What is OCD of the shoulder?
OCD (osteochondrosis dessicans) is probably the leading cause of osteoarthritis of the shoulder joint. Shoulder OCD occurs when a piece of cartilage separates from the underlying bone. Pain is due to inflammation of the joint and exposure of nerves in the bone under the cartilage flap.
Shoulder OCD in dogs has been demonstrated to be a genetic disease and cannot be caused by diet or exercise although excessive exercise in a dog with untreated shoulder OCD may make the lameness more severe.
OCD of the shoulder is usually found in young dogs ranging from 6 months to 2 years of age.
Normal Dog Shoulder Shoulder with OCD Lesion
What are the clinical sign of shoulder OCD
Dog is lameness of one or both forelegs. Dogs with shoulder OCD may have trouble getting up and often have some muscle loss and pain when the joint is moved.
How is Shoulder OCD Diagnosed?
The diagnosis of shoulder OCD is usually straightforward because most lesions are easy to see on radiographs (x-rays) of the shoulder joint. The normal curve of the joint surface is interrupted by a flat area representing the abnormal cartilage.
How is Shoulder OCD Treated?
Treatment of shoulder OCD should be strongly considered by dog owners because surgical removal of the flap almost always results in elimination of the lameness whereas nonsurgical management often results in continued limping and may result in severe osteoarthritis later in life. Removing the cartilage flap lets the underlying bone heal, stops the irritation of the joint, and keeps the flap from moving into another part of the joint where it might cause other problems.
There are two options for the treatment of Shoulder OCD
1. Standard Arthrotomy (Open Surgical) Approach
During an open surgical approach to the shoulder joint, a 2 inch incision is made and the muscles are just separated along their natural anatomical planes. Because we do not actually cut any muscles, tendons, or ligaments during the surgery, the recovery period after surgery is relatively short. The disadvantage of the open approach is that a less thorough examination of the joint and its associated structures can be made and loose pieces may be left behind in the front part of the shoulder joint.
2. Minimum Invasive Arthroscopic Approach
Surgical arthroscopy allows enhanced visualization of intra-articular structures and is also associated with limited postoperative morbidity. Arthroscopy entails less disruption of the periarticular soft tissue and decreased soft tissue disruption leads to less postoperative pain. This is especially true when multiple joints are involved and are operated arthroscopically under the same anesthetic procedure
Traditional Open Surgery Approach: Within a couple of days after the surgery most pets will bear some weight on the operated limb. By two weeks after surgery many of the operated dogs have mild to moderate lameness. By 8 weeks after surgery, your pet should be using the limb normally. Recovery can be somewhat variable from one pet to another.
Minimum Invasive Arthroscopic surgery. The recovery from surgery . Most dogs are bearing weight on the limb at the time of release from our hospital. Within two weeks the lameness generally is very mild.
During the first 6 to 8 weeks after surgery, activity is restricted to short leash walks outside. Running, jumping, or rough play is forbidden. Gradually increasing the activity, following the eighth week after surgery, allows for a safe return of function of the operated limb.
Possible Complications after treatment
The most common complication is swelling of the shoulder that resolves in several days. Anesthetic complications, infection, or nerve damage are very uncommon.
What is the outcome of treatment?
Whether the standard arthrotomy or arthroscopic approach is utilized, the response of OCD to surgical intervention is rapid and rewarding.The outcome with treatment of shoulder OCD is generally excellent with complete resolution of lameness over several months following surgery. Physical therapy can accelerate the recovery. In most cases there is little residual arthritis which may be apparent after very heavy exercise or as the dog becomes much older.