Objective: To determine the evidence for the most effective surgical treatment for elbow osteoarthritis with the least harm in dogs.
Study design: Systematic review.
Sample population: Peer-reviewed, English-language articles describing surgical treatments for elbow osteoarthritis in dogs.
Methods: 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).
Results: 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.
Conclusion: There is low evidence for any of the procedures, and the risk of harm is high.
Clinical significance: 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.
