Studies on elbow replacement in dogs

Re: Studies on elbow replacement in dogs

Niall Taylor — Mon, 22 Aug 2011 15:06:11 GMT

Thanks to everyone for their replies, very helpful. I have forwarded them on to my colleague who has charge of the case.

Cheers,

Niall

Re: Studies on elbow replacement in dogs

Judith Joyce — Sat, 20 Aug 2011 14:00:51 GMT

Malcolm Ness replying - away from home and using Judy's computer.

Total elbow replacement(TER) in dogs has had a chequered history. The first implants were implanted in client owned dogs about 20 years ago but the results were not encouraging. Mike Conzemius at Iowa State developed a cemented TER which was marketed by Biomedtrix. Again, outcomes were disappointing and to my knowledge only one or two surgeons (includingMike) ever operated more than 10 cases. There are some very fundamental problems with cemented TER systems. Mike is currently working on another, similar system and the guys at Liverpool are also developing yet another very similar, cemented system. Neither of these systems nor the several other development projects I have seen adress, to my satisfaction, the fundamental problems with cemented TERs and I am at a loss to understand the interest in these systems.

10 years or so ago, a novel, cementless TER system was developed and this has been subsequently marketed by Biomedtrix as the TATE elbow. The TATE is now the most widely used TER in dogs. Early clinical results are encouraging. There are 200+ cases operated world wide with 3 or 4 surgeons with personal case experience of over 20 cases. I was lucky enough to be involved in this project early on and we have operated nearly 30 elbows with follow up between 3mths and 4 years. We have had 2 failures but most dogs do remarkably well - pain control is early and excellent. Functional outcome has been good but the gait does not return to normal. We have more case experience than anyone in UK and have now taught at a number of TATE courses in Europe and US. The down sides are first, the surgery is time consuming and very technically demanding (I do lots of hip replacements and the jump up from THR to TATE is about the same as the jump from bitch spey to THR). Consequently it is costly. (We charge £6.5k for TATE and as a comparison £4.5K for THR all included). Second, there isn't really a good plan "B" if things go wrong - amputation or elbow arthrodesis - neither of which are good options.

That said, the patients generally do very well and clients, to date, have been very happy with the outcomes and several have asked about the possibility of having the second elbow replaced.

I am happy to discuss things in more detail via personal email (mgnjaj@aol.com)

Malcolm Ness

Re: Studies on elbow replacement in dogs

Ben Walton — Thu, 18 Aug 2011 19:37:30 GMT

Hi Niall,

The first TER system to take off to any degree was the Iowa State, as developed by Mike Conzemius (as referenced by David), and manufactured by Biomedtrix. This system is now pretty much dead in the water, Biomedtrix are now manufacturing the TATE system.

A new system, the Sirius, has recently been developed at Liverpool, and the first ones will be going onto dogs in the next few weeks.

Kyon have a medial compartment replacement in the pipeline, which is currently being tested in Florida.

I'm sure John Innes would be happy to field any enquiries - I can't think of anyone better to direct your queries to.

Ben

Re: Studies on elbow replacement in dogs

Anonymous — Thu, 18 Aug 2011 17:57:23 GMT

Couple of years old, but happens to be in a free-access issue of 'Veterinary Surgery' on elbow disease and might be a good starting point:

Nonconstrained elbow replacement in dogs.

Conzemius, M.

Veterinary Surgery 2009 Vol. 38 No. 2 pp. 279-284

http://onlinelibrary.wiley.com/doi/10.1111/vsu.2009.38.issue-2/issuetoc

(Same author has a 2page section in this years BSAVA Congress proceedings if you're a member:

BSAVA Congress 2011, The ICC/NIA, Birmingham, UK, 31 March - 3 April. Scientific Proceedings Veterinary Programme 2011 pp. 254-255)