not available unless previous arrangements have been made.
• Arrangements for the surgical procedure, if indicated, are determined at the time of the appointment. In general, surgery will not occur on the day of your appointment. Surgeries are generally scheduled to occur 1-2 days following your scheduled appointment. All patients undergoing anesthesia will be evaluated separately by the anesthesia service the day before the procedure.
• Please anticipate leaving your dog for surgery. In general, we avoid consultation visits followed by surgery at a later date as this delays necessary surgery and makes scheduling more complicated.

• The prognosis for dogs with elbow dysplasia varies considerably. In dogs with mild disease, arthroscopic treatment may result in completely normal limb function with return to all activities. In intermediate cases of elbow disease, dogs may require intermittent or long-term medical management with analgesics or cartilage protecting drugs. In severe cases, the need for chronic medical management is likely with arthroscopy alone.
• The prognosis following arthroscopy and osteotomy is still undetermined. We have seen very promising results in several severe cases of juvenile elbow arthritis and are encouraged; however, further clinical study is necessary before firm conclusions can be drawn.
• At this time we are offering the new osteotomy procedure in juvenile and adult cases of elbow arthritis.

• Cases will vary, but general recommendations are for suture removal 10-14 days after surgery. This may be performed at the VMTH or by your regular veterinarian. Dogs undergoing arthroscopy alone may not need to be seen at the VMTH for follow-up unless there has not been significant improvement.
• Dogs undergoing osteotomy for treatment of elbow disease will need to be seen for follow-up radiographs (x-rays) to be certain that adequate healing of the osteotomy has occurred prior to restoring full activity. Most patients will require two recheck examinations, typically 6-8 weeks and 10-12 weeks postoperatively, unless there are complications requiring additional care and follow-up.