In April 2018, Zoey, a three year old, female spayed Retriever cross, consulted with Dr. Courtney Campbell as a referral from Dr. Richard Canan of Newbury Park Veterinary Clinic. She had been lame on the left thoracic limb for a few weeks and it was reported that the lameness was more severe after periods of rest.  Dr. Canan tentatively diagnosed Zoey with elbow pathology and encouraged her owner to bring Zoey to VetSurg for consultation.

On her initial consultation, Zoey had moderate to severe pain in the left elbow. A mild effusion of the left elbow was noted and the joint capsule had early thickening. Sedated elbow radiographs revealed mild radio ulnar incongruity, moderate trochlear notch sclerosis, and mild osteophytosis of the medial coronoid process of the left elbow.

To improve sensitivity regarding the presence of medial coronoid fragmentation, the degree of elbow incongruity and to evaluate the quality of the subchondral bone in this region, an elbow CT scan was performed on site at VetSurg. The CT study confirmed the presence of elbow dysplasia secondary to fragmentation of the medial coronoid, mild elbow incongruity, elbow osteoarthritis, and flexor tendon enthesiopathy.  Zoey started a 3-week medical treatment trial and her lameness did not improve significantly. To get Zoey to return back to her normal athletic status, her family opted for minimally invasive arthroscopic surgery of her elbows to address the coronoid disease.

 

PICTURED BELOW
CT: Joint surfaces of radius and medial coronoid of ulna

 

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Left: Arthroscopic surgery  ~  Right: Arthroscopic image medial joint compartment

Zoey had arthroscopic surgery on her elbows in August of 2018. To address the fragmented medial coronoid process, a subtotal coronoidectomy and fragment removal was performed on her left elbow. Zoey’s lameness improved quickly in the initial part of her recovery, and she was walking and trotting very well at her 12-week recheck. At this stage Dr. Campbell recommended a slow integration back to normal activity. Although we often recommend biologic therapy with Platelet Rich Plasma (PRP) using 2-3 injections into the affected elbow joint after surgery to help hasten healing and provide anabolic support, Zoey’s recovery was uneventful and she did not require PRP.

You and your staff were amazing during Zoey's entire surgery and recovery process. Everyone was so loving toward Zoey and treated me and all of my concerns with such respect, concern, patience and thoroughness. Thank you for giving Zoey back her fun, enjoyable, and painless life. It is such a joy & blessing to see her have so much fun and it would not have happened without the VetSurg team.

Sara Jacobsen March 13, 2019