Systematic review of surgical treatment for severe elbow osteoarthritis in dogs

TL;DR

This systematic review evaluates the effectiveness and safety of surgical treatments for elbow osteoarthritis in dogs.

Contribution

The study provides a systematic review and comparison of success rates and risks for various surgical treatments of elbow osteoarthritis in dogs.

Findings

Canine unicompartmental elbow surgery had the highest success rate (91%-98%) and second-best number needed to harm (NNH, 7.6).

Sliding humeral osteotomy showed 43%-82% success with a NNH of 9.5.

Overall evidence for surgical efficacy is low, and risk of harm is high.

Abstract

To determine the evidence for the most effective surgical treatment for elbow osteoarthritis with the least harm in dogs.

Systematic review.

Peer‐reviewed, English‐language articles describing surgical treatments for elbow osteoarthritis in dogs.

A literature search was completed using CAB Abstracts, PubMed/MEDLINE, Scopus, and Web of Science on August 19, 2024 for articles describing surgical treatments for elbow osteoarthritis and medial compartment disease in dogs. Inclusion criteria were applied, and the resulting articles were evaluated for level of evidence (Wright scale) and combinability by success rates, and major complications using the number needed to harm (NNH).

Out of the 1231 unique articles, 15 were evaluated based on the inclusion criteria with five prospective studies, eight retrospective studies, and two case series studies. Success rates could not be combined because of variation in outcome reported. Canine unicompartmental elbow had the highest level of evidence for success (91%–98%) with the second best number needed to harm (NNH, 7.6). Sliding humeral osteotomy had the next best evidence with 43%–82% success and 9.5 NNH.

There is low evidence for any of the procedures, and the risk of harm is high.

Although CUE had the highest level of evidence, there is low evidence overall for efficacy of surgical procedures to treat OA in the elbow. A validated outcome measure with consistent follow‐up intervals to standardized comparisons would allow for better comparison of the outcomes of future studies.

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