Elbow Dysplasia

Most affected dogs develop noticeable signs between 4 and 12 months of age, coinciding with rapid skeletal growth. Watch for:

• Front-leg lameness — often worse after rest, improving briefly with movement, then worsening again with exercise
• Holding the affected elbow outward (abducting the leg) when standing or walking
• Stiffness after sleeping or lying down for extended periods
• Reluctance to exercise, play fetch, or go up stairs
• Pain or withdrawal when the elbow is manipulated or fully extended
• Swelling on the inner (medial) aspect of the elbow joint
• Both front legs are affected in a significant percentage of dogs — bilateral involvement can cause a subtle, shifting lameness that's easy to miss

Elbow dysplasia is primarily genetic in origin, but developmental factors during growth amplify or accelerate the underlying joint problems:

• Breed predisposition — Labrador and Golden Retrievers, German Shepherds, Rottweilers, Bernese Mountain Dogs, Chow Chows, and Newfoundlands are most commonly affected
• Rapid growth rate — large and giant breeds that grow fastest in the first year carry the highest risk
• Overnutrition in puppyhood — excess calcium and calories accelerate skeletal development in ways that stress still-maturing joint surfaces
• Body weight — excess weight amplifies the mechanical loading on abnormal elbow architecture
• Male dogs are affected more frequently than females in most breeds

Diagnosing elbow dysplasia requires a combination of physical examination and imaging — X-rays alone frequently underestimate the degree of internal joint damage.

Orthopedic examination — We assess the gait and isolate the lameness to the elbow by palpating and flexing each joint individually. Pain on full flexion or extension of the elbow, and especially on pronation (inward rotation of the paw), is a consistent finding.

Digital radiographs — Standard elbow views detect secondary arthritic changes, UAP, obvious OCD lesions, and gross incongruity. Because FMCP — the most common form — often shows only subtle or absent changes on plain X-rays, radiographs can underestimate internal damage.

CT scan — Computed tomography gives far superior detail of the coronoid process and joint surfaces, allowing accurate identification of fragmented or fissured cartilage that is invisible on standard X-rays. We have CT capability in-house. For any dog in whom surgery is being planned, CT is the preferred imaging modality.

The goal of treatment is to remove the pathological tissue causing joint damage, reduce inflammation, and slow the arthritis that has already begun accumulating.

Arthroscopic surgery — The preferred approach for FMCP and OCD. A small camera and instruments are inserted through tiny incisions to remove the fragmented coronoid process fragment or the loose OCD cartilage flap with precision and minimal disruption to surrounding tissue. Most dogs recover faster from arthroscopy than from open surgery.

Open elbow surgery — Used for UAP repair, certain incongruity corrections, and when arthroscopy isn't feasible. Techniques for UAP include lag-screw fixation (reattaching the process) or removal, depending on the dog's age and the bone's condition.

Proximal ulnar osteotomy — A controlled cut in the ulna that relieves pressure on the medial coronoid region; used in combination with arthroscopic fragment removal in cases of elbow incongruity.

Long-term arthritis management — Surgery addresses the cause of damage but cannot erase the arthritis already present. Ongoing support with veterinary NSAIDs, joint supplements, weight management, and controlled exercise maintains comfort as the dog ages.

A large-breed puppy limping on a front leg, or a young dog stiff after morning naps, warrants an elbow evaluation — not a wait-and-see approach. Surgery before significant arthritis has accumulated produces meaningfully better long-term outcomes than operating on a joint that's been degenerating for an extra year. Our team can examine the elbows, take in-house digital radiographs, and discuss whether CT imaging or a surgical consultation with Dr. Schulman makes sense. Book an appointment to get a clear picture of what's going on with your dog's front legs.